1199SEIU National Benefit Fund Insurance Coverage for Drug and Alcohol Rehab

Health insurance plans can help individuals who are suffering from a substance use disorder to pay for the cost of addiction treatment. Covered services may include medication-assisted detox, inpatient rehab and outpatient treatment services.

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The health insurance plans offered by 1199SEIU National Benefit Fund may be able to help patients pay for addiction treatment services. 1199SEIU National Benefit Fund’s Plan A and Plan B health insurance policies both include coverage for drug and alcohol rehab.

1199SEIU National Benefit Fund Insurance Plan A

  • Yearly Deductible: $0
  • Out-Of-Pocket Maximum: No out-of-pocket limit
  • In-Network Copay: No costs associated with most healthcare services
  • Out-Of-Network Copays: Some reimbursements available

Drug And Alcohol Detox Coverage

Drug and alcohol detox may be covered under 1199SEIU National Benefit Fund Insurance Plan A. If detox services are provided as part of an inpatient or outpatient program, medications to help control withdrawal symptoms may be covered. For services that are covered, there is no copy or coinsurance.

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Inpatient Rehab Coverage

Inpatient drug and alcohol rehab is covered under 1199SEIU National Benefit Fund Plan A. Inpatient rehab is also sometimes referred to as residential addiction treatment because the patient lives in the treatment center while they are recovering. Treatment lengths can range from 30 days to 90 days or longer, depending on the individual’s specific needs. There may be no charge for inpatient drug and alcohol rehabilitation services when prior authorization is received.

Outpatient Rehab Coverage

Outpatient drug and alcohol rehab is covered under 1199SEIU National Benefit Fund Plan A. There may be no charges when prior authorization has been received. Outpatient addiction treatment generally falls into two categories: partial hospitalization programs and individual provider visits.

Partial hospitalization is a type of intensive outpatient treatment that involves checking into a rehabilitation center for several hours each day to receive services. When an individual opts to simply use provider visits, they schedule individual counseling and therapy sessions with addiction treatment providers and other medical professionals as needed.

Coverage For Medication-Assisted Treatment

Medication-assisted treatment may be covered under 1199SEIU National Benefit Fund Plan A if it is part of an inpatient or outpatient treatment program. A differential charge may be assessed for certain medications.

This type of treatment involves taking a medication, like Suboxone (buprenorphine, naloxone) or Diskets (methadone), to control cravings and prevent withdrawal. These medications can be administered as injections, pills or implants under the skin.

Coverage For Sober Living Houses

Sober living houses may be covered under 1199SEIU National Benefit Fund Plan A. To determine if a sober living home is covered, the individual will need to speak with the specific home as well as the insurance provider.

Sober living homes are typically utilized if an individual needs more assistance with their recovery or time to practice coping skills after completing inpatient treatment or an intensive outpatient treatment program.

1199SEIU National Benefit Fund Insurance Plan B

  • Yearly Deductible: $0
  • Out-Of-Pocket Maximum: No out-of-pocket limit
  • In-Network Copay: No charge for most in-network healthcare services
  • Out-Of-Network Copay: Some reimbursements may be available

Drug And Alcohol Detox Coverage

1199SEIU National Benefit Fund Plan B covers drug and alcohol detox. Coverage is generally provided when the detox treatment is part of an intensive outpatient program or inpatient treatment program. Preauthorization is required.

Inpatient Rehab Coverage

Inpatient drug and alcohol rehab is covered under the 1199SEIU National Benefit Fund Plan B. Inpatient rehabilitation is assessed a $25 copay for in-network providers or a $25 copay plus provider charges for out-of-network providers.

To qualify for coverage under the Plan B policy, the individual must receive prior authorization unless treatment services were provided in relation to a health emergency. In the event of a medical emergency, authorization must be requested within 48 hours of admission.

Outpatient Rehab Coverage

1199SEIU National Benefit Fund Plan B may cover up to 100 percent of outpatient drug and alcohol rehab services for in-network providers. If an out-of-network provider is chosen, the individual can expect to pay the costs associated with receiving care.

The individual can choose a partial hospitalization program or an intensive outpatient program. Partial hospitalization involves receiving treatment, like counseling and behavioral therapy, at the treatment center during the day and returning home at night.

Coverage For Medication-Assisted Treatment

Medication-assisted treatment may be covered under 1199SEIU National Benefit Fund Plan B. This type of treatment involves combining behavioral therapy with physician-prescribed medications to help control cravings and prevent withdrawal.

However, in order to qualify for coverage, the medication-assisted treatment plan may need to be preauthorized, and it may need to be part of an inpatient or outpatient rehabilitation program.

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Coverage For Sober Living Houses

1199SEIU National Benefit Fund Plan B may cover sober living houses, which are utilized by individuals who are at an increased risk of relapsing if they were to return home directly after completing their initial treatment program. To determine if a sober living home is covered, contact the specific home as well as the insurance provider to determine coverage limitations and copays.

In-Network Vs. Out-Of-Network Insurance Coverage

Health insurance providers like 1199SEIU National Benefit Fund Insurance often designate medical providers as either in-network or out-of-network. In-network healthcare providers have a pricing and billing agreement with the insurance company, and they accept the provider’s health insurance plans. This results in lower out-of-pocket expenses for the individual who is receiving treatment.

When a healthcare provider is out-of-network, they do not have an agreement with the specific insurance provider, and the health insurance may not be accepted. Individuals who choose out-of-network providers may be responsible for up to 100 percent of the costs of receiving treatment.

How To Find Drug And Alcohol Rehab Centers That Accept 1199SEIU National Benefit Fund

  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.

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