The addiction epidemic has brought to light the fact that addiction treatment is just as much of a medical necessity as treatment for any other health issue. The number of Americans who require addiction treatment has skyrocketed in recent years. This epidemic has raised the issue of making addiction treatment accessible for everyone who needs it. Most health care insurance plans at cover at least a percentage of addiction treatment. If you have a Coventry healthcare insurance plan and are interested in a Pennsylvania rehab center, you may be questioning how your addiction treatment will be covered by your insurance.
Coventry Health Care Insurance’s Coverage for Addiction Treatment
Coventry Health Care Insurance is also known as CoventryOne. It has been the third largest healthcare company in the country since May of 2013, when it was acquired by Aetna. It provides healthcare insurance to groups and individuals. The level of coverage you receive for certain healthcare services is dependent upon your specific plan. There are several different plans you may have under Coventry Health Care Insurance.
- Medicare Plans
- Medicaid Plans
- Employer-Sponsored Plans
- Behavioral Health
The amount of coverage you will receive for rehab is dependent upon your specific plan and the state where you purchased your plan. The Silver plan covers approximately 70 percent of costs. The Gold plan covers approximately 80 percent of costs. Benefits for behavioral health are provided by Coventry Health Care Insurance through the MHNet Behavioral Health subsidiary. MHNet covers a variety of addiction-related services.
- Inpatient Rehabilitation
- Outpatient Rehabilitation
- Acute and Subacute Care
- Prevention and Follow-Up
- Individual and Group Therapy
- Other Mental Health Care
In order for you to use your Coventry Health Care Insurance plan to go to a Pennsylvania rehab, you must obtain a referral for the services that you will need. You will also need preauthorization for most services, which can be obtained online on the MHNet Behavioral Health Care Portal.
The length of time that will be covered will depend upon your plan and individual needs. It is likely that you will be covered for as long as you need to stay in treatment. Your medical experts and support staff in the rehab center will communicate with your insurance provider to negotiate the amount of time in which you will be covered. If your medical experts and support staff think you need to be in rehab for longer than your insurance will agree to cover you, they will most likely allow you to stay on a scholarship basis because they do not want your success in recovery to be derailed by insurance or financial issues.
Almost all of the Coventry Health Care Insurance Plans will cover both inpatient and outpatient rehabilitation. Coverage regarding luxury rehab centers, specialized rehab centers, and out-of-state rehab centers are more of a complex issue. If you live outside of Pennsylvania and/or seeking a luxury rehab center or a specialized rehab center, you should contact Coventry Health Care Insurance and speak to a representative about the specifics of being covered for your desired rehab center. If you live in Pennsylvania and are not seeking a luxury rehab center or a specialized rehab center, your coverage will be a less complex.
Why Health Insurance Companies Should Cover at Least 90 Days of Treatment
Addiction recovery is a process that must be done in three stages. For optimal recovery to be achieved, individuals must be able to take their time in each stage. Though each stage has an average amount of time in which it is completed, certain individuals may take a shorter amount of time or a longer amount of time to complete each stage.
- The Acute Adjustment Stage (30-45 Days)
Addiction is both a physiological and psychological disorder. Taking care of the physiological aspect of it is the first step in the road to recovery. The acute adjustment stage is when your body readjusting to functioning without drugs and/or alcohol.
- The Physical Healing Stage (30-90 days)
This is stage where your body will be repairing itself from the damage that was done by the drugs and/or alcohol. Nutrition, rest, and exercise are essential during this stage to accelerate the healing process.
- The Psychological Healing Stage(More than 90 Days)
This is the stage where you will be confronting the underlying psychological issues that contributed to your addiction. This stage tends to take the longest because it is so complex. Along with confronting the underlying psychological issues, you will be learning how to solve them in ways such as acquiring a new way of thinking and acquiring new coping mechanisms.
The entire recovery process definitely takes more than 90 days. However, an adequate amount of time spent in a rehabilitation center will provide you with a strong foundation for lifelong recovery. Studies have shown that those who stay in treatment for at least 90 days have a 90 percent chance of a successful recovery.
Health insurance companies tend to only cover the acute adjustment stage because that it is time period where the drugs and/or alcohol is detoxified from your system. They fail to address that the recovery process involves much more than detox. Recovering individuals need the help of a rehabilitation center to health themselves physically and psychologically, which takes some time. It would be much easier for those struggling with addiction to achieve a successful recovery if health insurance companies were willing to cover the necessary amount of time for a stay in a rehabilitation center.
Conclusion on Using Your Coventry Health Care Insurance Plan for a PA Rehab Center
Your Coventry Health Care Insurance Plan is definitely useful for covering your stay in a Pennsylvania rehab center. The specific coverage you will receive will depend on your plan, where you purchased your plan, the type of rehab center you are seeking, and whether or not you actually live in Pennsylvania. Though your Coventry Health Care Insurance plan will most likely not cover 100 percent of the costs, it will be a significant help in paying for your treatment and taking the first steps in the road to recovery. Recovery is a priceless gift, so take the first courses of action today by calling us today at 888-380-0342