Drug And Alcohol Rehabs That Accept GEHA Health

When you’re ready to enter drug and alcohol rehab, you might feel a bit overwhelmed with the process, especially the financial aspect. Knowing where you stand with your insurance—how much it covers, what will be your out-of-pocket expense, etc.—can help put your mind at ease. For those with GEHA Health, treatment is an option.

First, it may be reassuring to know that large group health plans are required to provide coverage for substance abuse and mental health services by the same standards as medical or surgical benefits. In other words, substance abuse and mental health treatment has to be treated like a medical condition.

This is thanks to the Mental Health Parity and Addiction Equity Act of 1996. The Act does not apply to small group plans, but coverage under those plans is regulated by the Affordable Care Act.

GEHA Health insurance plans provide coverage for drug and alcohol rehab stays as long as the stays are medically necessary.

Treatment Services Covered By GEHA PPO Plans

The best GEHA Health plans, the High PPO or Standard PPO plans, cover most medically necessary substance abuse or mental health treatment with a low copay or coinsurance cost. With these plans, you can choose to use either in-network or out-of-network providers. For out-of-network, you will pay a higher copay or coinsurance payment for your services.

The following are services covered by GEHA with minimal out-of-pocket expense to you:

  • Professional services: psychologists, psychiatrists, counselors, therapists, etc.
  • Diagnosis and treatment of mental health issues
  • Diagnosis and treatment of substance abuse issues
  • Testing diagnostics
  • Inpatient hospital care, when medically necessary
  • Inpatient rehab care, when medically necessary
  • Outpatient care, including intensive day treatment programs for aftercare

What Does GEHA Cover For Drug And Alcohol Rehab?

As with any health insurance plan, the types of treatment services covered depends on your plan. The best plans for substance abuse treatment and co-occurring mental health treatment include the high PPO and standard PPO plans.

The biggest requirement by GEHA is that treatment is deemed medically necessary. What does this mean? Medicare.gov defines the term to mean that in order to treat some illness, injury, condition, or disease, health care services or supplies are necessary.

While it may seem like you wouldn’t need health care services to treat drug or alcohol addiction, the truth is you do. “Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences,” according to the National Institute on Drug Abuse (NIDA).

Addiction is a disease (disorder) that affects the brain and body, and treating it requires medical services. For instance, if you struggle with addiction to alcohol or opioids, overcoming that addiction means you’ll first have to undergo detoxification, which should always be medically supervised.

Treatment for any substance abuse issues should be completed in an inpatient setting as well. Getting away from a substance-laden environment and triggers of abuse helps you heal faster. What does this mean for your insurance coverage? If you can prove that you need treatment to overcome addiction to drugs or alcohol, you can have coverage for that treatment.

However, GEHA does require precertification for treatment, or else they will decide whether it’s medically necessary. This can be as easy as talking to your coverage provider about your plans to undergo treatment and getting all the paperwork in order before you go.

To be safe, it’s best to get with your plan provider and discuss everything you need to have in order before you begin treatment. Our treatment specialists at RehabCenter.net can help you with the rest.

Important Details About GEHA Drug And Alcohol Rehab Coverage

Before you begin your rehab stay, you may want to know the biggest key components of your plan. GEHA’s High PPO and Standard PPO options are subject to the following guidelines:

  • Benefits are subject to the definitions and limitations of being considered medically necessary
  • Some benefits won’t start until you meet your calendar-year deductible
  • Copays for inpatient stays will be higher than routine or diagnostic visits
  • Admission copays for drug and alcohol treatment services will be higher for out-of-network providers than for in-network providers
  • If you don’t get precertification for hospital stays, you may have to pay a penalty

Again, the best way to know exactly which services will be covered, and what your overall cost will be, is to call your coverage provider and outline the services you need.

GEHA High Deductible Plans

Coverage guidelines for GEHA High Deductible plans work very similar to the PPO plans. The main difference is that, before benefits kick in, you have to meet your calendar year deductible. What does this mean for you?

In order to get treatment for drug or alcohol abuse in a rehab center, you would have to meet a high deductible, or spend a certain amount in health care coverage services. The amount depends on your plan, but is far more than what’s required by the PPO.

As with the PPO plans, you have to precertify for treatment, and your need must be deemed medically necessary.

Why Is Drug And Alcohol Rehab Important?

As mentioned above, addiction is a chronic disease. Treating it successfully means you have to go through the healing process, just as you would for any other disease. The best way to heal is in an environment that can get you away from substance abuse, away from triggers, and into a safe, welcoming space to recuperate.

Inpatient drug and alcohol rehabs provide medically supervised care, evidence-based treatment modalities, and holistic approaches to healing. You won’t find that just anywhere, and our rehab centers offer support from experienced professionals.

Also, in our rehab centers, you’ll receive care that meets your specific needs. If you’re struggling with alcohol and drug abuse, you can get care for both. If you’re struggling with substance abuse and a mental health disorder, you’ll be treated for both disorders at once to ensure you learn to manage each issue.

Some other notable services we provide include:

Get Into Drug And Alcohol Treatment Program Today

If you’ve been caught in the substance abuse cycle and are ready for a change, we can help. It’s not easy to admit you need treatment, but our rehab centers can make the process as easy as possible. They can even answer questions about which rehab centers comply with your insurance plan.

Contact us at RehabCenter.net today to learn more about drug and alcohol rehabs that accept GEHA Health and for all your treatment concerns.

For More Information Related to “GEHA Health Insurance” Be Sure To Check Out These Additional Resources From RehabCenter.net:


Centers For Medicare And Medicaid Services—The Mental Health Parity And Addiction Equity Act (MHPAEA)
GEHA—Plan Brochures
National Institute On Drug Abuse—DrugFacts: Understanding Drug Use And Addiction

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