The Affordable Care Act (ACA) is a landmark US federal statute that significantly reformed the U.S. health insurance system. Enacted by the 111th United States Congress and signed into law on March 23, 2010, it represents the U.S. healthcare system’s most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965.
This statute also includes coverage of drug rehabilitation in the insurance coverage, one example of which is the MultiPlan Coverage for Addiction Treatment. This addresses coverage for substance abuse treatment, aiming to make it more accessible to people via health insurance.
Is MultiPlan a PPO?
Depending upon the type of insurance plan to which you subscribe, your plan can cover either the cost of treatment in total or in a partial arrangement. MultiPlan PPOs are more flexible than most HMOs, as individuals do not have to change doctors they prefer to stay with. This can be reassuring to some members, as they may already feel safe and confident in the services provided by their preferred doctor. This can also allow for health plans to stay consistent, as they will be facilitated by the same care team throughout.
MultiPlans within the same network can be more cost-effective for coverage compared to out-of-network coverage. As with other types of insurance, individuals seeking treatment from providers outside of the MultiPlan network may have to pay significantly more for treatment (depending on the service). Third-party administrators, HMOs, and self-funded plans can also be involved in the MultiPlan coverage.
An important detail to note is that while individuals do have the freedom to choose which doctors they want, they may have to consider the premiums that they have to pay their chosen provider each month. This is why medical patients need to contact their insurance company to verify their coverage, determine the scope of their networks, and verify access to the services they wish to access. Having these answers in hand empowers them to make the best health decisions possible, without being surprised by a large bill later.
Does the MultiPlan Coverage include Dual Diagnosis?
Treatment for substance abuse disorders can be quite costly, and so are treatments for specific mental health issues. But addiction treatment facilities like Magnolia City Detox work with insurance providers to try and make addiction treatment accessible for people who may not have easy access to healthcare services. Seeking treatment for both addiction and mental health issues may seem daunting, which is why MultiPlan coverage appeals to many people.
MultiPlan insurance plans cover treatment for mental health issues alone, but the severity of the particular mental health issue could factor into the level of care needed. If the person also has an addiction, the effects of the substance may be shielding or distorting the actual symptoms of the mental illness.
Selecting an addiction treatment center that offers dual diagnosis treatment can provide far-reaching benefits, so it’s a good idea to ask about dual diagnosis treatment when communicating with an insurance company. Even if mental illness may not be a primary concern, it should be on the list of services to verify when initially communicating with an insurance company about addiction rehab coverage.
Types of Treatment Programs for Addiction
In many cases, people are worried about seeking long-term treatment purely because of the cost. They may perceive that a regular length of stay in a rehab facility could be prohibitively expensive already, and staying even longer would not be feasible.. However, this may not be the case, depending on coverage. An insurance policy may have a provision for a long-term recovery program, and solutions may come from other places (such as workplace assistance initiatives).
This highlights the importance of checking coverage and finding solutions for cost early on in the recovery process — the most important thing is making it so people can focus primarily on their recovery from addiction while in treatment. If a longer time in treatment program turns out to be necessary, having knowledge about treatment coverage going in can help the individual make informed decisions and not dismiss options outright.
Any kind of recovery from substance abuse disorder begins with the detoxification process, usually by way of medically assisted detox. Withdrawal symptoms begin to set in upon quitting a substance, sometimes quite early on. Depending upon the severity of the symptoms, the individual could require special care and medications to mitigate the effects of the withdrawal symptoms. A formal medical detox program assists the person detoxing by allowing for regular check-ins from medical professionals, who can also intervene immediately if they’re suffering from complications as a result of detox.
Sometimes, mental health issues or addiction cases may require staying in treatment facilities where clinically trained professionals and medical equipment are readily available. In such cases, enrolling in an inpatient rehab is the most ideal solution. These facilities offer a hospital-like environment where the individual is monitored and cared for during the duration of their stay, while also allowing them to fully “step away” from daily life to focus on their health.
Different people have different recovery rates from addiction. In some cases, substance abuse or mental health issues are so severe that the individual requires a longer stay in residential treatment. Having an insurance policy that has a provision for a long-term recovery program is immensely helpful in such instances.
Most people in recovery for a substance abuse disorder could require a little more therapy before they can fully integrate back into their normal lives. For these people, the best option would be an outpatient care program, where they are gradually acclimated to life outside of rehab and allowed greater freedom. This can also be a viable option for people with milder forms of addiction, who may not need the consistent monitoring of inpatient treatment.
There are many instances where treatment for either mental health issues or substance abuse could require the use of prescription medications. These medications may be a financial concern for people entering treatment. But MAT is commonly covered under insurance because it usually leads to lower rates of relapse over time, especially in the crucial early periods of recovery.
Treatment plans often include aftercare programs to ensure that the individual does not suffer from a relapse once they are out of the rehabilitation program. An aftercare program is far more cost-efficient, and in many cases far healthier, than having to check into rehab once more. It’s important to verify if aftercare treatment is covered before an individual enters an addiction treatment program.
Magnolia City Detox is a Member of the MultiPlan Network
At Magnolia City Detox in The Woodlands, TX, we find ways to make healthcare more accessible, allowing people who are seeking treatment with us to focus on what’s most important. The admissions team at our drug and alcohol detox center near Houston, Texas, can help verify your coverage and choose a plan that is appropriate for your situation and needs.
Contact us today to learn more about how we can help you find the best MultiPlan insurance coverage options. Be on the journey to breaking free, and be the best version of yourself today.
