PPOs and Drug Treatment Coverage

A PPO, or Preferred Provider Organization, is made up of a network of medical professionals and facilities that offer a number of medical services to subscribers. What is special about these arrangements is the fact that they are offered at a reduced rate. Moreover, while typical insurance companies require referrals when visiting physician other than your own, PPOs allow subscribers to consult with any doctor within its network.

Is rehab covered by PPOs?

After detox, the next step of drug treatment involves an outpatient or inpatient program. The Mental Health Parity and Addiction Equity Act of 2008 required both public and private insurance to cover substance abuse disorder treatment. Generally, PPOs do not cover rehab stay, but they are required to treat addiction like any other disease, which means that they cannot impose benefit limitations as compared to medical or surgical benefits.

What’s the treatment length that PPO will cover?

This will depend on your PPO policy. The average length of stay in an inpatient treatment is 30 to 105 days. Those taking outpatient treatments might take longer, often spending more than 120 days. A rehabilitation facility should be able to make a recommendation to your PPO on how long should you stay in a treatment program.

What specialty treatment is part of my PPO?

If you are employed, chances are you do not have a choice when it comes to drug rehab insurance coverage, because your employer makes that decision. This means that if your employer has access to some luxury options, you have some access, too. But before you decide to undergo treatment on some upscale facility, consider checking it with your PPO.

Inpatient vs. Outpatient Insurance

Inpatient and outpatient treatments both have the same goal in mind, and that is to teach you coping skills that you can take with you beyond the treatment. But insurers see them differently, which is why you would want to check with your PPO if it covers the program you want. Before you check in, go through your policy with your PPO to get a deeper understanding on what is and is not covered by your policy.

How to cover what my insurance will not?

If you PPO is unable to cover your entire treatment, there a number of ways you can try to avoid paying a massive amount. A number of rehabilitation centers offer installment plans that divides the total cost into more affordable monthly payments. If this is not available, it is a good idea to speak with the staff before you check in to work out a plan for the balance that your PPO will not cover.

I need help with my PPO. Whom can I talk to?

We at Resurgence know that addictions can be effectively treated, as we help families to recover every single day in our facility. We offer inpatient and outpatient care for addiction and our aftercare approach ensures that you have the tools you need to maintain sobriety when formal treatment is through.

If you need help with your treatment, call us at 855-458-0050 so we can check with your PPO and determine the right treatment for you.