Guide to MultiPlan Insurance Coverage for Addiction Treatment

Last Edited: December 29, 2023

Author
Matt Esaena
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Clinically Reviewed
Edward Jamison, MS, CAP, ICADC, LADC
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All of the information on this page has been reviewed and certified by an addiction professional.

Substance abuse treatment & MultiPlan Insurance Coverage.

Click Here for a confidential benefits check or call (866) 578-7471 to speak to a addiction specialist.

Alcohol and drug abuse has the potential to devastate not just the one suffering from the affliction, but the entire community. If it is left untreated, it will spiral out of control and become increasingly damaging, leading to death. It breaks up families, damages the economy, the health care system and the criminal justice system. Make no mistake that an addiction can cost lives.

The statistics on drug and alcohol abuse are very grim. A study in 2005 showed that 39 percent of all deaths in traffic accidents were related to alcohol. The study also showed that alcohol was involved in 40 percent of all violent crime across the country. The statistics on drug abuse are not much better.

If you or a loved one are struggling with drug or alcohol abuse it is vital that you seek help. A significant barrier to this is the cost. Under the 2010 Affordable Care Act, addiction now has to be treated as a mental health issue, which means insurance companies must cover at least some of it. Exactly how much will be covered will depend on the company, the plan and your geographic area. If you have MultiPlan insurance coverage, the first step should be to investigate exactly what your plan does and does not cover.

Coverage Through MultiPlan Insurance

Like the majority of other insurance companies, MultiPlan provides cover for issues relating to behavioral health, which includes drug or alcohol abuse. Exactly what they can cover depends on your personal policy. This is why you must go over the terms and conditions covered in your policy so that you will know exactly what your out of pocket costs will be. You must also look at whether there is a need for pre-authorization.

What Treatment Can You Get with MultiPlan?

There are many different treatment approaches to drug and alcohol abuse, and choosing the right type is vital if you are to be successful in your recovery. All addictions are unique and treatment should be equally unique. Some of the common options include:

  • Medically supervised detox
  • Inpatient rehab, which includes luxury and executive facilities
  • Outpatient rehab
  • Aftercare

In the vast majority of cases, outpatient rehab is the most convenient and affordable, but it is also not recommended for those suffering from a sever form of addiciton.

How Much Will MultiPlan Pay?

Your policy will determine just what your coverage is, which is why you must look through your plan before you enroll for treatment. Sometimes, you may be covered for detox, but not for rehab, or the other way around. You must find a provider that is within the MultiPlan network. While you may be able to go to an out of network provider, you will likely have much greater out of pocket expenses.

Rehab Cover with MultiPlan

Your individual policy with MultiPlan will determine whether or not rehab is covered for you. If it does, it is likely that this is part of their mental health services plan. You may also find that only part of your overall treatment will be covered. Depending on your policy, you may also have to have a referral in place from a primary physician before MultiPlan will agree to cover your treatment costs.

How Long Can You Stay in Rehab?

Because addiction treatment has to be unique, the length of time varies as well. The National Institute on Drug Abuse has stated that successful plans have to last for at least 30 days, however, many require much longer treatment. It is important for you to speak to the rehab facility you are considering as well as to your MultiPlan representative to find out whether you will be covered for an extended stay in rehab if necessary. There is no need to worry because these conversations will always be free, no obligation, and completely confidential.

What About Specialty Treatment?

Treatment for a drug or alcohol addiction may have to include specialized help. This is because an addiction is a multifaceted problem, with every facet requiring its own treatment. Sometimes, specialists are required for this. You must review particular elements of your MultiPlan policy. Exclusive and luxury facilities tend to have the most specialized services but they are generally private and more expensive, and it is likely that you will have higher out of pocket expenses by going there. Some of the specialized services you may require include mental health treatment for co-occurring disorders, alternative therapies, faith based treatment, group therapy and anger management. Whether or not MultiPlan will cover these types of therapies depends on your policy and usually, being able to demonstrate that there is a medical need for the said treatment.

Inpatient and Outpatient Treatment

Once you decide that you will be going to treatment, you have to decide whether to go to inpatient or outpatient facilities. It may be tempting to let the state of your finances decide this; outpatient treatment is generally cheaper but is not the most recommended of ways. In outpatient treatment, you do have flexibility, but it also means that you will have to remain in the environment in which your drug use was facilitated. With an inpatient facility, you are away from that environment, allowing you to focus purely on recovery. MultiPlan may cover both of these types of treatment.

How to Pay for What MultiPlan Does Not Cover

If you find that MultiPlan does not cover all of your treatment, there are other options out there for you. You may be eligible for a treatment loan, which is becoming increasingly popular. Organizations, like the Substance Abuse and Mental Health Services Administration have grants available for certain demographics. The treatment center you want to go to may also be able to enter you into a payment plan while some may even have scholarships available that you can apply for. The most important thing is that you seek the treatment that you need. Your MultiPlan insurance policy is likely to cover at least some of the treatment, and help is out there for any part that they don’t cover. By calling (866) 578-7471 you can determine what your insurance plan covers to make a decision on how you will proceed with your rehabilitation.