When people consider whether or not they should enroll in an addiction treatment program, they may wonder whether they can afford it. Those who have this concern might imagine that the only way to find addiction treatment is to pay the full cost completely out of pocket. However, many insurance plans, including Bright Health, might be able to cover the cost of all or part of an addiction treatment program. Further, several addiction treatment centers accept payment from Medicare and Medicaid. Ultimately, you have many options for receiving addiction treatment.
Bright Health Insurance offers coverage to those in Arizona. If you are enrolled in Bright Health Insurance, you may receive coverage for an addiction treatment program. One example of a Bright Health Insurance plan is called the Bright Health HMO. If you want to learn more about your options for addiction treatment coverage through Bright Health Insurance, please call us today at 623-335-0909.
Bright Health HMO has three tiers of coverage: Bronze, Silver, and Gold. In general, the Bronze plan offers the least amount of coverage. However, those on the Bronze plan pay the lowest monthly payment. Further, Gold plans often require the highest monthly payment. However, they offer the most amount of coverage. Finally, Silver plans fall somewhere in the middle. They have average coverage and average monthly payments. Each of the tiers of the Bright Health HMO may cover substance abuse treatment. But copays, deductibles, and/or coinsurance may apply.
HMO vs. PPO
If you are enrolled in Bright Health Insurance, you will also either have an HMO or PPO plan. Although it can be easy to get lost in all the insurance jargon, the difference between an HMO and a PPO is fairly simple.
Here are some characteristics of an HMO:
- HMO stands for Health Maintenance Organization.
- HMOs have a network of hospitals, medical centers, and primary care physicians.
- To be covered by an HMO, you will need to choose your physician within network.
- If you need to see a specialist, you will need to receive a referral from your primary care physician.
- Typically, HMO plans have lower monthly premiums.
- You can also expect to pay less out of pocket.
- You rarely have to file a claim for an HMO plan.
Here are some characteristics of a PPO plan:
- PPO stands for Preferred Provider Organization.
- You still have a network of physicians and healthcare centers, but you don’t need to stay within your network.
- Because PPOs have more flexibility, their monthly premiums and deductibles are usually higher.
- You may have to pay a doctor directly and then file a claim if you have a PPO plan.
Both of these plans can provide excellent coverage and stay within your budget. However, if you ultimately value flexibility the most, you will likely choose a PPO plan. If you value savings the most, you will likely choose an HMO plan.
Medicare and Medicaid in Arizona
If you do not have private insurance, you may feel that addiction treatment is out of your reach. However, there are many options for addiction treatment. For example, many treatment centers accept Medicare and Medicaid. In Arizona, there are 401 addiction treatment centers. 202 accept Medicare, 285 accept Medicaid, and 194 of them accept both. No matter what insurance you have, you can find a treatment center that is right for you.
Information on Medicare
In 1965, the United States Department of Health and Human Services established Medicare. Briefly, Medicare provides insurance coverage for elderly people and others who qualify. Medicare serves those who are 65 or older, some younger people who have disabilities, and people who have End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure that requires dialysis or a transplant. Further, Medicare offers services in the following parts:
- Hospital Insurance, Medicare Part A
- Medical Insurance, Medicare Part B
- Medicare Advantage, or all-in-one coverage, Medicare Part C
- Prescription drug coverage, Medicare Part D
Coverage of Inpatient, Outpatient, and Residential Treatment
While Medicare does not have a section dedicated to providing addiction treatment, people can receive coverage through Medicare for such treatment. Potentially, Medicare can cover inpatient, outpatient, and residential treatment. Coverage often depends on the provider and the treatment center. The following are brief explanations of these types of treatments.
Inpatient treatment takes place at a hospital or clinic. During this type of program, the patient lives at the place where he or she receives treatment. Usually, inpatient treatment is the most intensive of all the program options.
Outpatient treatment allows patients to live at home while receiving treatment. Normally, patients receive treatment for 3-4 hours each day. Outpatient treatment works well for those who have mild to moderate addictions.
Residential treatment is a mix of inpatient and outpatient treatment. In residential treatment, patients live in a community with other people also undergoing treatment. They travel together to the treatment center. This allows patients to have separation between their home life and their treatment. However, they also get to live in a community with other people who are going through something similar.
Medicaid for Arizona
Millions of people in the US receive healthcare through Medicaid. Primarily, Medicaid serves those who are economically disadvantaged. People with disabilities, pregnant women, children, and adults can all receive coverage from Medicaid. Through Medicaid, people can receive care who would not otherwise have the means to do so. States administer Medicaid, and the program is funded by states and the federal government.
In Arizona, those who don’t have insurance through a private company have several different options for treatment. For example, Arizona has a program called Arizona Health Care Cost Containment System (AHCCCS). AHCCCS was founded in 1982 and is is Arizona’s Medicaid program. In essence, AHCCCS is a federal healthcare program with funding by both federal and state governments. People can qualify for AHCCCS based on their income level.
How to Find Information
Substance abuse treatment options are commonly found in behavioral and mental health sections of insurance company websites. If you are looking for a specific facility, check your insurance company’s website to make sure the provider is covered by your plan. Many facilities in Tennessee offer payment assistance and/or offer their services on a sliding fee scale.
Find the Right Treatment for You
Ultimately, you have plenty of options for treatment no matter what type of insurance you have. One of your options for insurance is the Bright Health HMO from Bright Health Insurance. This plan offers three tiers of coverage: Bronze, Silver, and Gold. First, Bronze plan has the least amount of coverage and the lowest monthly payment. Second, the Gold plan is the opposite. This plan has the highest monthly payment and the most coverage. Third, the Silver plan falls somewhere in the middle. Each of the tiers of the Bright Health HMO has the possibility of covering addiction treatment. However, copays, deductibles, and/or coinsurance may still apply.
Further, those who are enrolled in Medicare or Medicaid may also have options for receiving treatment. Medicare often offers coverage for inpatient, outpatient, and residential treatment. Arizona has 401 addiction treatment centers. 192 of these addiction treatment centers accept both Medicare and Medicaid as payment. Additionally, several addiction treatment centers offer treatment on a sliding fee scale. In these cases, the treatment center accommodates the price of services to match the patient’s income level. Regardless of what type of insurance you have, you will be able to find an addiction treatment program that is right for you. If you have any questions about payment or insurance coverage for addiction treatment, please call today at 623-335-0909.