Pacificare Insurance Coverage for Alcohol and Drug Rehab

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The vast majority of insurance companies now cover substance abuse treatment to some degree, as the Affordable Car Act has now recognized addiction as a mental health disorder. That is why, if you have a Pacificare insurance policy, it is likely that they will also offer some sort of coverage to you. However, finding out exactly what they cover can be a lot trickier. Luckily, you can contact Pacificare directly and ask them what you are covered for. Also, there are other ways for you to find out what coverage you have as well, including:

  • Visiting the Pacificare website and reviewing their benefits
  • Checking your policy documents for information (get a copy of your policy if you have lost it)
  • Asking a rehab facility that you are interested in to do an insurance check for you.

Finding out whether you have coverage for rehab is always completely free and no obligation. It also will not affect your premiums in any way. Furthermore, regardless of how you find out what your coverage is, your information will always be 100 percent confidential.

Pacificare Insurance Coverage for Alcohol and Drug Rehab Treatment

The first thing you have to do is verify what your policy says about your coverage. As stated, you can do that through Pacificare directly, or you can ask a rehab facility to do it for you. In so doing, you will know exactly what services you can use, and what your out of pocket expenses are going to be.

What About Out of State Treatment?

Whether or not Pacificare will cover you if you want to receive treatment out of state is a complex one. Some people feel that fully removing themselves from a certain location that enabled their substance abuse in the past is the only way to get better and, sometimes, they are right about that. Whether or not Pacificare covers you, however, is another matter. Generally speaking, they prefer you to go to their in-network providers and these can be in a different state from where you are as well. Furthermore, you have the opportunity to go to an out of network provider and, as with the specialized treatment, increase your personal out of pocket expenses.

As you can see, there are quite a few things to think about when it comes to finding out whether or not your Pacificare insurance policy will cover your stay in rehab. What you must remember at all times, however, is that becoming clean or sober should supersede any potential barrier. If your policy does not cover you, or not as much as you would have liked to, and you feel you have found the perfect treatment for your needs, there are other options out there as well.

Do speak to applicable treatment facilities and ask them to complete an insurance check. This will, if nothing else, give you the peace of mind of knowing exactly what your out of pocket expenses are going to be. And, as such, you will be able to properly prepare yourself for your journey towards lasting sobriety.

Quick Stats:

37% of people claim that the U.S. is losing ground in the war on prescription drug abuse.

How Long Can I Go to Rehab?

How long you will be able to attend rehab and whether you can go to inpatient or outpatient treatment, will vary depending on your personal policy. As a rule of thumb, Pacificare will determine how much they will cover based on what your personal needs are. Therefore, Pacificare will usually expect some form of contact from your health care provider and/or the rehab facility who can inform them of how long that they expect you to stay.

Sometimes, the recommendation given at the start could be wrong, and it may transpire that you will need to stay in rehab for a longer period. The rehab facility will contact Pacificare about this and they are likely to agree to extend your coverage. If they don’t, don’t worry because it won’t mean that you will have to leave rehab immediately. Rather, it is likely that the facility will have some sort of sponsorship options in place, or they can direct you to grants and loans. Some even have payment plans. This is why finances should not be a barrier to you receiving the treatment that you need, as you will always find something to help you out.

Quick Stats:

52 Million Americans have abused prescription medications.

Inpatient and Outpatient Treatment

Generally speaking, Pacificare will cover you for both inpatient and outpatient treatment, but again, it will depend on exactly what your needs are. While outpatient treatment is definitely cheaper; it is also much less effective, particularly if you have a complex addiction or substance abuse order. Pacificare understands that by making sure they cover you for the treatment that you actually need, you will be far more likely to attain a life of sobriety, which results in much lower overall costs for them.

Quick Stats:

There are over 7.5 million fentanyl prescriptions written each year.

What About Specialized Treatment?

There are numerous forms of substance abuse treatment available, particularly with regards to residential facilities. These facilities have been designed for specific types of population groups. For instance:

  1. Luxury facilities have added amenities that make residents feel as if they are in a luxury resort. These include things like private rooms, comfortable bed-linen, and five star chefs. These facilities tend to also have complimentary therapies like equine therapy, yoga, massages and so on.
  2. Private luxury facilities are similar to number 1 but they have been designed specifically for VIP people, such as movie stars and politicians. These facilities, as the name suggests, are impenetrably private, to safeguard the confidentiality of its residents.
  3. Executive facilities, which have been designed for people who have executive jobs and cannot remove themselves fully from their work. In these facilities, residents may, at certain times during the day, access the internet or telephones, so that they can continue their work. Usually, executive facilities are also luxury facilities.

As a rule of thumb, Pacificare policies will not cover its members for any of the above three types of facilities. However, it is possible that they will cover a percentage of it, which could be that they would pay for a regular facility. You would then have to make up the rest of the cost yourself.