Drug And Alcohol Rehabs That Accept HealthSmart Insurance

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

April 16, 2019

Facing addiction can be a difficult process, as can reaching out for help for a variety of reasons. One of the most common concerns people have about seeking substance abuse treatment is the financial cost.

Many rehab centers in the United States accept health insurance to reduce treatment costs for people in need. If you are insured under a HealthSmart insurance plan, you may be able to use your insurance to help you pay for drug and alcohol rehab.

The path towards recovery can look different for each person but begins by reaching out for help. Finding rehab centers and treatment providers that accept HealthSmart insurance can allow you to focus on your treatment, and not on costs.

Does HealthSmart Cover Drug And Alcohol Rehab?

HealthSmart offers varying levels of coverage for many common substance abuse treatment services. How much your insurance can cover will depend on your plan’s benefits, and can vary based on location.

HealthSmart insurance members may also be responsible for deductibles or copays, depending on the type of service. Other limitations such as length of stay within a rehab center, for instance, may also apply.

Addiction Treatment Services Covered By HealthSmart Insurance

Depending on your HealthSmart plan, your insurance may be able to reduce or cover costs for various treatment services you receive in your journey towards recovery. Prior authorization or a referral from your doctor may be needed by your insurance prior to seeking treatment services.

Addiction treatment services that may be covered by your HealthSmart plan include:

• detox
• inpatient and residential rehab programs
• dual-diagnosis treatment
• mental health counseling
• outpatient treatment
• day treatment programs
• prescription medications

HealthSmart may not cover all types of therapy. Some plans may also pose limitations on how long they will cover treatment services.

The best way to find out what your plan will cover is by checking the policies in your plan. You may also contact a HealthSmart representative or RehabCenter.net treatment specialist who can walk through your options online or over the phone.

Inpatient Treatment

Entering an inpatient program for addiction can be a crucial part of the recovery process. Rehab programs can provide the structure and support many people need following detox to address the emotional and mental aspects of their addiction.

Inpatient treatment programs typically last between 30 and 90 days, but may last longer depending on the needs of the patient. During this time, patients may attend individual counseling, group therapy, and engage in other treatment services that can be beneficial for recovery.

This can include:

• dual-diagnosis (for co-occurring mental health disorders)
• mindfulness techniques
• life skills learning
• family counseling
• psychiatric care
• nutritional counseling
• relapse prevention

The amount of coverage your HealthSmart insurance can provide for inpatient treatment will depend on your specific plan. Some HealthSmart plans may only cover inpatient treatment for a certain amount of days.

You may also need to submit paperwork of medical necessity to your insurance prior to entering treatment. This can come from your doctor, who will likely need to perform a clinical assessment to determine your treatment needs.

If your plan includes coverage for inpatient treatment, you will also need to find a rehab center that accepts your insurance. Rehab programs can differ in what insurance providers they accept from their patients.

You can learn whether or not a rehab center accepts your insurance by contacting the facility or by asking your insurance provider.

Outpatient Treatment

Outpatient treatment is a step-down level of care that doesn’t involve living onsite in a facility. Different types of outpatient programs may be recommended for patients depending on their progress and their needs.

While some outpatient programs can still be intensive with more of a time commitment, others allow more flexibility for work, school, and other personal schedules.

Types of outpatient treatment that may be covered by HealthSmart include:

Partial Hospitalization Programs (PHP): Partial-hospitalization programs involve spending four to eight hours a day each day of the week receiving treatment at a facility. This is the most intensive outpatient option and requires the most time commitment.

Intensive Outpatient Programs (IOP): Intensive outpatient programs involve spending a few hours a day, two or three days a week in a treatment center. During this time, patients may meet with a counselor, attend group therapy, or meet with other members of their treatment team.

Standard Outpatient Treatment: People that are attending standard outpatient treatment may meet with outpatient providers within a facility or offsite out of a professional office. Most often, this involves meeting with a counselor once or twice a week.

Treatment for substance abuse doesn’t usually end once a person leaves rehab. In many cases, people will continue receiving some form of outpatient treatment for months or years after leaving an inpatient program.

Most often, this includes going to counseling or visiting support groups on a regular basis. Visits to a medical doctor can also be important for working toward and maintaining good health.

Some HealthSmart plans may have restrictions on how long members can continue receiving coverage for outpatient treatment. For instance, some plans may only cover a certain number of visits to an outpatient provider per calendar year.

Medications

Many people overcoming drug and alcohol addiction are prescribed certain medications to help them manage cravings, withdrawal symptoms, or co-occurring mental health problems.

HealthSmart insurance has a HealthSmartRx Solutions program that offers reduced costs and coverage for prescription drugs. While copayments and deductibles may vary by plan, members can generally expect to be eligible for some prescription coverage.

Features of the HealthSmartRx Solutions program include:

• access to over 69,000 in-network pharmacies
• customized and cost-effective drug plans according to the needs of each member
• member copay assistance
• high-cost drug management
• pharmacy discount card benefits capable of reducing prescription costs up to 75%
• dedication to negotiating with pharmaceutical companies to get more affordable prices on a wide variety of effective prescription drugs

Coverage for prescription drugs can also depend on the type of drug(s) you are taking. By talking with a HealthSmart representative or looking at your plan’s benefits, you can learn more about what medication costs your insurance may cover.

Common Questions About Using HealthSmart Insurance To Pay For Rehab

Understanding your HealthSmart plan benefits before entering treatment can help you avoid hidden costs or fees during and after your treatment.

You can get a better understanding of your health insurance coverage by talking through your health plan with a HealthSmart representative or treatment specialist.

Common questions to ask when using HealthSmart insurance to pay for rehab include:

• Does my HealthSmart plan cover detox? If so, do I need to submit any paperwork to you beforehand?
• Does HealthSmart cover inpatient programs within a rehab center? If so, for how long?
• Does HealthSmart cover medication-assisted treatment?
• Will my insurance require any out-of-pocket costs and copays for my treatment?
• What types of outpatient treatment can my plan cover?
• How do I submit pre-authorization to HealthSmart for treatment services?

Talking to a treatment specialist can be an important part of you or your loved one’s recovery process. Support specialists can provide you with the reassurance that you do not have to face this alone. They may also be able to refer you to cost-effective alternatives for treatment services that are not covered by your insurance.

How To Find Rehab Centers That Accept HealthSmart Insurance

Finding a rehab center that accepts your insurance and meets you or your loved one’s needs can be stressful. Talking to a specialist can help. Our compassionate team of treatment specialists are here to provide the resources you need to get help for you or your loved one struggling with addiction.

Millions of people abuse alcohol and various drugs each year, and many don’t seek professional help. Don’t wait to reach out. Contact us today to learn more about addiction treatment and find a rehab center that accepts your HealthSmart insurance.