How much is this going to cost? Can I afford it? Extremely fair questions and, fortunately, insurance is meant to offset and handle some of the costs associated with treatment for addiction. If you’re insured through AmeriHealth, there’s a great chance they’ll cover a portion of your rehab.
Addiction is many things; scary, hard, overwhelming and overpowering among others but one thing that it doesn’t have to be is permanent.
Substance abuse can be overcome.
Getting to the point that you understand change needs to happen in order to live the life you were meant to is huge. Being willing and ready to start the journey of recovery is a momentous shift in thought and action that’s as exciting as it is new.
Much goes into finding the right treatment center, one that’s tuned into your needs and as you start down that path there’s one chief concern that continually pops up: price.
How much is this going to cost? Can I afford it?
Extremely fair questions and, fortunately, insurance is meant to offset and handle some of the costs associated with treatment for addiction. If you’re insured through AmeriHealth, there’s a great chance they’ll cover a portion of your rehab.
AmeriHealth is actually a family of companies that serve both individuals and employers. Established in 1995, they cover over 265,000 people and 8,000 businesses in New Jersey and Pennsylvania. Their PPO, HMO and POS networks include more than 37,000 primary care physicians and specialists and more than 230 acute care and rehabilitation hospitals are part of their participating providers.
Through AmeriHealth Caritas, founded more than 35 years ago in Pennsylvania, they’ve grown to north of 5 million members in 13 states and D.C. Caritas provides health care solutions through Medicaid and Medicare managed care, pharmaceutical benefit management, behavioral health services and other administrative services.
The hard work of finding your way out of addiction is made easier by having the right team on your side and that includes an insurance company that is going to be there for you when you need it most.
Naturally, policies and plans can be confusing in what they cover so if you’re finding yourself scratching your head, don’t hesitate to reach out to our admissions team here at Thrive Treatment and lean on us for assistance in that process of finding out.
At Thrive Treatment℠ we accept most private insurance plans and we are in network with Cigna, MHN Health Net, First Health, and Anthem Blue Cross. Additional payment options are available so don’t hesitate to give us a call so we can get you the help that you need.
The short and easy answer is that they’ll pay for rehab as long as is necessary most likely. That said, it’s all tied to what they deem as being medically necessary. That’s really one of the key considerations in how long the coverage extends.
Each instance of substance abuse disorder is unique and treated as such. Given that, it’s only after understanding you and your addiction that a roadmap of recovery can be formulated.
For severe addiction, the recommendation for a treatment program might be 3 months, for example, for others with a more easily manageable case it could be 4 weeks’ worth of outpatient visits that do the trick. Ultimately, if AmeriHealth agrees to the assessment of the treatment center and the specifics of the plan that was put together, then they’ll most probably pay for some portion of it.
Their coverage options in terms of plans and product lines are extensive and encompass:
What AmeriHealth rehab coverage entails and includes specifically is dependent on which plan you have through them. Typically though, it’s likely they’ll cover some parts of:
Covered AmeriHealth drug rehab is based on what’s deemed medically necessary so it’s hard to say with too much specificity what an AmeriHealth plan would cover without an assessment by an addiction specialist.
Through AmeriHealth Caritas Pennsylvania, Behavioral Health Services, which include everything related to mental health and drug & alcohol services are provided by county-specific behavioral plans. As per their website, the Behavioral Health Managed Care Organization provides access to diagnostic, assessment, referral and treatment services including but not limited to:
Additionally, and as per the Affordable Care Act of 2010, any AmeriHealth plan acquired via the Marketplace, and actually all plans that are offered via the government, would therefore treat substance abuse disorders as an essential benefit.
The tiers are Platinum, Gold, Silver and Bronze and break down as follows with coverage kicking in after you’ve met your deductible:
Platinum – Highest monthly premium and the lowest deductible to reach before insurance kicks in. On average AmeriHealth would then cover 90% and you’d pay the other 10%.
Gold – Slightly lower monthly payment and slightly higher deductible to meet. About 80% is covered thereafter with you being responsible for 20%.
Silver – Even lower monthly premium and a yet higher deductible. Roughly 70% is covered by insurance after that and you handle 30%.
Bronze – The lowest monthly premium but the highest deductible to reach. After being met, around 60% of approved care is covered by insurance and you cover the other 40%.
It’s important to be aware that some procedures and types of treatment might require preauthorization before they’re covered, all the more reason to be knowledgeable about your plan before treatment starts.
Professional addiction treatment can be the difference between turning life around today and sinking further into the cycle of addiction and the added trauma, pain and consequences which can come with that.
It’s an unfortunate reality that the cost of rehab will play a role in the decision-making process but at Thrive Treatment we try to make that easier by accepting insurance from a wide variety of providers, including AmeriHealth.
It bears repeating that knowing the ins and outs of your AmeriHealth plan is imperative for putting your mind at ease regarding treatment and what exactly they’ll cover. You can find that information on your member website, by calling AmeriHealth directly or getting in touch with us. We’re more than willing to assist in you getting the knowledge you need to make an informed and confident decision.