Maine Affordable Healthcare Insurance Coverage
Health insurance is an important consideration for all people, particularly those with substance abuse problems. Insurance can help these patients afford the care they need to correct their life course and get started back on the path towards health. The coverage provided from plan to plan can vary, however, and patients need to familiarize themselves with their own treatment options so they can maximize their benefits. Here is what all patients should know about their Affordable Healthcare plans in Maine.
Substance Abuse and Affordable Healthcare in Maine
For patients in Maine, there are a number of plans available through the Affordable Healthcare Act. These plans are offered through Anthem Blue Cross Blue Shield as well as Harvard Pilgrim. The plans available are divided into three levels: Gold, Silver, and Bronze. These levels describe the amount of coverage patients can expect from their plans as well as the relative cost of the plan. Gold plans generally have the highest monthly premiums, but they will cover 80 percent of the healthcare costs. Silver plans cost a little less per month, but they cover only 70 percent of the healthcare costs. Bronze plans cost the least each month, but cover only 60 percent of the healthcare costs. They will also have the highest deductibles. Bronze level deductibles currently fall between $4,200 and $6,200 in Maine. Silver level deductibles fall between $1,800 and $4,000. Gold plan deductibles fall between $750 and $1,400. This deductible must be met before the insurance plan will begin to pay for medical care.
For those struggling with substance abuse, it is helpful to know that all plans will offer coverage for both inpatient and outpatient substance abuse and mental health treatment. This give patients the freedom they need to pursue the care required to get started on the path towards recovery. For some patients, inpatient care– with 24/7 supervision and support, intensive therapy and a complete change in environment– will be an important part of achieving sobriety. For others, regular outpatient treatment– while still returning home to a personal support network– will be enough to reach personal goals. The cost for these treatments will vary depending upon the plan. Some plans will charge a copayment, which could be as low as $10 or as high as a few hundred. Other plans will have a coinsurance payment, which will often be between 10 and 40 percent. There are a few plans that will not have any costs outside of meeting the deductible.
Patients needing substance abuse treatment will also need to consider the detox process. This is the process through which patients will rid their bodies of their substance of choice. For some people, it may be accomplished through will power, but most people will need some kind of medical intervention. While some inpatient programs offer detox, many patients might also be able to find the help they need through hospitals. It is important to note that emergency room costs can also vary widely depending upon the plan. Most plans currently offered in Maine will have a $250 copay, although a few have a $500 copay or a 20 – 30 percent coinsurance payment for the emergency room. Emergency room care can be an important step for many patients before they check into a detox program and begin treatment.
It is also common for many patients to need medications to help them through the detox process. These medications can make detox safer and it can lessen the physical discomfort and cravings, giving patients a greater ability to focus on their treatment. All plans will come with a distinct formulary which describes the cost of the different medications. Most plans divide medications by classifications such as generic, preferred or specialty drugs. Patients can work with their provider to see where their needed medications fall and if there are any substitutions that can help lower the cost of the needed prescriptions.
Those struggling with substance abuse should not be afraid to take the first step and get help. Insurance plans will provide coverage for much of the care, alleviating financial stress. Those interested in learning more about their insurance plan and their care options can use the resources on RehabCenter.net to get started.