Understanding Your Insurance Coverage with Amethyst
Your long-term well being is important to your insurance providers. We often worry about our physical state, but what sometimes is forgotten is that mental health is just as important. Consequently, most people aren’t fully aware of their healthcare benefits. Whether you’re intimidated by the complexity of insurance or aren’t sure where to start, we’ve got you covered. Amethyst Recovery Center has a team of specialists ready to review your insurance policy, so there’s no need to worry.
Compared to a general health plan, the structure of one for mental health and rehabilitation purposes varies. That’s why it’s important to understand the difference between the two when it comes to coverage, co-pays, and out-of-pocket deductibles. This is something we can explain to you when you reach out to our experts today.
Verify Your Insurance Benefits
We want to make sure to walk you through the entire process and ensure that you understand what your insurance covers. You should never shy away from seeking and receiving help because of financial worries – there’s always a way to make treatment work for those who need it.
All forms are confidential, encrypted, and HIPAA-compliant for your safety and security.
Health insurance plans are generally required to provide some level of coverage for addiction treatment and for behavioral healthcare. In some instances, coverage will leave only a small copay or deductible remaining for the patient. There are even times when treatment can be entirely covered by healthcare coverage.
Fill out the safe, HIPAA-compliant insurance verification form on this page to find out what your responsibility might be for treatment. Our team will help you understand your health insurance policy and the coverages that might apply to your treatment needs.
At Amethyst, our priority is to help you understand and get the most out of your insurance benefits so that you can begin focusing on your recovery.
How Much Does Drug and Alcohol Rehab Cost?
Your treatment costs will be determined based on your unique care needs and individual requirements. Because Amethyst Recovery Center does not provide a cookie-cutter, one-size-fits-all treatment approach, we cannot immediately estimate your treatment without first learning some important details about your healthcare needs. Drug or alcohol rehab can cost anywhere between $2,000 and $25,000 a month or more. But don’t let this scare you away from getting the help you need! It is quite rare for any patient to pay the full cost of treatment out of pocket. Most will use health insurance and other support systems to offset treatment costs substantially from the initial cash price.
Instant Verification of Benefits
In-Network Insurance at Amethyst Recovery
We are in-network with many different major insurance companies. Coverage may differ across our facilities and between patients and insurance programs. We recommend you call to speak with our experienced staff about your coverage options and to access the maximum benefits available
How to Find Out if Your Insurance Covers Drug Rehab Services in Florida
It’s best to check with your insurance provider ahead of time, so that you can review your policy and understand coverage options that are available to you before you begin working with a treatment provider. At Amethyst Recovery Center in Port St Lucie, Florida, our skilled admissions team will help you navigate the insurance verification process to determine the most appropriate treatment options for you based on your policy.
To find out instantly if your insurance may cover all or part of the cost of addiction treatment, call us at 888-447-.7724. An admissions agent will answer the phone and help guide you through the verification process and next steps to getting the help you need for recovery. We’ll help you figure out which treatment centers in Florida are in-network for your policy, and we’ll advise you on the most appropriate programs for your recovery needs.
How We Do It: Getting You the Addiction Treatment You need
When embarking on this recovery journey, it may be intimidating to think about where to start. You may have some ideas in my mind concerning your level of treatment, but we like to emphasize that a lot of the time people look for what they want – not what they need. After lots of discussions, we will tailor a treatment program that uniquely fits your physical and mental needs. Aside from discussion, we also will have you go through some physical and mental assessments to ensure that we understand what you’re going through, from the inside out.
We’re not ones to beat around the bush – we want to be as thorough as possible from the very first step. Keep reading to find out how we go through the insurance process to make it as stress-free as possible for you or a loved one.
Step 1: Checking Your Benefits
Step 2: Determining Your Options
Step 3: Program Education
Step 4: Professional Referral
Step 1: Reviewing Your Insurance Benefits
We begin with a complimentary and in-depth review of your insurance benefits. The reviews done by our specialists are typically more thorough than what the company’s representatives may do, as we focus more on the benefits for mental health and substance abuse.
