Community Health Choice Insurance Coverage for Drug & Alcohol Rehab

Struggling with substance use is often taboo, but it’s more common than many people think. In a 2018 national study, the Substance Abuse and Mental Health Services Administration (SAMHSA) found that 8.1 million Americans had at least one illicit drug use disorder, and 14.8 million Americans struggled with alcohol use disorder.^{1, p. 37-38}

If you struggle with misusing substances, you might wonder how to get the help you need to break free. Getting treatment can be expensive, but fortunately, your health insurance can likely pay some or all of the cost.

If you have Community Health Choice insurance coverage, will they help you pay for the cost of coverage? Yes, they can, although your specific amount of coverage will vary depending on your plan. Be sure to call the phone number on the back of your insurance card to get the details before you commit to a treatment program.

This guide will help you understand how to use your Community Health Choice plan to get the care you need. Breaking free of substance use will put you on a path to a much better life, and you deserve it.

Check Community Health Choice Insurance Coverage for Addiction Treatment

One of the first questions many people have is, “How much will my insurance pay?” The answer varies based on your specific plan, so it’s important to verify your insurance before you choose a treatment program.

You can call the phone number on the back of your insurance card, or you can contact American Addiction Centers (AAC) by phone or online at any time. Our admissions navigators can review your insurance in just a few minutes as they speak with you. We can also help answer the questions you might have about rehab.

You deserve a happy, healthy life free from addiction. You can take the first steps by contacting us today.

What is Community Health Choice Insurance?

Community Health Choice is a Texas-based non-profit managed care organization.^{2, first paragraph} The company was founded in 1997 by Harris Health System and initially offered Medicaid coverage to lower-income families.^{2, first paragraph}

Over time, the plans offered grew to include a wide variety of affordable plans, along with a broad provider network of over 12,000 medical professionals.^{2, Community network} The focus of Community Health Choice is to improve the health and well-being of Texans who are often underserved by helping them access high-quality healthcare.^{2, mission.}

Today, Community Health Choice Healthcare covers 460,000 members, and the network includes 95 hospitals and 1,385 pharmacies.^{2, community network}

Community Health Choice Health Plans

What options are available when you’re looking for a Community Health Choice health plan? There are a variety of plans available depending on your circumstances and needs.

Many Americans choose to get affordable health insurance plans through the Marketplace, and some Community Health Choice insurance plans are available.^{3, Marketplace plans} You can look at a variety of options and find the balance of monthly premium and out-of-pocket costs that makes the most sense for you.^{3, Marketplace plans} You’ll have access to a broad medical network, which can make it easier to get the care you need.^{3, Marketplace plans}

If you’re a lower-income Texan, you might qualify for the Texas STAR (Medicaid) plan.^{3, Texas STAR} This is a no-cost program for families with lower incomes.^{3, Texas STAR} This program includes coverage for children and medical care for pregnant women.^{3, Texas STAR}

If your family makes too much for the Texas STAR plan but you have children who need coverage, you might qualify for the Texas CHIP plan, which covers children under age 19 whose families make too much to qualify for Medicaid.^{3, Texas CHIP}

Finally, if you qualify for Medicare but want to explore an affordable Medicare Advantage plan, Community Health Choice offers a plan with many additional benefits, such as dental coverage, hearing aids, and vision coverage. ^{3, Medicare D-SNP} For seniors with lower income, this plan can be a great benefit.^{3, Medicare D-SNP}

Can you use Community Health Choice insurance for addiction treatment? Yes—the Affordable Care Act (ACA) requires all long-term insurance plans to cover 10 essential health benefits, which include mental health and substance use treatment.^{4, fifth bullet}

As a result, you can trust your Community Health Choice insurance plan to pay for some or all of the cost of substance use treatment.

What will Community Health Choice insurance cover?

There’s no one-size-fits-all solution for addiction treatment. Instead, your doctor will work with you to determine the treatment plan that makes the most sense for your needs. The doctor will ask about what substances you use and your history of use, along with questions about your use triggers, home environment, and more.

