Tufts Health Plan Insurance Coverage for Drug and Alcohol Rehabilitation

Individuals do not have to continue living with addiction out of fear of high treatment costs. A health insurance policy, like the policies offered by Tufts Health Plan, can greatly reduce expenses so that adults who need drug and alcohol rehabilitation can get the help they need.

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

Tufts Health Plan insurance coverage can help make getting inpatient and outpatient drug and alcohol rehabilitation affordable. Tufts Health Plan offers several levels of health insurance, including direct connect, bronze and silver, so that individuals can find a plan that fits their monthly budgets.

Tufts Health Plan Direct ConnectorCare I

  • Annual Deductible: $0
  • Yearly Out-Of-Pocket Maximum: $0
  • In-Network Copays: no charge for most services
  • Out-Of-Network Care: emergency services only

Drug And Alcohol Detox Coverage

The Tufts Health Plan Direct ConnectorCare I insurance policy may cover alcohol and drug detox services for those with a substance use disorder. Detox services may include palliative care to help ease or prevent uncomfortable withdrawal symptoms and medical support for more serious symptoms. There is typically no charge for covered services.

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Inpatient Rehab Coverage

Inpatient drug and alcohol rehab at a residential addiction treatment center is covered under the Tufts Health Plan Direct ConnectorCare I plan. Covered inpatient services are grouped under mental health, behavioral health, and substance use disorder services. There is no charge for inpatient services, and preauthorization is not required. Limitations on the length of stay may apply.

Outpatient Rehab Coverage

Outpatient rehabilitation for a substance use disorder is covered under the Tufts Health Plan Direct ConnectorCare I insurance policy. There are no costs associated with receiving treatment when the individual chooses at in-network provider.

Individuals can attend up to 12 outpatient therapy visits per the calendar year. If more than 12 visits are required, preauthorization is required to receive coverage for continued treatment.

Coverage For Medication-Assisted Treatment

Medication-assisted treatment may be covered for individuals who are dependent on alcohol, opioids or benzodiazepines. This type of treatment involves taking a prescription medication to prevent withdrawal and decrease cravings, in combination with behavioral therapy to develop relapse-prevention skills. For covered services, there is no charge for doctor visits. MAT medications may require a copay between $1 and $7.30.

Coverage For Sober Living Houses

Sober living homes may be covered under the Tufts Health Plan Direct ConnectorCare I insurance policy. A sober living home is a group home that provides support for individuals who have completed an initial inpatient or intensive outpatient treatment program. To learn whether a stay in a specific sober living home would be covered, contact the facility or Tufts directly to determine specific coverage levels and any copay or coinsurance requirements.

Tufts Health Plan Direct Bronze 2500

  • Yearly Deductible: $2,500
  • Out-of-Pocket Maximum: $7,350
  • In-Network Copay: copays range from $25 to $1,000
  • Out-Of-Network Copays: emergency room, ambulance transport, and urgent care only

Drug And Alcohol Detox Coverage

The Tufts Health Plan Direct Bronze 2500 may cover drug and alcohol detox as part of an inpatient or outpatient addiction treatment program. Detox is the beginning stage of treatment and involves letting the body rid itself of drugs and alcohol. If the physical and psychological withdrawal symptoms are severe, medical care and medications may be required. A copay is typically required for covered services.

Inpatient Rehab Coverage

Inpatient services for drug and alcohol rehabilitation are covered under the Direct Bronze 2500 insurance policy. Individuals have assessed a $1,000 copay per visit for in-network treatment centers. Out-of-network centers are not covered.

Outpatient Rehab Coverage

Outpatient addiction treatment services are covered under the Tufts Health Plan Direct Bronze 2500 insurance policy. Individuals can expect to pay $30 per visit. Patients are limited to 12 outpatient visits per year. If additional visits are needed, prior authorization must be acquired.

Coverage For Medication-Assisted Treatment

Medication-assisted treatment for alcohol, opioid, and benzodiazepine dependencies may be covered. Prescription medications, such as Suboxone (buprenorphine, naloxone) and Diskets (methadone), are used to help control cravings and reduce or prevent withdrawal symptoms while the individual recovers. Covered treatments are subject to prescription drug copays and any applicable health provider copays or coinsurance requirements.

Coverage For Sober Living Houses

Sober living houses may be covered under the Direct Bronze 2500 insurance policy. Sober living homes are structured environments that provide a substance-free living environment for those who are recovering from a substance use disorder. To determine if a sober living home is covered, speak with the specific facility.

Tufts Health Plan Direct Silver 2000

  • Yearly Deductible: $2,000
  • Out-Of-Pocket Maximum: $7,350
  • In-Network Copay: copay amounts range from $30 to $1,000
  • Out-Of-Network Copay: emergency room visits, ambulance transport, and urgent care are covered

Drug And Alcohol Detox Coverage

Drug and alcohol detox services may be covered under the Tufts Health Plan Direct Silver 2000 insurance policy. Covered inpatient or outpatient services may be assessed a copay or coinsurance amount.

Inpatient Rehab Coverage

Inpatient rehabilitation at a residential addiction treatment center is covered under the Tufts Health Plan Direct Silver 2000 insurance policy. Inpatient treatment is either classified at short-term (30 days) or long-term (90+ days). Individuals must pay a $1,000 copay per visit. There is no preauthorization requirement.

Outpatient Rehab Coverage

Outpatient drug and alcohol rehabilitation is covered under the Direct Silver 2000 policy. Provider visits are assessed a $30 copay for the first 12 visits per the calendar year. If additional visits are needed, preauthorization is required.

Coverage For Medication-Assisted Treatment

The Direct Silver 2000 health insurance policy may cover medication-assisted treatment, which involves taking a prescribed medication to help control withdrawal symptoms and cravings. Individuals may be assessed a copay for physician visits, as well as copays for the medications.

Coverage For Sober Living Houses

Sober living houses may be covered under the Direct Silver 2000 plan. These are residential facilities that help people to continue their recovery from substance use disorder. To determine if a sober living home is covered, call the specific home and have them verify insurance coverage. The health insurance provider can also be contacted to verify that the facility is in-network.

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

Insurance providers such as Tufts Health Plan typically designate providers as either in-network or out-of-network. When a provider is in-network, they have an agreement with the insurance company to provide services at specific rates and to accept the insurance policies. This results in lower out-of-pocket expenses for the covered individual.

When a healthcare provider is not in the insurance company’s network, it means there is no agreement or contract with the insurance company, and they may not accept the health insurance plans. This results in higher out-of-pocket expenses for the individual.

How To Find Drug And Alcohol Rehab Centers That Accept Tufts Health Plan

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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