Step 2: Determining What Kind of Treatment Your Insurance Covers
Once we understand the scope of your insurance coverage, we can start sorting through which center and program would be the right fit for you.
Although insurance companies can never guarantee one way or another that your claim will be approved, Amethyst will have a more concrete idea based on our experience with many treatment centers nationwide and what type of insurance benefits they tend to accept.
Step 3: Sorting Through Programs That Don’t Meet Your Standards
This is the part where we go through the details of your insurance benefits. We’ll think of realistic options on how to get you on the road to recovery. As mentioned above, we’ll narrow down your options based on what your insurance covers.
Our experts would not recommend a treatment program to you that does not factor in all parts of your health and individual needs. If there are certain amenities or resources that are very important to you, please communicate with us so we could better adapt to your needs.
Step 4: Making a Professional Referral to a Treatment Program
When we identify the program that best suits all your needs, we’ll make a professional referral to ensure you can obtain the help you need. In only a matter of days, we can have you begin enrollment at our facility. If you still have any anxiousness that your insurance claim will be denied, it’s comforting to know that the risk lies with our treatment center, rather than you.
Health Insurance that Covers Suboxone
Many Americans have begun using Suboxone to help fight opioid addiction, but there is one major problem. Without insurance, Suboxone can be a very costly monthly expense. Fortunately, we work with a number of insurance providers across the nation, and many do cover Suboxone treatment. Give Amethyst Recovery Center a call to determine exactly what your insurance policy covers.
What Types of Rehab Does Health Insurance Cover?
There are an estimated 17,000 treatment centers in the United States, each providing different services, levels of care, and treatment programs. It’s important to understand what types of rehab your health insurance can cover, but to do that, you need basic knowledge of the different types of treatment these facilities are offering.
Depending on specific details about your insurance plan, the most common forms of addiction treatment covered by health insurance include inpatient and outpatient treatment, but many other forms of care can also be covered.
- Medical Detox
- Inpatient Rehab
- Outpatient Rehab
- Intensive Outpatient Programs (IOP)
- Partial Hospitalization Programs (PHP)
- Dual Diagnosis Mental Health Treatment
- Medication Assisted Treatment (MAT)
Many of the programs listed above are offered at Amethyst Recovery Center or one of our sister addiction treatment locations in South Florida or primary mental health treatment centers in Port St. Lucie. To find out if your insurance will cover treatment at Amethyst Recovery Center, call our admissions helpline.
Types of Healthcare Plans & Coverage Benefits
HMO
An HMO generally has a lower deductible than a PPO and offers coverage at a lower overall cost than PPO. However, HMOs do generally use a referral system for things like specialist treatment or out-of-network care, requiring the patient to see the primary care physician for referral to these outside services. This can place strain on navigating some kinds of care, but it does help the patient form a better bond with his or her primary healthcare provider.
If you’re not seeking out-of-network care or specialty care, HMOs have the benefit of being more affordable and offering overall lower monthly premiums. All in-network services are covered with low monthly premiums and pre-set deductibles or copays, leaving the only questionable cost of healthcare being out-of-network care. This makes it easier to plan for monthly healthcare costs with fewer “surprises” in overall care costs or needs.
PPO
Unlike an HMO, the PPO plan allows patients to seek out-of-network services and specialty providers without a referral from their primary care physician. In fact, PPOs are very flexible, allowing members to visit healthcare providers of their choice both in-network and out-of-network. The major difference here is that members will pay less for in-network services than they will for out-of-network services.
While merely having the option to see a specialist without a referral is a key selling point for most PPO plans, it’s important for you to consider whether or not higher monthly premiums and generally higher deductibles for services are worth the trade-off. You’ll pay more for a PPO overall, but you could save substantially IF you’re going to frequently use out-of-network care or specialty services. These are the kinds of considerations you’ll need to make ahead of purchasing a healthcare plan, should you be considering this next step in the healing process.
