Moda Health Insurance Coverage For Drug And Alcohol Rehab

Many people who struggle with addiction wonder if drug and alcohol rehab would be covered by their insurance. Moda Health offers multiple insurance plans that include varying levels of coverage for addiction treatment.

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Moda Health is an insurance provider serving residents of Alaska, Oregon and Washington. In operation since 1955, Moda Health offers both group and individual healthcare plans that give patients peace of mind.

The plans offered by Moda Health range in type and price depending on location and whether the plan is individual or a group plan through an employer or other organization. Plans are also sometimes further broken down into metal levels, such as bronze, silver and gold, that indicate premium costs and out-of-pocket costs.

One commonality is that each plan covers drug and alcohol treatments as part of the plan’s behavioral health benefits. In most cases, the patient will have to fulfill a deductible first and then pay 20 percent of the cost treatment for inpatient services, or $10 per visit for outpatient services. Out-of-pocket costs may be higher for treatments provided at out-of-network facilities.

Does Moda Health Cover Drug And Alcohol Detox?

Moda Health refers to drug and alcohol detox as withdrawal management, and insurance does cover this treatment. In most cases, detox is provided along with inpatient or outpatient rehabilitation. The basic cost for inpatient behavioral health treatments are 20 percent after deductible, and outpatient visits are $10 per in-network visit.

Detox provides support for the patient as drugs or alcohol are withheld and the body goes into withdrawal. At this point, medications and other forms of medical care are provided to minimize withdrawal and keep the patient comfortable. Once the body has detoxed from drugs or alcohol, then the patient is better able to enter the recovery phase and start learning how to live life without substance use.

Does Moda Health Cover Inpatient Rehab?

Yes, inpatient drug and alcohol rehabilitation is covered by Moda Health as a behavioral health treatment. For most plans in the Moda Health portfolio, a patient would pay 20 percent of the standard costs for an in-network facility after reaching their deductible.

Inpatient rehab is also called residential addiction treatment. This treatment is provided on-site, and the patient lives in the facility and has access to support 24 hours a day. Care is provided by doctors, nurses, therapists and many other caregivers in a residential setting.

Residential addiction treatment patients live in a group setting with others who are struggling with similar issues. Patient will attend therapy and participate in recovery activities each day. Facilities vary greatly, and many also have programs that allow a patient to work on gaining new hobbies, education and employable skills.

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Does Moda Health Cover Outpatient Rehab?

In addition to residential addiction treatment, Moda Health also provides coverage for outpatient drug and alcohol rehabilitation. Patients can participate in treatment either on a part-time basis each day or by visiting a therapist or other rehabilitation expert as needed. In-network outpatient visits are usually $10 per visit, though some treatments may be 20 percent of the cost after the deductible is met.

Outpatient rehab provides the same high level of care and therapeutic services as inpatient programs, but the patient lives at home or in a sober living home while enrolled in the treatment program. The patient has more flexibility and independence and will be able to work or be with their family at the same time. Outpatient treatments may include therapy sessions, group meetings, medical treatments and other recovery activities.

Does Moda Health Cover Medication-Assisted Treatment?

Yes, Moda Health does cover medication-assisted treatment as a potential therapy for certain cases. As behavioral health handles all drug and alcohol treatment claims, the patient will need to discuss MAT with a doctor and find out if one of these FDA-approved medications would be a good choice for their recovery. In many cases, the medications used in MAT are covered at the standard prescription drug rate, which varies from drug to drug.

Some of the common types of drugs used in medication-assisted treatment include Suboxone (buprenorphine, naloxone), Diskets (methadone) and Vivitrol (naltrexone). These medications often make it easier for an individual to stay in recovery by preventing withdrawal and minimizing cravings. However, because of the potential for abuse with some medications, patients are expected to meet with their doctors on a regular basis to make sure things are going as planned.

Does Moda Health Cover Sober Living Houses?

Moda Health doesn’t cover sober living houses directly, but some assistance may be available for other outpatient care. Living in a sober living house often means part of the day will be spent in outpatient rehab, which would be covered by Moda Health. In addition, medication-assisted treatment and other costs may be defrayed as well.

Even though it may not be covered, a sober living house is an excellent option for many people in early recovery. Sober living homes allow residents to practice their relapse-prevention skills in a safe environment where exposure to triggers is limited or prevented entirely. Patients who are finishing up a longer stay at an inpatient rehab may want to consider sober living houses to see if it may be a good option to help ease the transition back into independent life.

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Questions About Treatment?

Call now to be connected with one of our compassionate treatment specialists.
(888) 966-8973

In-Network Vs. Out-Of-Network

There are two different types of coverage for drug and alcohol rehab: in-network and out-of-network. Moda Health provides a higher coverage rate for treatment obtained in-network, because those healthcare providers charge an agreed-upon rate for services. Out-of-network care typically comes with higher out-of-pocket costs for the same services.

How To Find Drug And Alcohol Rehab Centers That Accept Moda Health

  1. 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.
  2. 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.
  3. Call the treatment center you or your loved one is interested in. The treatment center’s admissions team can answer questions about covered services.

Moda Health - https://www.modahealth.com/pdfs/med_criteria/ChemicalDependencyTreatment.pdf

Moda Health - https://www.modahealth.com/pdfs/ben_sum/OR/170101/Moda_Connexus_Platinum_250_SG_2018_OR.pdf

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