HealthPartners Insurance Coverage For Drug And Alcohol Rehab
Breaking an addiction is not easy, but with the right help, those who are ready to to heal can find success. People with HealthPartners insurance can use their insurance coverage to offset the cost of many addiction treatment services.
For someone struggling with addiction, the cost of treatment can be a barrier that prevents them from getting help. HealthPartners is a health insurance program offering health plans in Minnesota and Wisconsin that include coverage for drug and alcohol rehab.
Because HealthPartners is compliant with the Affordable Care Act, all insurance policies include some level of alcohol and drug addiction treatment as part of the behavioral health services coverage. This coverage includes inpatient and outpatient services.
HealthPartners is an integrated health care organization that helps its 1.8 million customers throughout Minnesota and Wisconsin manage their healthcare costs more effectively. Individuals who purchase HealthPartners insurance can choose from a number of plan types. Plans are divided by metal levels based on the deductible, copay and premium cost.
Members in Minnesota can choose from the following plans:
- Peak Gold: deductible of $1,000 individual and $2,000 family, coinsurance rate of 20 percent
- Peak Silver: deductible of up to $3,500 individual and $7,000 family, coinsurance of up to 20 percent
- Peak Bronze: deductible of $6,000 individual and $12,000 family, coinsurance rate of 20 percent
- Peak Catastrophic: deductible of $7,350 individual, $14,700 family, no coinsurance
- Peak HSA: deductible of up to $6,600 individual, $13,200 family, up to 15 percent coinsurance
HealthPartners’ Wisconsin plans have similar structures, with slightly different deductibles.
Does HealthPartners Cover Drug And Alcohol Detox?
Alcohol and drug detox programs are covered under the HealthPartners coverage for behavioral health. Each individual plan has its own terms for out-of-pocket expenses. In general, patients must meet their deductibles and may be responsible for a coinsurance cost after doing so.
Drug and alcohol detox programs provide support while patients go through the withdrawal that follows stopping using drugs or drinking alcohol. Medically supported detox programs offer close medical supervision and support to help patients successfully make it through this phase of treatment. For many people, detox is the first step on the road to recovery.
Does HealthPartners Cover Inpatient Rehab?
Inpatient addiction treatment is covered under HealthPartners insurance plans. All plans require the patient to meet a deductible before insurance benefits kicks in. Some plans cover the full amount after deductible, while others charge a coinsurance fee of around 20 percent.
After detox, residential addiction treatment is the next step in recovery. In these programs, patients check in to a residential treatment facility where they receive therapy and live on-site. They are in a drug- and alcohol-free environment surrounded by support, which helps to reinforce the recovery skills learned in therapy.
Inpatient treatment may not be necessary for all patients. Those that do need it, however, should choose a facility carefully to ensure they are getting the best possible treatment and service.
Does HealthPartners Cover Outpatient Rehab?
Outpatient rehab is covered under the HealthPartners behavioral health services benefits, which varies depending on the plan the patient carries. As an example, the Peak Gold plan allows unlimited behavioral health outpatient visits, but patients will pay a $10 copay per visit. Other plans require the patient to meet the deductible, then pay a coinsurance fee or no fee at all.
Outpatient rehab is typically the step taken after inpatient treatment. This level of care allows the patient to live at home while visiting the treatment facility for treatment services, counseling and support. It can be intensive, with many hours spent in treatment, or minimal, depending on the severity of the addiction.
Does HealthPartners Cover Medication-Assisted Treatment?
Medication-assisted treatment combines behavioral therapy with prescription medications to assist in recovery from addiction. These medications are often used in detox as well to prevent or minimize withdrawal symptoms.
If a patient’s doctor recommends medication-assisted treatment, coverage would fall under the HealthPartners prescription drug services. Under most HealthPartners plans, patients pay $5 for low-cost generic prescription drugs and $25 for high-cost generic drugs. If the patient is using non-generic drugs, they must first meet the deductible. After that, the cost is 20 percent of the cost of the medication.
Many prescription medications can help ease the symptoms of withdrawal. Some drugs will make the addictive substance less appealing, and can even make the person feel unwell if they drink or use drugs. Drugs commonly used in medication-assisted treatment include Diskets (methadone), Suboxone (buprenorphine, naloxone) and Vivitrol (naltrexone).
Does HealthPartners Cover Sober Living Houses?
Because sober living houses do not typically provide treatment services, this level of care is not covered as part of HealthPartners insurance plans. Patients who choose to use a sober living house as part of their treatment will likely be responsible for the full cost.
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A sober living house offers a person who is in early recovery housing that is guaranteed to be free of drugs and alcohol. Patients can go from their sober living house to an outpatient treatment session, work, school or attend to other responsibilities. By removing triggers from the living environment, sober living houses can be an excellent step toward learning to navigate regular life without substance use.
In-Network Vs. Out-Of-Network Treatment
HealthPartners members are encouraged to visit providers within their respective networks. Services from in-network providers are eligible for the highest coverage levels and lowest out-of-pocket expenses.
Members are allowed to use providers that are out-of-network, but when they do they pay nearly double their deductible amount as well as a higher copay or coinsurance fee.
Yet people battling addiction need the best possible treatment facility for their own unique needs. When a patient has found an addiction treatment facility that seems to be a good fit, that facility can perform a verification of benefits to determine if they are within the HealthPartners network.
How To Find Drug And Alcohol Rehab Centers That Accept HealthPartners
- Contact Addiction Campuses for an immediate verification of benefits. Addiction Campuses can answer questions about insurance and addiction treatment and perform a no-obligation verification of insurance benefits on your behalf.
- Contact the insurance provider by using the phone number on the back of the insurance card or by visiting the provider’s website. A representative will be able to match you to an in-network drug and alcohol rehab center.
- Call the treatment center you or your loved one is interested in. The treatment center’s admissions team can answer questions about covered services.