Rehab Centers That Accept Physicians Plus Insurance
Medically reviewed byIsaac Alexis, M.D., AAMA, AMP-BC
April 18, 2019
If you have Physicians Plus insurance, your benefits may help lower the cost of addiction treatment. Services such as detoxification, inpatient rehab centers, and medication-assisted treatment may be covered by your Physicians Plus insurance plan.
Addiction is a disease that can be treated at a quality rehab center. However, it can be difficult to find affordable rehab programs without the use of health insurance. Members of Physicians Plus can use their benefits to reduce the cost of addiction treatment.
Since 1986, Physicians Plus insurance has been providing health care options to people throughout south-central Wisconsin. Their coverage includes behavioral health benefits, such as inpatient or outpatient rehab programs.
Physicians Plus currently provides coverage for about 65,000 people. The exact amount of addiction treatment coverage you have will vary based on your plan.
Does Physicians Plus Insurance Cover Drug And Alcohol Addiction Treatment?
Yes. Physicians Plus insurance is required to cover behavioral health needs and addiction treatment at the same level they cover other medical conditions. This is due to the Mental Health Parity and Addiction Equity Act.
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Depending on your plan, your Physicians Plus coverage may have certain limitations. There may be a maximum number of days that your plan covers treatment or a cap on the dollar amount covered per day.
Some Physicians Plus plans cover an overall percentage of the treatment cost. A Physicians Plus customer care representative will be able to further explain the details of your coverage.
Addiction Treatment Services Covered By Physicians Plus
There are many approaches to addiction treatment, including different levels of outpatient treatment. Each of these unique approaches help people recover from the physical, mental, and social consequences of addiction.
Addiction is a complex disease, and no one approach to treatment is best. It’s important to learn about the different treatment services covered by your insurance, and determine which will be the best fit for you or your loved one.
Drug and alcohol rehab services covered under Physicians Plus plans may include:
- medically supervised detox
- family interventions
- inpatient treatment
- medication-assisted treatment
- outpatient rehab programs
- dual diagnosis treatment
- mental health counseling
To maximize your coverage, Physicians Plan may require that you seek treatment at an in-network provider. You may also be asked to obtain a medical referral from your doctor. This means your doctor will fill out a form that states how treatment is medically necessary.
Medically Assisted Detox
One of the initial stages of treating drug or alcohol addiction is medically supervised detox. This process allows the body to clear itself of toxins, and can take several weeks, depending on the level of usage.
During the detox process, people may experience withdrawal symptoms that can range from mild to severe. Withdrawal symptoms can be physical and psychological, and in some cases, even life-threatening.
Detoxing in a medically supervised environment ensures that patients are kept as safe and comfortable as possible. Many Physicians Plus plans cover detox services, including medication-assisted treatment (MAT).
MAT can ease withdrawal symptoms, and also lessen drug cravings. Long-term use of MAT can also reduce a person’s chance of relapse. Prescription drug coverage through your Physicians Plus insurance may vary, and you may be responsible for a small copay per prescription.
Inpatient rehab centers are residential and provide an intensive level of care. Staying at an inpatient rehab center is often necessary to overcome an addiction. In residential treatment, clients are provided with 24-hour supervision and support.
A rigorous daily treatment structure is also provided. This may include individual counseling, group therapy, and classes on addiction education and sober living skills.
Many insurance plans require pre-authorization in order to be covered for an inpatient treatment program. This means your doctor will likely need to fill out a form stating that inpatient treatment is necessary for your recovery. Prior authorization requirements vary by plan.
Experts agree that spending at least 90 days in treatment is associated with better recovery outcomes. Using your Physicians Plus insurance to help cover the cost of treatment can lessen the financial burden of attending inpatient treatment.
Inpatient programs may be most beneficial for those who don’t have a solid support system, or who suffer from additional physical and mental health conditions. If you or your loved one has tried treatment before and it didn’t work, it may be time to consider an inpatient program.
Treatment specialists will be able to help you figure out the best level of treatment for you. Speak with a Physicians Plus representative to clarify your coverage details.
Once a person has completed inpatient treatment, they may want to consider aftercare support options. These options can include several types of outpatient programs, which are offered on a more flexible schedule.
Outpatient programs often work best when they directly follow inpatient treatment. These “day treatment” options can also work well for those who can’t attend inpatient treatment, due to professional or family responsibilities.
Outpatient programs are usually held in a convenient, public location like a local health department or doctor’s office. Standard outpatient programs may offer treatment sessions twice per week, whereas intensive outpatient programs (IOPs) provide treatment three times per week.
Partial hospitalization programs (PHPs) are the most intensive type of outpatient treatment, and sessions are offered up to five days per week. The amount of coverage Physicians Plus will provide for outpatient treatment may vary by plan.
Using Your Physicians Plus Insurance To Pay For A Rehab Center
Once you’ve become familiar with the different types of addiction treatment, it can be helpful to contact a rehab center directly. Check to see if they take Physicians Plus insurance, and inquire about specific treatment services.
After that, you may want to contact Physicians Plus and see if the rehab center is considered to be in-network. Because Physicians Plus is located in Wisconsin, they may only offer in-network coverage within the state.
Knowing the details of your coverage can help you get the most out of your health insurance. This can ease the process of enrolling in a rehab center.
Frequently Asked Questions About Using Physicians Plus For Addiction Treatment
It can be confusing to wade through the details of your insurance plan, especially when dealing with an addiction. Contacting a treatment specialist and Physicians Plus representative will help you feel more empowered in the decision-making process.
You may find it helpful to have a list of questions on hand, in order to make sure all your concerns are addressed. This clarity will also help you avoid any unexpected costs or fees associated with addiction treatment.
Important questions to ask when using Physicians Plus to pay for treatment include:
- Does my Physicians Plus plan cover inpatient treatment? If so, for how long?
- Do my benefits cover inpatient detoxification?
- Do I need to submit pre-authorization paperwork to Physicians Plus?
- Do my benefits provide coverage for different levels of outpatient treatment?
- Is medication-assisted treatment covered by my plan?
- Am I responsible for any copayments, coinsurance, or meeting any deductibles?
- What am I required to pay out-of-pocket?
- Are there any Physicians Plus forms I need to sign before I am covered for treatment?
How To Find A Rehab Program That Accepts Physicians Plus Insurance
Finding the best treatment center for you or a loved one can be a complicated process. Being prepared with the details of your insurance coverage can relieve some of the stress.
To learn more about rehab centers that accept Physicians Plus insurance, contact one of our treatment specialists today.Article Sources
National Institute on Drug Abuse - Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)