Delaware Affordable Healthcare Insurance Coverage
Health insurance is one of the resources that can help you pay for the cost of addiction and/or mental health treatment in Delaware. You can find plans offered through the Affordable Care Act in your state that will cover these types of treatment. Aetna and Highmark Blue Cross Blue Shield are two well-known insurance companies that offer plans through the marketplace in Delaware.
Choose your plan based on the coverage it offers, as well as how much you will need to pay. Bronze and Silver plans cost less but have higher deductibles, while Gold and Platinum are the opposite. We give you an idea of plan options in your state below. Once you choose a plan, check whether it will cover detoxification, holistic treatment, wilderness programs, or other types of care you might need or want for a successful recovery.
Under Aetna, one Bronze choice is the DE Aetna Bronze $15 Copay PPO plan. This plan allows you to go to providers inside or outside the network, with a deductible of $6,850 for an individual who stays in the plan network. This plan requires a 0 percent coinsurance for both entering an inpatient facility and entering an outpatient rehab program when you visit a network provider. If you have your heart set on a provider or facility outside the network, expect to spend a 50 percent coinsurance.
At the Bronze level, you could instead choose a BCBS (Blue Cross Blue Shield) plan. One is the Highmark Delaware Bronze Shared Cost Blue EPO 6000 plan, which has a deductible of $6,000 for an individual. This EPO plan only covers network facilities and professionals, with a 10 percent coinsurance required by you for inpatient and outpatient care. You need to get preauthorization for your treatment.
An Aetna Silver level option is the DE Aetna Silver $10 Copay PPO plan. This plan comes with a $3,500 individual deductible for in-network care. If you stay in your plan’s network, you pay a $75 copay for each outpatient visit, with no deductible required, or a $500 copay for an inpatient admission and a 30 percent coinsurance for the inpatient treatment. Outside the network, both types of treatment cost a 50 percent co-insurance, and you need precertification for inpatient care.
A Silver Highmark BCBS plan is the Highmark Delaware Blue Cross Blue Shield Shared Cost 3100 plan, which is an EPO plan with a $3,100 individual deductible. On this plan, you would pay a $50 copay for each outpatient visit for mental or behavioral health. If you’d rather receive inpatient care, you would be expected to pay a 25 percent coinsurance. This plan does not cover out-of-network providers, and you need preauthorization for both inpatient and outpatient care.
A Gold option under Aetna is the DE Aetna Gold $10 Copay PPO plan, which has an individual, in-network deductible of $1,400. For in-network care, you pay a $40 copay for each outpatient visit, with no deductible, or a 20 percent coinsurance if you enter an inpatient facility. Outside the plan network, both types cost a 50 percent coinsurance, plus you need to get your inpatient care pre-authorized outside the network or you face a fee.
A Gold BCBS option is the Highmark Delaware Blue Cross Blue Shield Health Savings 2100 plan, which is an EPO plan with a health savings account. Your individual deductible would be $2,100 on this plan. With this plan, only in-network facilities and professionals are covered, and the treatment comes with absolutely no cost to you. Nonetheless, you need to get your treatment approved in advance, whether you prefer inpatient or outpatient care.
You could also get the highest Platinum plan coverage through BCBS in this state. This company offers the Highmark Delaware Shared Cost Blue EPO 300 plan, which is an EPO plan with a $300 deductible for individuals. On this plan, only the in-network care is covered. You would pay a $20 copay each time you go for an outpatient visit or a 10 percent coinsurance when you enter an inpatient facility. You need authorization before you begin treatment.