• Is Free Inpatient Drug Rehab Possible Under HMO Insurance?

    May 12, 2017 | jferrara86
  • You may feel compelled to attempt dangerous alternatives like at home or cold-turkey detox.¬†Even other programs offered by organizations with questionable qualifications. These are often not evidence based. Some people give up on the idea altogether. What they may not know is that there are several alternatives available, to access free inpatient drug rehab.

    The emotional, physical, and financial cost of addiction can be a real struggle. When money is scarce, the idea of entering a treatment program can seem impossible, because… well, money is simply not available.


    Paying for Rehab


    For people seeking treatment for addiction, there are several options available to pay for treatment services. Private and public health insurers can compensate a portion of the expenses incurred under inpatient or outpatient treatment. Regardless of the type of addiction. When considering the right type of rehab for addiction, it’s best to determine whether inpatient or outpatient treatment is the better choice. Knowing as much as possible about these forms of treatment centers will ensure the decision you make will work best for you.

    The most popular way to help cover for rehab and addiction treatment is utilizing health insurance, which can significantly reduce the costs, and sometimes provide full free inpatient drug rehab. Many private HMO and PPO plans can reduce the hassle and expenses associated with recovery.

    money from free inpatient drug rehab

    Make it rain money from free inpatient drug rehab


    Addiction Treatment Insurance For Free Inpatient Drug Rehab


    These days, insurance companies do understand addiction in its truer essence; a medical condition that is very treatable. The insurers essentially take the responsibility of covering for the cost of addiction treatment. Since they recognize the negative effects that substance abuse and specific behavioral addiction on the physical and psychiatric health of a person.

    Now healthcare providers look at addiction rehab as a precautionary medical concern. In turn they provide insurance that ideally covers addiction treatment. It’s more economical for them and beneficial to thwart the impact of long-term addiction, than to pay when the problem has aggravated some time later.

    With the right insurance plan in hand, you can receive exceptional medical care with free inpatient drug rehabilitation, or at a price that won’t empty your savings. However, having the wrong plan can be quite costly and even leave you with some questionable coverage with unclear terms on what is allowed under the plan and what’s not. For individuals, both HMO and PPO insurance offer the coverage needed for addiction rehab and treatment.


    Managed Care Plans


    About 31% of Americans are covered under some sort of HMO. In case you are under this category, it is very important to know the workings of a typical HMO plan. In general, HMO operates through managed care, and they contact you directly via healthcare operators like doctors, and hospitals. They ideally provide a network of services that all the members of the HMO can utilize for their medical needs.

    Under most HMO plans, rehab services are available, though restrictions might apply, and therefore make the process of getting recovery and other services difficult. Such limitations include:

    • Rehab facilities available for use
    • Restrictions on out-of-care network
    • Having to convince a primary care physician on the necessity of treatment
    • Healthcare recommendations made by your physician are reviewed by the HMO administration


    You will be ideally assigned to a doctor who will oversee your treatment process with an HMO plan. The doctor provides much of the care you need, and will use the healthcare professionals that are already under the HMO’s network of contracted partners. While the payment of the care and treatment is kept low, you will have to pay some small deductibles and some co-payments.

    Rehab services working with a HMO might have many different results depending on the services that you find available. When the HMO are partners with the treatment facilities, your primary care physician should recommend you some specialty treatment before you are allowed to enter a rehab center.

    When a physician recommends you for addiction treatment this is only the first step toward¬†your rehab treatment journey. Keep in mind that the HMO might still do a review of the physician’s recommendation before you are allowed to receive your treatment, to decide if the treatment is really necessary. This review might deny you treatment, though appeals to challenge such a denial are generally available to HMO members.

    Outside state-run organizations can help with independent reviews in case an appeal is denied. These are limited to rejections for medical reasons and not necessarily contract restrictions. For the HMOs that don’t have existing rehab partnerships, the process is significantly more difficult, but it’s still possible.

    The main advantage of working with an in-network program is that the HMO plan maintains strict quality and cost controls with its contracted providers, who are usually contracted by the government to offer services sanctioned by the accreditation and government agencies.


    Out-of-Network Care


    If your HMO doesn’t have an addiction treatment center or rehab partnership, you may need to pursue an outside HMO network in order to receive your treatment. Of course, your results will differ when you go outside the HMO network, depending on the specific HMO under which you are insured. The contracted partnerships are ideally ways to save on the costs of medical care, with medical care providers often charging the HMO significantly less than they would charge a patient directly.

    If you decide to go outside the network, the HMO has no contracted billing arrangements with the rehab or addiction treatment center. This means that the price can be considerably higher than you would pay under a partnered facility. In case you are wondering how to find the right rehab facility in your area, it’s always advisable to speak to a knowledgeable operator, to match your list of rehabilitation needs with a list of rehab programs and facilities.

    The HMO can handle the higher cost incurred in two ways. The HMO can decide to pass on the difference in price to you, and still charge you a higher deductible, copay, or coinsurance rate. Alternatively, the HMO may decide not to cover the out-of-network medical care or the cost of rehab at all, and leave you to pay the total on yourself. If you have insurance and feel the need to talk to someone call our number at 732-333-6275 to talk to an insurance and medical professional that can place you in the right care.