From drinking ayahuasca to equine therapy, there’s a rehab program out there that does it, but that doesn’t mean they all work — or if your insurance will cover it. The different types of health insurance plans can be confusing as hell. Maybe you see a “PPO” description on your health insurance card, but don’t know exactly what that means for you when looking for addiction treatment coverage. Here’s your guide to PPOs and how these plans can help you go to a drug rehab that actually works.
What’s a PPO?
PPO stands for Preferred Provider Organization. A PPO typically has higher monthly premiums, but you have the freedom to choose what doctors you see, whether they’re in-network or out-of-network. This is especially helpful when it comes to choosing a rehab facility (more on that later). A premium is the amount you pay each month for your insurance. While PPOs typically have higher monthly premiums, they often have lower deductibles. A deductible is a set amount of healthcare expenses you’d have to pay before your insurance will begin to pay for their portion of the cost. Most marketplace insurance companies offer different levels of coverage, such as:
Bronze – 60% coverage
Silver – 70% coverage
Gold – 80% coverage
Platinum – 90% coverage
So, if you have a Gold PPO plan, that means the insurance company would generally cover 80% of the cost of medical services, but depending on your benefits it may or may not include coverage for rehab.
What Types of Addiction Treatment Will a PPO Cover?
Addiction treatment isn’t your basic doctor visit, so your insurance plan may not cover the same, if any, of addiction treatments.
Detox
The first step to getting clean and sober is to detox your body from all the drugs and crap. Withdrawals can be deadly and detox needs to be done under constant professional care. This makes the cost of detox more expensive — meaning your insurance provider may not cover it, but will cover other types of treatment. Check your benefits to find out or give us a call.
Residential Treatment
When you hear the word “rehab,” residential addiction treatment is generally what people are referring to. The daily amount is cheaper than detox’s daily cost, but you’re staying for 30-90 days at the treatment facility. How many days your insurance covers depends on your plan and your deductible. Give Transformations Care a call to find out how many days in rehab your provider will cover.
OutPatient
OutPatient treatment is more affordable since it doesn’t house or feed patients. While insurance may be more willing to pay for the cost, but remember that residential treatment gives you a chance to get away from life’s triggers, which could end up making the difference between whether or not you stay clean for good.
Benefits of Using PPO Insurance to Pay For Rehab
What are the benefits of having a PPO plan when looking for addiction treatment? With a PPO insurance plan, you’re able to choose a rehab based on their program and not because your insurance doesn’t give you any other choice. Even if a treatment center is out-of-network, they’ll most likely still cover a portion of the cost.
One of the main things you should look for in a rehab is if they use a dual-diagnosis approach to treatment. At Transformations Care, our dual-diagnosis program will treat both your addiction and the mental health issues fueling it — so you can kick your drug addiction for good! Everyone deserves a second chance! Whether you have a PPO insurance plan or not, we’ll help you find a way to pay for addiction treatment. Give us a call at 424.339.0965 to see what your PPO plan will cover and other payment options.
GUIDE
Getting Clean & Sober at Home
Today, more than 75% of hospitals and healthcare providers offer access to telehealth treatment, with 29 states having gone so far as to enact telehealth parity laws, which force insurance companies to reimburse patients for telehealth at the same rates as they would for in-person treatment.
If you’ve been thinking about getting clean and sober, or if you’ve been wanting to work on and strengthen the recovery you already have, it’s never been easier to do it through telehealth.
"*" indicates required fields