Attending Rehab with Insurance Provided Through Work

Understanding Your Work-Provided Insurance Benefits

Work-provided insurance benefits vary widely depending on the type of insurance (HMO, PPO, POS, etc), the insurance company your workplace has chosen, and your individual plan’s details. They may offer health and dental coverage, as well as retirement savings plans, disability insurance, and life insurance plans. In most cases, your health insurance will extend to your family members including your spouse and children, helping cover the costs of doctor’s visits, specialist treatments, dental care, and more. 

Going to rehab with insurance will cost you a lot less than if you don’t have insurance. Your plan may cover some or all of the costs associated with treatment, saving you thousands. Each type of insurance has its own set of rules, with some only covering certain levels of care within in-network facilities and others being more flexible (but more expensive). Understanding your benefits will ensure you can maximize your insurance, and pay less out-of-pocket. 

 

Determining Your Rehab Coverage Details

If you are ready to start treatment, the first step is to determine what your insurance will cover. You can always contact your health insurance company with any questions, or log in to their online portal to read through your coverage. Sometimes, insurance language can be difficult to understand, especially when it comes to copayments, deductibles, and what is covered vs. what is not covered. 

When you’re getting ready to go to rehab, searching for a treatment center that offers what you need while determining whether it’s in-network and covered by your insurance can be overwhelming. If you’re having trouble understanding the complex insurance jargon or simply want somebody to help you figure it all out, you can call the treatment center for help. At WhiteSands, we are always available and are happy to answer all your questions. Our team can customize treatment plans to maximize insurance benefits while putting your health and safety first.

How to Approach HR or Your Insurance Provider for Information

It’s a good idea to prepare before you speak to HR or your insurance provider, so you don’t miss any important details or forget an important question. Some of the information you may want to bring to the conversation include:

• Your insurance membership card
• Any applicable health insurance information
• Your work identification
• A list of questions you need answers to

Some important questions to ask are:

• What type of insurance are you enrolled in?
• What addiction treatments are covered, and for how long?
• Are inpatient stays included in your coverage?
• Are prescription medications included in your coverage?
• Do you need to use an in-network provider, and if so, where can you find them?
• Is pre-approval or prior authorization needed before starting treatment?
• Do you need a referral from your primary care physician?
• Are there criteria that deem detox and rehab as medically necessary? 
• Do you have to pay co-pays or deductibles before the insurance kicks in?

Make sure to take detailed notes, including who you talked to and when you spoke to them in case you need to refer back to that information in later conversations or clarify any information they gave you. 

Navigating Pre-Authorization and Other Insurance Requirements

Sometimes, your insurance company will require you to take additional steps before they agree to pay for your treatment. You might have to get preauthorization before your insurance will agree to pay for treatment. This can be frustrating if you are ready to go to rehab but have to wait for the insurance to agree to pay. 

Some ways to stay on top of these issues include:

• Communicating clearly and effectively, and asking questions if you don’t understand what is expected
• Understand the process, and what your insurance company needs, to make the process as simple as possible 

Advocating for yourself at this time may feel difficult, but it may be important if you are kept waiting due to a paperwork issue. One of the ways you can make sure that meeting insurance requirements is faster is to authorize the use of electronic health records, so all your information is ready to go and can be sent electronically between authorized parties like your physician and the insurance company, rather than waiting for a paper copy to arrive in the mail. 

At WhiteSands we can verify your insurance coverage quickly and efficiently, to help you get care as soon as possible. We understand that time is of the essence for people with addiction, and will do all we can to expedite the process for you. 

Financial Considerations: Understanding Co-pays, Deductibles, and Out-of-Pocket Costs

There are often additional costs you have to pay, even if your insurance agrees to cover your treatment. These include:

Deductibles 

Deductibles are a yearly dollar amount you must pay yourself before your insurance coverage kicks in. For example, if you have a $500 deductible, and you must go to several appointments throughout the year that cost $300, you will pay the full $300 for the first appointment, and then $200 for the second appointment to meet the deductible amount. Your insurance will cover the rest of the year.

Copays 

After you’ve met your deductible, you may still have to pay a copayment, or “copay”. Copays are a fixed dollar amount you will pay at each treatment, doctor visit, or appointment, with the rest of the visit covered by your insurance. 

Out-of-Pocket Costs

Some other common out-of-pocket costs you might encounter are off-label prescription drug use, beauty or cosmetic treatments, holistic practices, alternative medicine, or new technologies not yet recognized by insurance.

Privacy and Confidentiality When Using Work-Provided Insurance for Rehab

Thanks to federal laws like the Americans with Disabilities Act (ADA) and the Health Insurance Portability and Accountability Act (HIPAA) all personal information regarding your substance use disorder and treatment must be kept private, with all paperwork stored securely, away from other workplace files. Your information must be kept confidential, and your employer may not discriminate against you in any way when you return to work after treatment. 

The Role of Employee Assistance Programs (EAPs) in Accessing Rehab Services

Employee Assistance Programs (EAPs) are free and confidential programs your employer may offer to help you work through difficult personal or work-related life situations. EAPs offer counseling, evaluation services, and referrals to other helpful treatments from an objective third-party counselor who does not work for your company. They will not tell your employer you have contacted them, as EAP services are always kept private. 

If you have a substance use disorder, your EAP counselor can provide an evaluation and referral for rehab services. To get started, you can contact the EAP counselor yourself, and they will guide you in taking the next steps. They will evaluate your needs, and assist you in navigating the process of getting the care you need, including detox, inpatient and outpatient rehab services, behavioral health care, and counseling, as well as navigating the sometimes complex process of going to rehab with insurance. The EAP is free, but once you transfer into the rehab program your insurance will pay some of the costs, with the rest paid out-of-pocket. Each insurance plan is unique in what it will cover, but your EAP counselor can help you understand your rights and responsibilities. 

Why Choose WhiteSands Treatment for Rehab Covered by Work Insurance?

Choosing WhiteSands will give you access to the full continuum of care, from your first day in detox, through inpatient and outpatient treatment and beyond. Our programs are always customized to best suit each patient’s unique needs, with an effective combination of evidence-based therapies and treatments, along with holistic programming and alternative options like fitness training, art therapy, and mindfulness meditation. 

You can call us any time to get started or to speak confidentially to a qualified counselor about rehab with insurance coverage and how it all works. If you want to know more, please phone 877-855-3470. We can help you start your recovery journey, today.

If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.