Will My Presbyterian Insurance Cover Drug Rehab?
Presbyterian Healthcare Insurance is insurance coverage mainly provided in New Mexico. However, individuals with Presbyterian policies that cover out-of-network costs can enroll in addiction treatment at Elevate Addiction Services.
Addiction treatment services typically covered by Presbyterian Health Insurance, include:
- individual substance use disorder (SUD) therapy
- intensive outpatient programs (IOP)
- medical detoxification
- one-on-one, group, and family therapies
Insurance Plans Offered by Presbyterian
While all Presbyterian plans cover emergency care services wherever you are, not all plans will cover non-emergency services such as drug and alcohol rehab.
Policies offered at Presbyterian are designed to fit both your health situation as well as your wallet.
Individual and family plans from Presbyterian include:
- Platinum – offers the lowest out-of-pocket costs and the highest monthly premium.
- Gold – offer lower monthly premiums from platinum plans and slightly higher out-of-pocket costs.
- Silver – offer lower monthly premiums and higher out-of-pocket costs than Gold and Platinum plans.
- Bronze – has the highest out-of-pocket costs and lowest monthly premiums of all plans.
Finding the Right Addiction Treatment for Your Needs
Suppose your Presbyterian insurance plan covers out-of-network non-emergency services. In that case, you will need a referral from their primary care provider and prior authorization that states their substance abuse treatment is medically necessary.
In most cases, individuals will find that their provider network’s treatment options are more likely to receive more insurance coverage than out-of-network treatment services. However, not all treatment programs are created equally, and sometimes receiving treatment at an out-of-network center can be more influential to your recovery.
Things to Consider When Choosing an Addiction Treatment Program
Individuals considering addiction treatment will want to think long and hard about their situation and choose a treatment program accordingly. Anyone who has experienced the following may want to consider an inpatient treatment program:
- prior relapse
- addiction to more than one substance
- dual diagnosis of substance use and mental health disorders
- struggling with substance abuse for more than six consecutive months
Inpatient programs are designed to assist people with the above issues in a safe and helpful manner. If someone has not experienced any of the above factors, it may be easier to enroll in an outpatient program for greater flexibility and less cost.
How to Cover Costs that Your Presbyterian Insurance Doesn’t Pay For
Typically, most insurance companies will require someone to pay some portion of their addiction treatment out-of pocket. Some common fees to think about include:
- your deductible – your out-of-pocket cost before your insurance will kick in their percentage of the coverage offered on your plan.
- your coinsurance – this is the amount of treatment cost that is not covered by your policy. For example, if you have an 80/20 plan you will need to pay the 20 percent not covered by your insurance.
- your copay – A copay is different from coinsurance in that it is a predetermined amount, not a percentage. Individuals will need to review their policy details to see if this is applicable to their situation.
Verify Your Health Insurance Plan & Find Holistic Addiction Treatment
You can verify your Presbyterian Health Insurance for free on our website. Once you have submitted your information, a member of our admissions team will reach out to you and explain how your insurance applies to treatment at Elevate Addiction Services.
At Elevate, we believe in treating the whole person, not simply their addiction symptoms. Our holistic treatment focuses on each part of an individual: mental, physical, and emotional health.
Learn more about how your Presbyterian Healthcare insurance can be used to cover addiction treatment by calling us today.
This page does not provide medical advice
Written by Elevate Addiction Services | © 2022 Elevate Addiction Services | All Rights Reserved