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11 THINGS YOU NEED TO KNOW ABOUT INSURANCE AND RECOVERY
If you find yourself wanting to go to rehab and you’re seeking recovery, but you’re unsure of what your insurance options are, this is the best place to start! The first thing you should do is ask your insurance representative and/or KLEAN’s admissions staff (855-774-7839) a few questions. As a start, here are the “11 Things You Need to Know About Insurance and Recovery”.
1. Does your insurance cover rehab and, if so, what levels of care are covered?
Most PPO plans offers excellent coverage for detox rehab through your plan’s behavioral health side, including general substance abuse treatment. Medical and Behavioral Health are usually separate sides of insurance. However, most PPO insurance covers both inpatient and outpatient treatment facilities, giving you an option to what kind of treatment you would prefer. Insurance coverage can vary depending on where you live and coverage can vary from plan to plan. The best step toward finding recovery is to check the terms of your policy and find out exactly what is covered.
- You can get started by calling member services and asking, “Is my plan an HMO, PPO, POS, or EPO?”
- If you have an HMO, POS, or EPO policy, you must stay In-Network.
- However, if you have a “PPO,” your insurance will often pay for a range of rehab facilities, from luxury treatment centers to basic outpatient centers.
2. How Much Does Rehab at KLEAN Cost with Insurance?
Of course, rehab cost can vary greatly and cost is based on a variety of factors. Rehab treatment may be completely covered if you have already met your deductible and annual out-of-pocket maximum for the year. It is important to verify your benefits before entering a treatment facility. You can check with member services and ask, “Do I have a deductible?” “What will be covered if I go to rehab?” Generally, if you have a PPO insurance plan, KLEAN Treatment Center is 100% covered after your deductible has been satisfied.
3. Can I Pay Out of Pocket for Treatment My Insurance Won’t Cover?
Of course! If you decide to get treatment at one of our facilities and it costs more than what your policy covers, you will simply be paying the difference for treatment. If you have a high-deductible plan or a high inpatient copay, KLEAN Treatment Centers offers payment plan options.
- Additionally, our California, Oregon, and Washington facilities may offer scholarships based on need–i.e., if you find yourself in great financial need and suffering from a grave addiction.
4. What Does It Mean When My Insurance Asks: “Are You Going to Outpatient or Inpatient Rehab?”
Some insurance plans include inpatient residential facilities and some only allow outpatient treatment (example: one-on-one therapy and/or group sessions).
- Inpatient care requires that you to stay in the facility. It can be a great idea, since withdrawal symptoms are not only annoying but painful. Your triggers may be present if you choose to stay close to home or your old using area, which is also why an inpatient setting can be a plus. Insurance coverage for KLEAN is usually offered for initial detoxification through inpatient settings. However, if you need to remain in school or work, you can choose one of our outpatient locations from California, Oregon, to Washington.
- There are other in-patient options such as executive, luxury, or private rehab, which may include dog friendly facilities (based on location).
- Outpatient care lets you stay home and go to work/school while seeking treatment.
- We are also CARF accredited, which may be an insurance requirement for seeking treatment. This also lets you know you’re going to a secure and ethical rehab.
5. Why Should You Choose an Insurance Accepted Residential Treatment Center?
Our residential programs may be a great fit for you if you wish to be surrounded by others experiencing the same struggle with drug or alcohol addiction. We also specialize in dual-diagnosis treatment at our West Hollywood location. KLEAN is an excellent option for providing you with room and board, support from other patients and counselors, and everything you need to go through the recovery process. We also provide a space that is away from your triggers, in a safe and drug-free environment for 30, 60 or 90 days. This is the primary reason most people choose to stay in a residential rehab center covered by PPO insurance.
6. Will My Insurance Pay for Local Rehab, and/or Can I Go to Out-of-State Treatment?
Insurance coverage for drug and alcohol abuse varies depending on where the addiction treatment is located. Sometimes one insurance plan won’t cover treatment in California, but will cover the treatment in Oregon. Another issue is that California may require the drug rehab facility to be state licensed or CARF accredited. KLEAN is both state licensed and CARF accredited.
For example, if you are based in California, Oregon, or Washington, you can go to a local KLEAN treatment center for outpatient treatment. However, if you are planning on going to a residential center for inpatient treatment, and you have PPO coverage, it doesn’t matter where you live, as PPO insurance will cover that treatment just about anywhere.
7. “KLEAN Seems Like a Luxury Rehab. Will My Insurance Cover It?”
Yes, PPO coverage often includes luxury or private drug rehab. Insurance companies such as MODA Health, Shasta Administrators, Aetna, Cigna, Humana, UMR, Optum, First Choice, Blue Shield and Anthem Blue Cross accept KLEAN as a out of network facility. While KLEAN may be considered luxurious by some, KLEAN’s focus is on providing the best personalized care. That said, KLEAN is able to provide privacy for those seeking addiction treatment, including high-profile individuals who desire exclusive treatment and a private room. Contact a KLEAN Treatment Advisor >>
8. What Will My Insurance Cover as Far as Length of Time and Treatment Programs?
All KLEAN Treatment Centers are accepted out-of-network treatment facilities. Most plans will cover the following different program lengths/options:
- 15-30 Day Residential Programs
- 60 Day Residential Programs
- 90 Day Residential Programs.
Aetna coverage for addiction can allow longer treatment programs, such as 6-months and up to 18-months. Again, there are many factors should considered in deciding on the duration of treatment. Some of these reasons include: how severe of an addiction you have, how long you have been dealing with your addiction, and what other mental health or substance abuse problems you might be facing. For example, KLEAN West Hollywood’s program specifically caters to dual-diagnosis treatment.
9. What If I Have No Insurance?
If you don’t have insurance, you can still visit a local KLEAN Treatment Center or speak to a KLEAN Treatment Advisor to discuss your options.
10. Will My Insurance Cover Multiple Rehab Stays and Could Rehab Make My Insurance Premiums Higher?
Often, PPO insurance plans will cover multiple rehab stays. Depending on whether you need to stay longer than your original 30 or 60-day program, or you return to the rehab center for continued treatments, insurance will usually cover it. Be sure to check your policy to get more information on multiple stay coverage. A question you can ask is: “Do I have a lifetime maximum or day limit for rehab?”
No, your insurance premiums will not go higher. This is a very common question. However, there is no need to worry about insurance premiums going up with your plan, after rehab stays. It is illegal to raise the premium due to mental health and chemical dependency diagnosis.
11. Does my Insurance Pay for Aftercare?
Aftercare allows you to continue working on recovering from your addiction to drugs and/or alcohol. Aftercare is normally in the form of outpatient group therapy or individual therapy. At KLEAN, we offer individual sessions, as well as group sessions, which are covered by insurance plans such as Aetna, Cigna, Anthem Blue Cross, MODA Health, Humana, UMR, tribal policies, etc.
Thank you for reading “11 Things You Need to Know About Insurance and Recovery”. We know that addiction is hard, but getting treatment doesn’t have to be.
If you find you need help for drugs or alcohol abuse, but feel confused about what your insurance covers, that’s where we come in. KLEAN accepts MODA Health plans, tribal policies such as Shasta Administrators, Blue Shield, Blue Cross, UMR, Optum, United Health Care, First Choice, GEHA, Aetna, Cigna, Rocky Mountain Health Plan and more. Call KLEAN at 855-774-7839 to speak with a Treatment Advisor about what choices you have to get on the KLEAN track.
KLEAN Treatment Centers Contributing Writer – Olivia
FOR MORE INFORMATION
CALL KLEAN at 855-774-7839
or TEXT 310-401-0808