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Drug And Alcohol Rehabs That Accept Priority Health

Jennifer Cousineau MSCP, LPCI, NCC

Medically reviewed by

Jennifer Cousineau MSCP, LPCI, NCC

April 18, 2019

Insurance companies like Priority Health can help people lower the cost of drug and alcohol rehab programs. By using your health plan benefits, you may be able to reduce the cost of treatment services that include detoxification and outpatient treatment.

Too often, people struggling with addiction don’t seek treatment because of cost. Fortunately, your health insurance plan can help lessen the financial burden so often associated with drug and alcohol rehab programs.

Priority Health is a non-profit health insurance company that was founded by a group of physicians in Michigan. For the last 30 years, Priority Health has been providing health care that benefits members along with the community.

As the second largest health plan in Michigan, Priority Health is committed to making sure their members have access to quality care. They spend 90 cents of every dollar on direct care for their members.

Before you seek addiction treatment, make sure to verify what your Priority Health plan covers. The amount of coverage this company provides for rehab centers will vary by plan.

Does Priority Health Insurance Cover Addiction Treatment?

Insurance companies like Priority Health are required to provide coverage for addiction treatment, at the same level they would cover another health concern.

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However, Priority Health has strict policies and high standards when it comes to providing coverage. Any substance use disorder treatment must meet specific criteria, and be considered medically necessary.

Priority Health upholds these requirements in order to maintain a high level of care. They want to ensure that members are receiving personalized drug and alcohol rehab services that are a good fit for their situation.

A Priority Health representative will be able to further explain these pre-authorization policies to you. Although this process seems complicated, it will ultimately ensure you receive quality addiction treatment.

Drug And Alcohol Rehab Services Covered By Priority Health

Because each person and their addiction is unique, there is a wide range of addiction treatment services to choose from. Priority Health offers coverage for each of these rehab services, in order to best meet the needs of its members.

Since Priority Health is a non-profit health insurance provider, they may only provide coverage at treatment centers and hospitals that are in-network. Fortunately, nearly 95 percent of the providers in Michigan participate with Priority Health.

Addiction treatment services that may be covered by Priority Health plans include:

  • medical detoxification
  • residential treatment
  • partial hospitalization programs (PHP)
  • intensive outpatient programs (IOP)
  • drug screenings

Priority Health may require pre-authorization for some of these treatment services. This means your doctor may be asked to fill out a form stating that the treatment is medically necessary for your recovery.

Medically Assisted Detox

When a person stops using drugs or alcohol, their body requires a period of time to clear itself of the toxins. This process is called detoxification and can cause a person to experience painful withdrawal symptoms.

Priority Health provides coverage for several levels of medically assisted detox. Inpatient detoxification takes place in a hospital, under nursing and medical care. This level of detox is covered by Priority Health when a person is at risk for severe withdrawal symptoms.

Ambulatory detoxification is a “step down” level of detox and includes medical supervision. This type of detox is covered when people are experiencing mild to moderate withdrawal symptoms.

Medical detox will ensure that patients are kept as comfortable as possible during detoxification. Many medically monitored detox programs will also utilize MAT or medication-assisted treatment. MAT reduces withdrawal symptoms and can help to prevent relapse.

Inpatient Treatment

Inpatient treatment centers, often called residential programs, are the most intensive type of treatment. Most residential rehab programs last between 30-90 days. During this time, patients participate in structured sessions that include individual counseling and group therapy.

Research has found that spending at least 90 days in treatment can set a person up for a more successful recovery. Inpatient treatment can work well for those who do not have a solid support system, or who have tried other types of treatment before.

Most insurance plans require pre-authorization in order to be covered for an inpatient rehab center. To verify your plan’s level of coverage, contact a Priority Health representative directly.

Partial Hospitalization Programs (PHP)

Partial hospitalization is an intensive, non-residential level of care. Medical and nursing services are provided, along with mental health counseling and individual therapy.

PHP can be a good option for those who have recently completed an inpatient treatment program. Many people benefit from aftercare programs like PHPs, where they are provided additional support and accountability (including drug screenings).

Intensive Outpatient Programs (IOP)

In an IOP, clients meet several times per week with their counselor. They may engage in various therapies, addiction education classes, and group discussions on sober living skills.

Outpatient programs work best for those who already have a support system and can maintain a level of personal safety. If a person is at risk for relapse, they should consider a higher level of care.

IOPs are often scheduled in morning or evening sessions, so people can maintain their work, student, or family commitments. Some people start their treatment in IOP, in order to build coping skills. Others attend an IOP after completing treatment at an inpatient rehab program.

How To Use Your Priority Health Plan To Pay For Drug And Alcohol Rehab

Addiction is a complex disease, and no one approach to treatment is best. After reviewing the different treatment services available to you, you’ll be better equipped to select a rehab center that sounds like the best fit.

The first thing you’ll want to do is verify your coverage with a treatment specialist and a Priority Health representative. Understanding your Priority Health benefits will ease the stress that often comes with researching different treatment options.

Common Questions About Using Priority Health For Addiction Treatment

Insurance plans can get complicated, fast. In order to best understand the benefits available to you, it’s important to connect with a Priority Health team member directly.

They will be able to explain what services are covered and help estimate your out-of-pocket cost. You may want to have a list of questions on hand, to make sure your concerns are fully addressed.

Frequently asked questions about using Priority Health for rehab centers include:

  • How do I meet Priority Health’s substance use treatment coverage criteria?
  • Do my benefits cover inpatient and ambulatory detoxification?
  • Does my plan cover inpatient treatment? For what lengths of stay?
  • Do my benefits provide coverage for PHP or IOP?
  • Does my doctor need to submit pre-authorization paperwork to Priority Health?
  • What am I required to pay out-of-pocket?

How To Find A Rehab Center That Accepts Priority Health Insurance

Learning how to get the most from your insurance benefits can take time. It’s always a good idea to start by arming yourself with the facts about your plan, your coverage, and the treatment services you are interested in.

Allow one of our treatment specialists to help guide you in this process. To learn more about drug and alcohol rehabs that accept Priority Health, contact us today.

Priority Health - About us, SUBSTANCE USE DISORDER FACILITY PROGRAM CRITERIA, Priority Health Michigan service area

National Institute on Drug Abuse - Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

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