POS
Point of Sale or Point of Services insurance programs generally have similar requirements to an HMO, although some will allow for out-of-network care coverage. Services are typically priced and determined at the point of sale or based on where the service is rendered. Plan policies vary from one health insurance provider and plan to the next, especially with POS policies.
You need to do your homework and research insurance plans and policies ahead of time so that you best understand your coverages and the options available to you. This way, when the time comes that you need help and actually need to go see a doctor or specialty healthcare provider, you can do so with ease and understanding of what to expect.
Can You Go to Drug Rehab Without Insurance?
If you’re thinking about going to drug rehab without insurance, it’s equally important to call for help to begin planning your next steps as if you had full insurance coverage. Don’t let a lack of insurance be a barrier to you accessing the treatment you need!
Many local rehab centers will provide treatment for patients who do not have health coverage. Likewise, many people who struggle with addiction don’t immediately realize how accessible treatment actually is until they begin navigating this process. Not only do states offer financial assistance for individuals seeking treatment without insurance, but many free rehab centers and state-funded rehab centers offer low to no-cost addiction treatment services.
State-funded health insurance coverage options may also be available to assist those who are struggling with addiction and may have a lack of income or be low-income. Programs such as Medicaid and other state-funded or government-funded insurance programs make free or nearly-free drug rehab an option to those who need it.
Additionally, paying for drug rehab out of pocket may be possible with the support of friends or family, loans, credit cards, payment plans, or sliding-fee structures. And, many rehab centers offer scholarship programs on a limited, case-by-case basis. This is where it becomes so important to discuss all of your options with a local drug rehab center in order to determine exactly what financial coverage for treatment might look like for you. (Hint: there are more options available than you might think!)
Can You Go to Drug Rehab Without Insurance?
The Affordable Care Act and Its Impact on Insurance for Drug Rehab
If you’re uninsured, and thinking about seeking treatment for addiction, you may be wondering how the Affordable Care Act figures into your recovery plan? Congress passed the Affordable Care Act in 2010 making health insurance more accessible, and affordable, for more people. Laws implemented as a result of this Act also make expanded medical support through state and government-funded Medicaid programs more accessible.
What does this all mean? Essentially, the Affordable Care Act (ACA) makes getting insurance easier, more affordable, and more widely accessible. It also lists substance use disorder as an “essential benefit” which means that all healthcare insurance providers who sell plans through the marketplace must offer coverage for addiction treatment and mental health services. Finally, the ACA makes preexisting conditions (such as addiction to drugs or alcohol) no longer a factor that can be used in determining ineligibility for coverage – in other words, an insurer cannot turn you down for coverage on the basis of having a pre-existing addiction to drugs or alcohol.
Essentially, the ACA can help you get treatment. However, obtaining coverage through the marketplace has strict limitations around the timeframe and periods in which plans can be purchased. Generally health plans must be purchased during open enrollment which under the ACA takes place between November 1 and January 15 each year. Once open enrollment has passed, plans may be purchased only in special circumstances in which a qualifying life event triggers a “Special Enrollment Period.”
Learn more about the ACA and open enrollment at https://healthcare.gov
Begin Your Road to Recovery Today
Nothing should stand in the way of you receiving the help you need to achieve long-term wellness and sobriety. Figuring out what your insurance covers doesn’t have to be stressful. In fact, it can actually be quite easy. Any questions or concerns you have, we’re here to answer! Don’t hesitate to reach out to our caring specialists at 888.241.7124 or contact us here.
Laurel McGinnis
Brie Rodriguez
JOHN GAU
MARK GUDIM
CORI BAIZA
AMANDA MARINELLI, DNP, BBA, AG NP-BC, PMHNP-BC, CARN-AP
Jeffrey M. Bishop, D.O.