Wisconsin Affordable Healthcare Insurance Coverage
The citizens of Wisconsin who need drug rehab have the benefit of over 80 different affordable healthcare plans thanks to the Affordable Care Act. For those considering treatment for alcohol or drug addiction, insurance can help shoulder some of the cost. Finding the right plan will help you decide what treatment is best for you and your health situation.
Of the four companies in Wisconsin, Unity offers the most policies. They currently have five Bronze, nine Silver, five Gold, and six Platinum plans for the state. Bronze plans typically have high deductibles and lower monthly premiums with deductibles that range from $6,300 to $6,600 per year. All plans are HMOs, meaning you must work through a primary care physician and utilize in-network care.
For most of the Bronze level plans, you pay a copay of outpatient care, but Unity covers the full cost of inpatient treatment after you meet the deductible. The copayment arraignment is available at any time. The amount of the copayments varies by policy. For example, the Unity Prime Bronze 45/125 Value plan offers a $45 copay while you pay $55 with the Unity Prime Bronze 55/150 policy. The exception is the Unity Prime Bronze HSA plan. With this program, there is no copay. Unity covers both in and outpatient care after you meet the deductible.
The Silver, Gold, and Platinum plans have a different structure for substance abuse treatment. You pay a coinsurance percentage after you meet the deductible. For instance, with the Unity Prime Silver Exclusive Value plan, the coinsurance payment is 50% of inpatient treatment. For Gold plans, your contribution drops to 10 and 20 percent. But the outpatient coverage remains the same and you make a copayment per visit regardless of your deductible.
Another big contender in the Wisconsin insurance market is Dean Health. This company offers both HMO and EPO plans. EPO means you must use a preferred provider for all services including drug treatment. Dean Health offers plans at all levels, but the majority of the programs follow the same basic structure: they all pay 100% of the cost of inpatient treatment after you meet the deductible.
Several of the plans require a copayment for the first three outpatient visits. The amount varies by policy but expect to pay anywhere from $25 to $75 per visit. A few plans add a small coinsurance fee for inpatient care. For example, with the Dean Gold Copay Plus 1000X01 policy, you pay 10% after the deductible and the company covers 90% of the cost. You need to stay in-network for treatment to benefit from the coverage.
The biggest challenge for Wisconsin insurance shoppers is wading through all the options available to you. Take your time and review the benefits offered by each company, so you have the best coverage in place when you get treatment. Don’t hesitate to contact us to learn more about insurance and how it can help you regain lifelong sobriety.