Addiction Rehabilitation Treatment Coverage with Value Options Insurance
Value Options is a popular medical insurance company that works together with many national treatment centers and hospitals. As part of their plans, they usually also offer coverage for detox services, particularly to those who have Plan I membership. Detox is required before patients can go enter into rehab, and is the first step on their road to recovery.
In general, detox will be covered as part of your hospital benefits. However, this means that you can only go to an in network provider, unless you are experiencing an emergency. Value Options does not cover detox for those who have a Plan II membership.
Value Options Insurance Coverage for Alcohol and Drug Rehab
If you have Plan I Value Options membership, then your rehab and treatment will be covered, so long as your provider is approved and in their network. Unfortunately, you will not receive any coverage for rehab and substance abuse treatment if you hold Plan II membership.
In terms of choosing your treatment, you can go to a provider that is outside of the Value Options network. However, doing so means that you cannot exceed the allowed total dollar amount as part of your plan. If it does exceed this, then you will have to pay the rest yourself out of your own pocket. It is also likely that you will have to pay the full fee up front when you use an out of network provider, and then claim the costs back from your insurance company.
Value Options will usually only cover short term rehab for those with a substance abuse problem. Exactly what “short term” means, however, will depend on what treatment plan is recommended to you. Hence, there is no clear cut answer as to what is and is not covered. You can find out about this by contacting Value Options directly, or asking your chosen rehab facility to run an insurance check for you. Either way, the information is 100 percent confidential and no obligation, nor will it influence your premiums.
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Value Options and Specialty Addiction Treatment
Depending on the insurance plan that you are a member of, it is possible that you can enroll in a luxury treatment facility as well. These facilities have far more amenities than regular rehab centers, and this can be beneficial in terms of swifter recovery. However, the majority of plans do not cover specialty treatment, mainly because it is not classed as a medical necessity to have things such as private rooms, ocean views, massage therapy, and five star dining facilities. Hence, before you check in, do make sure that you have completed an insurance check so that you know exactly what you will and will not have to pay.
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Value Options Insurance Coverage – Inpatient and Outpatient Treatment
Value Options’s hospital benefit covers both inpatient and outpatient treatment for those who have Plan I membership. However, it is important that the treatment is pre-approved first, and that the provider is within the Value Options network as well. Additionally, the major medical benefit of the Value Options plan may cover a number of extra charges for professional outpatient services. However, this is again something that you need to look into first. If they are covered, then you can go to both in network and out of network providers. The caveat is that your plan will only allow for a certain dollar amount, and you have to stay within that limit.
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Covering What Value Options Will Not Pay For
If you have chosen to go to an out of network provider, and their fee is higher than the dollar amount you are entitled to under your insurance benefits, you will be responsible to pay the difference between the two. Luckily, options exist for you outside of your medical insurance carrier. You could ask for sponsorship from the treatment facility itself. Grants are also available, and so are treatment loans. Furthermore, most rehab facilities have payment plans available, usually on a sliding scale, so that you can meet the associated fees and get the treatment you so desperately need.
Inpatient Treatment Preferable Over Outpatient Treatment
The Substance Abuse and Mental Health Services Administration has reported that 70% of those who attend an inpatient substance abuse treatment facility can complete their period of rehab and overcome their addiction. Yet, the figures are just 40 percent for those who use an outpatient treatment option. What this demonstrates is that it is vital that you choose the rehab facility that works for you, and that is likely to be a residential, inpatient program. The program you choose will have a massive impact on the chance of you actually achieving that sober, healthy life you are looking for.
Finance as a Barrier to Treatment
Unfortunately, finance is often a huge barrier for people who want to receive treatment. While they understand that a lifetime of drug or alcohol abuse is far more expensive than going to rehab, most simply do not have the money to pay for the care and treatment that they need. Under the Affordable Care Act, however, substance abuse problems are now recognized as a mental health issue, and treated as such. This means that all insurance providers must cover substance abuse treatment at least to some degree.
The best thing for you to do is look into the various rehab facilities that are available, and identify the one that you believe to be most appropriate to your individual needs. Once you have that facility located, you can ask them to complete an insurance check for you, which is discreet, free, and no obligation. This will show you exactly what you will have to pay, giving you the opportunity to start to look for funding sources. Do not be tempted to go to a provider that you don’t have faith in, just because more of the costs are covered. It is unlikely that you will be successful at all, which means your insurance will have been paid for nothing. This, in turn, also means that you may find it more difficult to back to rehab at a later stage.