Rehab Centers That Accept Physicians Plus Insurance
A person with Physicians Plus Insurance may have insurance benefits that cover drug and alcohol addiction treatment. These services could include detoxification and inpatient and/or outpatient care. Individuals who are addicted to opioid drugs, such as heroin or prescription painkillers may have coverage for medication-assisted treatment for opioid use disorders.
What Is Physicians Plus Insurance Insurance?
Since 1986, Physicians Plus Insurance, a managed care organization, has been offering a wide range of comprehensive health insurance options to individuals and employers alike. In fall of 2018, Physicians Plus along with Unity Health Insurance and Gundersen Health Plan will be integrated into the Quartz brand. Quartz is an insurance carrier that has Medicare offerings in addition to individual, family, and group plans.
Currently, about 65,000 members located in south central Wisconsin have insurance coverage through Physicians Plus. For these individuals and their families, this coverage may mean the difference between a continued life of addiction and expanded addiction treatment options that provide hope and a chance for sobriety.
Does Physicians Plus Insurance Provide Services For Substance Abuse Treatment?
Typically, insurance providers have guidelines that limit the amount and/or type of treatment a person receives through their insurance. This information may change the length and type of program a person is able to enroll in, depending on their financial circumstances.
An insurance plan may limit the number of days a person is able to receive coverage for or they may put a cap on the dollar amount that is covered each day. Other benefit plans may outline that only a certain percentage of the total cost is covered. Understanding these guidelines can help a person to get the most out of their insurance. It can also give them a more clear idea of what amount they may have to pay out of pocket.
This doesn’t mean that a person has to receive treatment only for the number of days or amount that is covered. If a person wishes to enroll in a treatment program that is longer or more expensive, they can do so if they have other financial means that can help them pay for the additional cost.
While cost is surely an important concern, a person’s treatment needs and goals should be strongly considered when choosing a treatment program. Research has shown that treatment lasting three months or more produces the most favorable outcomes in most individuals.
If a person’s insurance plan does cover addiction treatment, certain restrictions may apply. In addition to this, the exact amount a person will be responsible for paying could be influenced by a plan’s copays, coinsurance, deductible, and out-of-pocket maximum. Knowing these amounts can also help a person to have a more definitive idea of what their personal contribution may be.
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Does Physicians Plus Insurance Cover The Cost of Outpatient Substance Abuse Treatment?
Physicians Plus Insurance may provide benefits that include coverage for outpatient addiction treatment.
Outpatient treatment has a number of roles in addiction treatment. While some people do find sobriety using outpatient treatment alone, this service is often more beneficial when used in a different way.
Outpatient treatment may be a good option for a person who has experienced a mild relapse or a person who fears they are getting close to one. Other people prefer to use outpatient treatment as a way to brush up on recovery principles after they’re been successfully sober for a period of time. In addition to these options, outpatient treatment plays a vital role in addiction aftercare directly after inpatient treatment ends.
When used as a follow up to inpatient treatment, traditional outpatient and intensive outpatient programs can act as a step-down service. This means that these programs help a person to transition and adjust to daily living after the structured life of residential treatment. If covered, the way outpatient treatment can be used will be determined by each plan.
Does Physicians Plus Insurance Cover The Cost Of Treatment At An Inpatient Rehab Center?
Physicians Plus Insurance benefits may cover services for inpatient alcohol or drug addiction treatment. This coverage could include inpatient detoxification or residential treatment, or a combination of both. The exact benefits and amounts covered will vary per each person’s plan.
Every person facing recovery from drugs or alcohol has different treatment needs. In many cases, these needs are best treated in an inpatient drug rehab center. Insurance coverage can help a person to realize these needs to the fullest of their ability.
While short-term and outpatient treatment programs are typically less expensive, these aren’t necessarily the best options for a person’s treatment needs. While these options can help a person get sober, they may be better for a person who is looking to work through relapse. Because of this, many individuals find greater success in an inpatient residential drug rehab program.
In addition to short-term, 28 to 30-day programs, inpatient addiction treatment may also be:
Certain drugs form strong physical dependencies, a state that can be treated in an inpatient detoxification program. Here, dependencies to alcohol, benzodiazepines and opioid drugs (like heroin, fentanyl, and prescription painkillers) are commonly treated by medications to reduce and alleviate withdrawal symptoms.
