PHCS Insurance Coverage for Drug & Alcohol Rehab Treatment

Are you or a loved one considering attending rehab for drug or alcohol use? Is the cost keeping you from seeking treatment? Recovery from drug or alcohol addiction is hard work, and your chosen recovery center can make a difference in your healing. Find out how Private Health Care Systems (PHCS) Insurance will cover the recovery cost of attending Resurgence Behavioral Health and how insurance works for rehab programs below.

What Is PHCS Insurance & How Does It Work?

The MultiPlan PHCS network is the nation’s largest and most comprehensive independent Preferred Provider Organization (PPO) network. This network offers access in all states, including more than 700,000 healthcare professionals, 4,500 hospitals, and 70,000 ancillary care facilities.

 PHCS Insurance contracts with thousands of care providers nationwide, including doctors, labs, hospitals, pharmacies, and other services. These care providers are “in-network”; these care providers have agreed with PHCS to provide specific services at a specific cost. Resurgence Behavioral Health is an in-network care provider for PHCS Insurance, meaning you don’t need to get approval like you would for an out-network facility. Out-network means that the care provider will bill you what they charge for the service, usually more than in-network, and PHCS will pay what they deem the service to be worth, leaving you to pay the balance. Out-network also means that you might need to secure pre-approval for the treatment and file your claim rather than the provider taking care of that for you.

What are PHCS Types of Plans?

The PHCS and MultiPlan networks are medical doctors and facilities that health plans use to provide a broader choice of healthcare providers offering discounted services to their members. MultiPlan does not provide insurance, administer benefit plans, or pay claims to doctors or facilities. Instead, the MultiPlan Network is a nationwide complementary PPO network.

Rehab Facilities That May Accept PHCS 

Suppose your health insurance is with PHCS. In that case, the good news is that Resurgence Behavioral Health accepts PHCS as a key out-network drug and alcohol rehabilitation service. This will make finding the treatment you need much more accessible than with another out-network provider. We have years of experience dealing with insurance companies and will gladly help you navigate the administrative process of accessing care. Call us at 1-855-458-0050 to verify your insurance; our admission specialists are standing by 24/7 to answer your questions about treatment. 

Does PHCS Insurance Cover Rehab Treatment?

PHCS Insurance will cover rehabilitation treatment. The affordable care act mandates that all insurers treat mental health and addiction as essential services. PHCS Insurance is required by law to cover part of the rehab cost. In some cases, you may need to secure a referral from your primary doctor or a letter stating that rehab is a medical necessity. The total amount covered varies; PHCS has hundreds of plans that differ from state to state. 

How to Check Your PHCS Insurance Coverage

As PHCS is not a health insurance company, you’ll want to check with your employer’s HR or health insurer directly to see your benefits. Suppose your insurance card has the PHCS logo. In that case, your health plan is most likely utilizing the MultiPlan Network to give you access to an additional choice of providers that have agreed to offer a service discount.

What Does PHCS Insurance Cover?

PHCS Insurance covers comprehensive coverage for treating substance use disorders, also known as addiction. This means that a wide variety of therapies are included in what they will provide coverage for, such as

• Cognitive Behavioral Therapy
• Dialectical Behavioral Therapy
• Rational Emotive Behavioral Therapy
• SMART Recovery
• Medication Assisted Therapy
• Therapy for co-occurring disorders

Cognitive behavioral therapy is an umbrella term in which many different kinds of therapies exist, of which PHCS Insurance will also cover a portion.

Does PHCS Insurance Cover Mental Health & Substance Abuse Treatment?

Many Americans with substance use disorders also have co-occurring mental health disorders. Almost half of people with addiction also have illnesses such as depression, anxiety, bipolar disorder, schizophrenia, and PTSD. It is critical to treat both substance use and mental health disorders at the same time for therapy to be effective. PHCS Insurance is mandated to cover all mental health problems, including substance use. Therapists and doctors will work with you to assess for co-occurring health problems and provide treatment.

Does PHCS Insurance Cover Inpatient Rehab?

Inpatient treatment at Resurgence is our most intensive program, requiring you to live at our treatment facility. Inpatient rehab is also the most costly treatment; your care team will work with you and the insurance company to determine if an inpatient program is right for you. PHCS Insurance will cover the cost of inpatient treatment based on factors such as age, substance use, and length of use. Inpatient treatment programs allow you to focus solely on healing without the distractions of living, such as work and school.

Does PHCS Insurance Cover Intensive Outpatient Rehab?

PHCS Insurance will cover an Intensive Outpatient Program (IOP). An IOP is a good choice for anyone experiencing less severe symptoms of addiction, completing around 9-20 hours of therapy a week. An IOP can be scheduled around work, school, or family obligations.

Does PHCS Insurance Cover Partial Hospitalization?

PHCS Insurance will also cover Partial Hospitalization Programs (PHP). A PHP will have you attend treatment at the facility during the day but return home or to a sober living residence at night. You can expect at least 20 hours of therapy per week on a PHP program.

How Long Will PHCS Insurance Cover Rehab?

Rehab stays are divided into 30, 60, or 90-day increments. Your care team will recommend how much time you should spend in treatment, increasing the duration as needed. PHCS will cover these periods based on national care models from Substance Abuse and Mental Health Services Administration (SAMHSA).

PHCS Insurance May Offer Treatment Coverage for the Following Addictions: 

• Addiction to alcohol (alcoholism)
• Addiction to illicit drugs
• Addiction to prescription drugs
• Co-occurring disorders
• Trauma-related disorders
• Mental health disorders

PHCS Insurance offers comprehensive coverage for many types of addiction and mental health disorders.

What are the Options if PHCS Insurance Does Not Cover the Cost of Rehab?

Insurance companies are bound by law to cover costs when treating addiction. You may need to provide a letter of medical necessity from your primary doctor for them to pay for rehab. You may also need to file an external appeal if they refuse to cover rehab costs. If you are struggling with your insurer, contact the state representative for insurance law compliance. If you can’t wait for these administrative processes, contact the rehab center you wish to attend, many have payment plans or private financing. You are unique in this world and irreplaceable. Drug and alcohol use is hard on the body; every day you wait for treatment is a risk of injury and death.

Verify Your Insurance with Us

Using Resurgence Behavioral Health to verify your insurance is quick and easy with our online form. We will gladly help you navigate the administrative process with your insurance company, and we have years of experience doing so. 

Next Steps with Insurance Coverage for Rehab Treatment with Resurgence Behavioral Health

Give the people who love you peace of mind knowing that you are safe and under medical supervision at Resurgence. It would be an honor for us to help you achieve sobriety. Many of our staff were once in your place, unsure if a change is possible, and now dedicate themselves to helping others recover from drug and alcohol use. Our facility is bright, spacious, and comfortable, with high-end furnishings and amenities like a private chef. We genuinely care about your success; you’ll never feel like a number or like you’re in a hospital when in treatment. You are capable of change, of choosing a different life for yourself. You must make the first step on your road to recovery; the time for change is now. Call us at 1-855-458-0050 to unlock your new way of life.