Terms You Should Know – Insurance

When completing the admissions process for yourself or on behalf of a loved one, understanding the financial matters surrounding any services provided by the treatment center will significantly influence your next steps. If you have insurance coverage, Peaks Recovery can assist you with processing the claims.

Firstly, you should know whether your insurance coverage will extend to addiction treatment. The Mental Health Parity and Addiction Equity Act of 2008 confirm that relevant insurance firms are now obliged by federal law to cover some aspects of substance abuse. 

HMO Insurance Policy

Over 75 million Americans have HMO (health maintenance organization) coverage, making it the most likely insurance policy for clients to use. The coverage can vary depending on a range of factors, including location and plan you’re on, and HMO coverage covers in-network providers.

There are limitations on where insurance claims can be made and the exact coverage will be determined by the duration of treatment, the choice between inpatient and outpatient services, and the actions of the physician who refers you. 

Understanding ASAM Levels of Care

PPO (preferred provider organization) insurance policies are another commonly held solution. They work with a smaller network but do not require you to get a physician’s referral. You can visit any healthcare providers covered by the plan, which extends to most addiction centers. Here at Peaks Recovery, we can assist you with PPO coverage. PPO coverage will most likely cover out-of-network providers.

Things To Check In Advance

As well as checking that your health insurance plan will help cover the costs of your substance abuse rehab, it’s important to check the finer details to avoid any nasty shocks and ensure that you can make the smartest financial decisions. Money worries are the last thing you need during this process. Some of the key issues to consider are;

  • Deductibles – PPO insurance policies, for example, will often charge a deductible whenever you visit a healthcare specialist, including an addiction treatment center. It is what your insurance decides will be your portion to pay.
  • Reimbursement – This is what your insurance company has decided to pay your provider.
  • Out-of-pocket costs – Costs your insurance will not cover, possibly ancillary services provided within the program.
  • Balancing billing – this is a bill that requires you to pay the difference between the overall treatment cost and the amount that the health insurance plan covers.

The ability to make a calculated decision before starting any treatment will provide the peace of mind that you deserve.

Get help with Peaks Recovery

While the financial aspects are crucial, the most important thing is that you gain the right level of support that is built for sustained success. Contact Peaks Recovery to learn more about treatments and insurance payments today.