Inpatient treatment centers generally offer a more diverse selection of treatments and therapies. Individuals typically have more time to engage themselves in behavioral therapies and counseling sessions, giving them a better opportunity to learn coping and relapse prevention skills. These treatments are further enhanced by the residential setting of inpatient treatment.
Living on campus at a treatment facility helps a person to focus on their recovery without the distraction of day-to-day life that is often present in outpatient treatment. This environment also gives a person greater opportunity to interact with peers and addiction specialist who offer guidance, inspiration, and accountability.
In addition to this, many inpatient drug rehab centers offer specialized addiction treatment programs that provide even more individualized care. These options include dual diagnosis treatment, gender-specific (men’s- and- women’s only) and religious or faith-based programs.
Does Physicians Plus Insurance Cover the Cost of Suboxone?
Physicians Plus Insurance may cover Suboxone for its members, however, in certain cases, there may be limits and restrictions that specify how the brand and generic versions of the drug can be prescribed to a patient. Both the Suboxone film of varying dosages and a buprenorphine/naloxone combination medication listed as a Suboxone tab equivalent are listed on various Physicians Plus Insurance formularies.
A drug formulary lists medications that are covered by an insurance plan, in addition to any limits or restrictions that may apply, such as a prior authorization. A drug formulary may vary from plan to plan, and the drugs it covers may change. For this reason, exact prescription drug coverage can only be determined by the insurance carrier. A good treatment facility will work with a person to determine what these benefits are.
Suboxone is an evidence-based medication for the treatment of opioid use disorders. Suboxone is commonly used in medication-assisted treatment programs to reduce or stop opioid drug abuse. When used this way, Suboxone is supported by counseling and behavioral therapy to address both the physical and psychological impacts of addiction.
Suboxone is a combination drug of naloxone and buprenorphine. Buprenorphine targets symptoms of the opioid use disorder by reducing cravings and withdrawal symptoms, while naloxone reduces the possibility of drug misuse and abuse. Due to these properties, Suboxone is frequently used in medically supported detoxification programs to help ease a person off their opioid drug of abuse.
In order for a person to receive coverage for Suboxone, a prior authorization may have to be submitted on their behalf. This means that the prescribing doctor submits the reason for the medication’s prescription (addiction) and evidence as to why the treatment is necessary. Once a prior authorization request is approved, the medication can be dispensed as part of a person’s treatment plan.
Does Physicians Plus Insurance Cover the Cost of Methadone Maintenance?
Methadone is also an evidence-based approach to treating opioid use disorders. Like Suboxone, it can be used to reduce or alleviate cravings and other symptoms of opioid withdrawal. It’s also used in medication-assisted treatment as a maintenance medication. This means that it’s prescribed beyond the time a person detoxes to help them reduce opioid abuse or maintain long-term abstinence.
Methadone has a higher potential for abuse and addiction than does buprenorphine, and for this reason, its use has more restrictions. Only opioid treatment program certified by the Substance Abuse and Mental Health Services Administration can administer methadone. Some treatment facilities prefer Suboxone or other buprenorphine-based medications because of this abuse liability.
Finding A Rehab Center That Accepts Physicians Plus Insurance
When a person’s in need of treatment, time matters. Understanding the scope of a person’s insurance benefits can help to speed up this process and get a person in the right treatment program faster. Even if a person’s treatment center of choice isn’t considered in-network, their coverage may still provide partial assistance within their out-of-network benefits package.
Using insurance benefits to obtain quality, comprehensive addiction treatment can give a person greater treatment options. Instead of being limited to only what a person can afford out of pocket, a person may have a larger number of options if they use insurance and other forms of payment assistance.
In addition to insurance, the following options may help a person afford addiction treatment:
- help from loved ones
- scholarships or grants
- treatment financing
- sliding fee scales
- personal loans
- medical credit cards
Our highly trained addiction specialists can help a person or their family to determine exactly the best way to make their insurance and other resources work for them.
Contact Rehabcenter.net for more info on addiction treatment programs that take insurance.
Additional resources from RehabCenter.net:
- Alcohol And Drug Rehabs That Accept Aetna Insurance
- Alcohol And Drug Rehabs That Accept Blue Cross Blue Shield Insurance
- Alcohol And Drug Rehabs That Accept Cigna Insurance
- Alcohol And Drug Rehabs That Accept Humana Health Insurance
- Alcohol And Drug Rehabs That Accept United Healthcare Insurance