Will My Insurance Policy/PPO Cover the Cost of Drug Rehab?

If you’ve been searching “drug rehab near me” and wondering about whether it’s time to go to rehab, this section is what you need.

These are some of the insurance providers/plans that most drug rehab facilities accept. Find your provider on this list and see whether you will be covered for a drug rehab in Sacramento.

We’ve done our best to ensure the accuracy of the below list, but policy coverage may change. For the most up to date information, please call us toll-free at (916) 229-9970 to check if your insurance plan covers drug rehab.

Aetna Premium Insurance

Aetna does cover drug rehab. They also offer a 24-hour drug support line that can help you find a rehab facility quickly. Aetna also offers coverage with facilities that are more at the luxury end of the price range, in case you’re concerned about being stuck in a low budget clinic.

When seeking Aetna drug rehab, you’re covered for these treatments if you’re insured by them:

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Detox

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Residential or inpatient rehab

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Outpatient treatment (intensive)

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Partial treatment in hospital

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Programs with continuing care (or alumni programs)

Anthem Coverage

Anthem Health Insurance gives their clients alcohol and drug detox and rehab coverage under its plan for behavior health care. This spans all 50 states in the U.S. and covers both outpatient and inpatient substance addiction treatment, but coverage does vary from state to state, although typically both inpatient and outpatient programs are supported.

Blue Cross Blue Shield / BCBS

Blue Cross and Blue Shield Association does cover rehab, but this is dependent upon the policy you hold.

If you’re part of the Federal Employee Program, for instance, you’re covered for individual and group therapy sessions in outpatient rehab, but must cover the additional co-pay.

If you do seek residential treatment with Blue Cross Blue Shield drug rehab, you need pre-certification and have to pay a $500 fee. When seeking Blue Cross Blue Shield Drug Rehab facilities, make sure you find this out beforehand.

Note there will be differences in terms of individual limits, co-pays, deductibles, maximums per day, and per stay. Typically, programs that are in-network will offer more coverage than those that are out-network.

 

Blue Shield of California

Most company and personal health insurance plans have benefits for addiction treatment, and this more than likely includes your plan with Blue Shield of California. What you must do is find out specifically which center will accept this plan, along with the associated fees. We’ve typically seen coverage for those with this plan get routed through Magellan for its services.

 

Cigna Drug Rehab

Many options exist with this provider including basic and more advanced treatment. Your Cigna drug rehab options might let you attend a private center for rehabilitation.

With Cigna, the level of coverage seems to vary more than others. It is likely you will have to go through a physical examination by a doctor to determine the severity of your addiction and whether or not it will be covered under your plan.

Harvard Pilgrim

Harvard Pilgrim is focused mainly on coverage to people in New England: Massachusetts, Connecticut, Maine and New Hampshire. If Harvard Pilgrim is your provider, it may be difficult to locate treatment centers in California. You will have to contact them with the specific details of your policy to discover what options are available.

Humana Rehab Coverage

Humana requires clients to pay expenses toward their health care costs yearly before it helps you with medical bills, but this could differ for individual policies. If your employer provides group insurance and the program is in-network, rehab should be covered.

Kaiser Permanente

Every plan with this company will cover at least part of your rehab costs, though specifics vary by the policy details and whether you are covered with your work or independently.

The “tier” of your plan will determine your level of coverage, with 60% being the minimum.

Magellan Drug Rehabilitation Coverage

If your health insurance plan is with Magellan and includes LifeResources, you will probably be covered by most rehab programs, along with any needed detox period.

The level of coverage varies, but they will at least pay for part of your rehab. In the majority of plans, Magellan will cover (2) 28-day rehab programs and up to $3,500 annually for outpatient treatment.

MHN

MHN does have coverage for facilities that are in its network of healthcare providers. Depending on your policy, it may cover some combination inpatient, outpatient, partial hospitalization, and residential treatment programs.

OPTUM

Both outpatient and intensive care management are covered by OPTUM. In-network centers are mandated by the plan. They also can be more limiting in approved treatments than some other providers.

 

United Healthcare

United offers a range of coverage through United Behavioral Health. Inpatient, outpatient, and follow-up care are all possibilities, depending on your plan. They have approximately 3,600 inpatient and outpatient treatment centers in their network. See this list for Sacramento.

ValueOptions

Clients with ValueOptions Plan I membership are covered for detox services in many hospitals and treatment centers in Sacramento. You can follow this link for a list for Sacramento.

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