While each treatment plan is unique, there are some common treatment options they may include.^5,6

• Inpatient Rehab. Inpatient substance abuse treatment is a common approach to treating a variety of substance use concerns. Patients live at the treatment center full-time and receive around-the-clock care. Treatment typically includes counseling, medication, and educational programs.
• Outpatient Rehab. Outpatient substance use treatment typically involves a series of counseling and therapy sessions. These happen a few hours a week, allowing you to continue to work or attend school during treatment. You’ll learn how to manage your triggers and emotions in a healthy way to break free of substance use.
• Intensive Outpatient Programs (IOP). Intensive outpatient programs (IOPs) for substance use treatment provide regular group and individual counseling sessions, which you will attend several hours per week. The care is more focused, and you’ll attend therapy more often than in a regular inpatient program.
• Partial Hospitalization Programs (PHP). Partial hospitalization programs (PHPs) for substance use treatment provide structured, full-time care without requiring you to live at the treatment facility. You attend treatment daily for several hours per day.

Of course, the most important part of your treatment program is completing it. It’s common to feel better partway through the process and want to leave early, but seeing your program through to graduation is the best way to set yourself up for success.

Does Community Health Choice Insurance Cover Mental Health Care Facilities?

Mental health is another common concern for those who struggle with substance use. In fact, 50% of those who struggle with substances also have a mental health diagnosis.^{7, second paragraph} This is known as a co-occurring disorder, and the most common mental health concerns include anxiety, depression, post-traumatic stress disorder (PTSD), attention-deficit hyperactivity disorder (ADHD), and personality disorders.^{7, second paragraph}

If you have a co-occurring disorder, it’s important to treat both your mental health and substance use together. This type of integrated treatment has been shown to be far more effective than addressing only one or the other.^{8, first paragraph}

Will your Community Health insurance plan cover your mental health treatment as well as substance use? It will—both mental health and substance use are part of the 10 essential health benefits required by the ACA.^{4, fifth bullet}

Keep in mind that your coverage amounts will vary depending on your insurance plan, so be sure to do Community Health Choice Insurance verification by calling the number on your insurance card or contacting AAC anytime, 24/7.

How Long Does Community Health Choice Insurance Cover Rehab?

How long is rehab? It’s a common question, and there’s no one right answer that fits everyone. However, studies have shown that it takes a least 90 days for most people to make a significant change in their substance use, so most programs are at least three months long.^{9, fifth point}

However, your ideal treatment program may be longer than that—it all depends on your needs. That’s why it’s important to work closely with your doctor to find the plan that works best for you.

The amount of Community Health Choice insurance behavioral health coverage and how long it lasts will depend on your specific plan, so be sure to get the details before entering treatment.

What if my Community Health Choice policy does not cover rehab?

As you look at different treatment options, you might discover that your Community Health Choice insurance payment won’t pay the full cost of your program. Or, you might find that the specific program you’re most interested in isn’t part of the network covered by your insurance, so you have to pay the full cost yourself.

Don’t let that stop you from getting the treatment you need. There are many ways to pay for substance use treatment, and insurance is only part of the picture. For example, some treatment centers have a sliding scale of fees based on your income. You might also be able to borrow money from friends and family to get the help you need.

Treatment programs may also offer scholarships, or you might be able to set up a payment plan. There are many ways to be creative about paying for rehab.

The main thing is to get the help you need right away. Substance use has significant long-term legal and health consequences, and you want to break free before it’s too late. Once you’re happier, healthier, and not using these substances, you’ll be in a far better position to handle your financial obligations.

Community Health Choice Insurance In Network vs. Out of Network Rehab Centers

As you look at different treatment programs, you’ll notice that some of them are “out-of-network” while others are “in-network” with your Community Health Choice insurance rehabilitation coverage.

What does that mean?

All insurance plans have a group of providers that have agreed to treat their members for a lower cost than usual.^{10, p. 1 What’s a Provider Network} These providers are part of the insurance network, and if you use them for care you pay less out-of-pocket.^{10, p. 1 What’s a Provider Network}

It’s important to remember that many insurance plans do not offer any coverage for out-of-network care.^{10, p. 2, Why do some plans…}  That means that to maximize your insurance coverage, you should try to find an in-network treatment program if possible. However, if you can’t, don’t worry—as we mentioned above, there are many ways to pay for rehab.

Getting the care you need is what’s important. You can contact AAC to review your coverage and find treatment centers within your insurance plan’s network.

A happy, healthy life that’s free of substance use is within your reach. Take the first step by contacting us today.