What Does Coventry Insurance Cover for Detox and Rehab Services?

Founded in 1986, Coventry Health Care is a medical insurance provider available in various states, including Florida. Acquired by Aetna in 2013, Coventry offers both HMO and PPO plans, and an extensive network of doctors and other healthcare providers, including mental health care. If you or a loved one requires medical detox or rehabilitation services for a substance use disorder, you can seek help through Coventry Health Care’s rehab coverage.

 

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Table of contents

» Does Coventry Cover Inpatient Rehab Programs?

» How Can You Check Your Coventry Plan Benefits for Addiction Treatment?

» Do You Need Pre-Authorization for Rehab Services With Coventry?

» Are There In-Network Rehab Centers for Coventry Members?

» Key Takeaways on Coventry Health Care Rehab Coverage

» Resources

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Does Coventry Cover Inpatient Rehab Programs?

Yes, Coventry Health Care normally provides insurance coverage for inpatient rehabilitation programs, where a person would stay at a mental health facility for a specific amount of time. Inpatient rehab can last anywhere from a few weeks to six months, depending on the facility, program, and a person’s needs. Coventry provides coverage for inpatient rehab programs for a specific time, depending on your current insurance plan and provider.

Because Coventry was acquired by Aetna in 2013, members also have access to Aetna’s health care services and providers. Additionally, Coventry Health Care offers coverage for outpatient rehabilitation services.

Inpatient vs. Outpatient Rehab

According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2023 National Survey on Drug Use and Health, 48.5 million people aged 12 or older had a substance abuse disorder in the past year. While outpatient treatment is still the most popular, SAMHSA’s National Survey of Substance Abuse Treatment Services (N-SSATS): 2020 shows that almost 59,000 people sought non-hospital residential inpatient treatment in 2020.

Inpatient rehabilitation offers some benefits when compared to outpatient services, including:

• Constant access to mental health care professionals and support.
• No access to substances, triggers, environments, or situations that might trigger abuse.
• Continuous monitoring of withdrawal symptoms during medical detox.
• Treatment for any co-existing mental health concerns that may be causing your substance use disorder or making it worse.
• Access to on-site support groups and holistic therapies.
• Part of a community of those who understand your struggles.

There are also some potential cons when attending inpatient rehab, such as:

• Need to take off from school or work for an extended period of time.
• Might need to travel to an inpatient facility.
• Can only see family members for a certain amount of time each week.
• Cost can be higher than outpatient rehab.
• Transition back to your normal life can take some time.

What Substance Use Disorder Treatments Does Coventry Cover?

Depending on your specific health care plan, Coventry Health Care offers coverage for several substance use disorder treatment options:

• Inpatient rehab
• Outpatient rehab
• Intensive outpatient treatment (IOP)
• Medical detox
• Medically-assisted treatment (MAT)
• Individual and group therapy
• Family therapy
• Certain holistic/alternative treatments
• Rehabilitation aftercare

What Mental Health Issues Does Coventry Cover for Dual Diagnosis Treatment?

According to the National Institutes of Health (NIH), the Cover of Common Comorbidities with Substance Use Disorders Research Report, about one in every four people with a serious mental illness also has a substance use disorder.

If you need dual diagnosis treatment, Coventry Health Care provides coverage for many mental health conditions that are often linked to a substance use disorder, including:

• Anxiety
• Depression
• Eating disorders
• Post-traumatic stress disorder (PTSD)
• Bipolar disorder
• Attention-deficit hyperactivity disorder (ADHD)
• Schizophrenia

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How Can You Check Your Coventry Plan Benefits for Addiction Treatment?

There are a few easy ways to check your Coventry Health Care rehab coverage before making an appointment at Florida drug rehabs that accept insurance:

• Online: As Coventry is now part of Aetna, you can access Aetna’s online member portal. From there, you can log in and find out information on your rehabilitation service and detox coverage, as well as information for other mental health services.
• Call: Use the customer service phone number printed on the back of your insurance card to contact Coventry/Aetna. You’ll be able to find out information on your coverage and ask any questions you may have regarding deductibles and co-pays.
• Talk to Your Treatment Center: The addiction treatment center you select will also be able to provide you with information on what is covered through your Coventry Health Care plan, and offer information on anticipated out-of-pocket expenses.

Remember that your insurance plan will determine your coverage and whether your treatment center is in-network or out-of-network.

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Do You Need Pre-Authorization for Rehab Services With Coventry?

Yes, you will need pre-authorization for services through your Coventry Health Care rehab coverage in almost all cases. In fact, most health insurance requires pre-authorization before it can cover mental health care services. By letting your insurance company know your health needs, you can be entirely sure of what they will and will not cover, helping to ensure you receive no surprise medical bills.

If you or a loved one needs pre-authorization for medical detox or rehabilitation services, here are a few essential things to remember:

• The pre-authorization process can start immediately if you select a Coventry/Aetna in-network treatment center.
• If you select an out-of-network addiction treatment center, talk to the facility’s staff to find out what they need from you to start the process, such as any forms you may need to fill out.
• Remember that pre-authorization can take a few weeks, especially when requesting approval for an out-of-network treatment center.
• Save copies of all forms and written communications during the pre-authorization process in case you encounter any issues or your request is denied.
• Denied pre-authorization requests can be appealed. A request is often denied because some information the insurance provider needs is missing. Contact Coventry directly to find out what was denied and how it can be appealed. Your treatment center can also guide you through the appeal process.

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Are There In-Network Rehab Centers for Coventry Members?

Because Coventry Health Care is now part of Aetna, members can access an extensive network of mental health professionals and rehabilitation centers.

Using an in-network doctor or treatment center offers several advantages:

• Because in-network centers are under contract with your health insurance provider, they can offer their services at a lower rate.
• Out-of-pocket expenses — such as co-pays and deductibles — will be lower at an inpatient center.
• The pre-authorization process is much quicker with an in-network facility.

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Key Takeaways on Coventry Health Care Rehab Coverage

• Coventry Health Care is a medical insurance provider available in Florida.
• Coventry was acquired by Aetna in 2013, providing customers with full access to Aetna’s extensive network of medical health professionals and treatment centers.
• Coventry Health Care rehab coverage includes inpatient programs.
• You can easily check your addiction treatment plan benefits online by calling customer service or contacting your treatment center.
• Like most health insurances, you will need pre-authorization for rehab services with Coventry Health Care.

WhiteSands Treatment welcomes Coventry Health Care members to visit any of our drug and alcohol addiction treatment centers across Florida. In addition to full-service options for substance use disorders, WhiteSands also provides treatment for co-occurring mental health disorders, which are often the root of substance abuse. Choose from inpatient, intensive outpatient, and outpatient rehabilitation depending on your needs, as well as medical detox, family therapy, and holistic treatment options.

For more information on WhiteSands Alcohol and Drug Rehab in Florida and what to bring to drug rehab, call us today at 877-855-3470.

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Resources

• Substance Abuse and Mental Health Services Administration — 2023 National Survey on Drug Use and Health
• Substance Abuse and Mental Health Services Administration — National Survey Of Substance Abuse Treatment Services (N-SSATS): 2020
• National Institutes of Health (NIH) — Common Comorbidities with Substance Use Disorders Research Report

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.