Prominence Health Plan Insurance Coverage For Drug And Alcohol Rehab

Getting treatment for an addiction can seem harrowing, especially when deciding how to pay for treatment. Prominence Health Plan offers health insurance plans that can help pay for treatment in an inpatient or outpatient rehabilitation center.

Addictioncampuses.com Prominence Health Plan Insurance Coverage For Drug And Alcohol Rehab

Prominence Health Plan offers small-group insurance plans for employers as well as Medicare Advantage health plans for those who qualify for Medicare. These plans offer coverage for those seeking treatment for a substance use disorder as well as mental health services.

Prominence Health Triple Choice Gold

  • Yearly Deductible: $1,000
  • Out-of-Pocket Maximum: $6,000
  • In-Network Copay: Ranges from $25 to 30 percent
  • Out-of-network Copay: Ranges from $50 to 50 percent, depending on service

Does Prominence Health Triple Choice Gold Cover Drug And Alcohol Detox?

Prominence Health Triple Choice Gold covers inpatient and outpatient healthcare for drug and alcohol detox that includes medications, counseling and therapy sessions. Individuals who work for an employer that offers the Triple Choice Gold health plan can expect to pay $25 for outpatient office visits or 30 percent after the calendar year deductible has been met.

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Does Prominence Health Triple Choice Gold Cover Inpatient Rehab?

Inpatient addiction treatment is a great choice for individuals who need to focus on healing from a substance use disorder without the distractions of daily life. The Prominence Health Triple Choice Gold health insurance plan covers inpatient rehab for drug and alcohol addiction. Individuals can expect to pay for services until they meet the yearly deductible and then a coinsurance amount after the deductible is met, usually 50 percent.

Does Prominence Health Triple Choice Gold Cover Outpatient Rehab?

Outpatient rehabilitation for substance use disorder is covered under the Triple Choice Gold health insurance plan. Individuals can expect to pay $25 per office visit and a certain amount of coinsurance for each day of treatment.

Does Prominence Health Triple Choice Gold Cover Medication-Assisted Treatment?

For individuals who need a little extra help in handling withdrawal symptoms and cravings, the Triple Choice Gold insurance plan may cover medication-assisted treatment as part of an inpatient or outpatient program. Individuals would be expected to pay any applicable copays or coinsurance requirements for medications.

Does Prominence Health Triple Choice Gold Cover Sober Living Houses?

For individuals who are at an increased risk of relapse, a sober living house may be the answer. These residential living centers offer a structured environment while allowing the individual certain freedoms, like the ability to get a job or go to school. The Triple Choice Gold plan may cover sober living houses, but it is best to check with the specific sober living home as well as Prominence Health to ensure coverage is available.

Prominence Health Triple Choice Silver

  • Yearly Deductible: $3,000
  • Out-of-Pocket Maximum: $7,000
  • In-Network Copay: Ranges from $50 to 40 percent
  • Out-Of-Network Copay: 50 percent coinsurance

Does Prominence Health Triple Choice Silver Cover Drug And Alcohol Detox?

The Prominence Health Triple Choice Silver health insurance plan covers drug and alcohol detox as part of an inpatient or outpatient treatment program. This comprehensive health insurance plan covers 60 percent of the costs associated with receiving treatment after the yearly deductible is met.

Does Prominence Health Triple Choice Silver Cover Inpatient Rehab?

Inpatient rehabilitation at a residential addiction treatment center is covered for individuals suffering from a substance use disorder. Prominence Health covers 60 percent of the costs associated with receiving drug and alcohol rehab services, including individual and group therapy after the yearly deductible is met.

Does Prominence Health Triple Choice Silver Cover Outpatient Rehab?

Outpatient addiction treatment is covered, including partial hospitalization and outpatient office visits with a counselor. Individuals can expect to pay $50 per office visit and 40 percent in coinsurance for all other outpatient treatment services.

Does Prominence Health Triple Choice Silver Cover Medication-Assisted Treatment?

Medication-assisted treatment may be covered as part of an inpatient or outpatient drug and alcohol treatment program. However, the individual may be responsible for paying the full price of the medications. All other services associated with the medication-assisted treatment may be covered at 60 percent.

Does Prominence Health Triple Choice Silver Cover Sober Living Houses?

To determine if the Triple Choice Silver insurance plan covers sober living houses, it is best to speak with the treatment center or Prominence Health to determine whether the sober living home is covered and how much the associated coinsurance payments or copays would be.

Prominence Health Medicare Advantage

  • Yearly Deductible: $0
  • Out-of-Pocket Maximum: $3,400 to $4,500
  • In-Network Copay: Ranges from $15 to $300, depending on service
  • Out-Of-Network Medical Services: Not applicable

Does Prominence Health Medicare Advantage Cover Drug And Alcohol Detox?

Drug and alcohol detox may be covered under mental health services if the individual has a qualifying mental health disorder as well as a substance use disorder. In order to qualify for coverage, the individual must have prior authorization.

Does Prominence Health Medicare Advantage Cover Inpatient Rehab?

Inpatient mental health services are covered under the Medicare Advantage plan, which may include addiction treatment. Individuals can expect to pay $300 per day for the first five days. Days six through 90 are covered at 100 percent.

Does Prominence Health Medicare Advantage Cover Outpatient Rehab?

Outpatient rehabilitation for individuals suffering from a substance use disorder may be covered under the mental health services provisions. For outpatient treatment, individuals can expect to pay $40 per office visit and $55 per day for partial hospitalization services.

Does Prominence Health Medicare Advantage Cover Medication-Assisted Treatment?

Medication-assisted treatment, including prescriptions for Suboxone (buprenorphine and naloxone) and methadone, may be covered under the medical services. Copays for medications range from no cost to 33 percent.

Does Prominence Health Medicare Advantage Cover Sober Living Houses?

To determine if sober living homes are covered under the Medicare Advantage health insurance plan, it may be best to talk with Prominence Health or the specific sober living home. These services may or may not be covered under this particular insurance plan.

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In-Network Vs. Out-of-network Insurance Coverage

When it comes to getting affordable treatment for substance use disorder, choosing an in-network provider results in the least amount of out-of-pocket expenses, while choosing an out-of-network provider results in more out-of-pocket expenses. Thankfully, if the first choice isn’t in the insurance company’s network, there are other rehabilitation centers that are in-network.

How To Find Drug And Alcohol Rehab Centers That Accept Prominence Health Plans

1) Call 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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