First Care Insurance Coverage for Drug & Alcohol Addiction Treatment Near Me

Substance use is an issue that isn’t isolated to a specific part of the country. In 2018, 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 substance use, you may be wondering how to pay for the treatment you need to break free. The good news is that your health insurance can help you pay some or all of the cost of rehab.

If you have First Care Healthcare, you might have questions about how to use this coverage to get the right substance use treatment. Remember that the amount of coverage you receive will depend on your specific insurance plan, so you want to verify your coverage before committing to a treatment program.

This guide will help you understand your First Care health plan and use it to its maximum advantage when it comes to getting rehab treatment.

Check First Care Insurance Coverage for Addiction Treatment

First Care Healthcare is a Texas-based health insurance company that offers a wide variety of health insurance plans.^{2, Health plans that work for Texans} For example, you can purchase a Marketplace plan for yourself, receive coverage through your employer, or have First Care for Medicaid or CHIP coverage.^{2, plan types graphic}

Each one of these plans is different, so you’ll want to ensure you understand the specific coverage you have before choosing a rehab program. You can check your coverage by calling the phone number on the back of your insurance card or by contacting American Addiction Centers (AAC) online or by phone.

Our admissions navigators are available for you 24/7 and can verify your insurance in just a few minutes while chatting with you. They can also answer any questions you might have about rehab.

We want to make it easy for you to get the help you need, so don’t be afraid to contact us anytime.

What is First Care Insurance?

First Care Insurance was founded in Amarillo, Texas in 1985.^{3, second paragraph} The company is owned by the Baylor Scott & White Health Plan and serves 400,000 members in 171 counties.^{3, second paragraph}

The company is focused on its commitment to the community, which means they participate in service projects, sponsor athletic events, and supports charitable causes.^{3, third and fourth paragraph} To keep healthcare costs lower, the company offers simple plans that are easy to use, fit your budget, and meet your healthcare needs.^{3, fifth paragraph}

The mission of First Care Insurance is to provide customers access to high-quality, affordable healthcare through strong partnerships in local communities.^{3, Our Partners}

First Care Health Plans

What plans can you get through First Care insurance coverage? First Care offers a variety of plans, including Medicaid plans, Marketplace plans, and plans through employers.^{2, health plan graphics}

Individual and family plans are available through the health insurance marketplace in Texas.^{4, top section} The plans are grouped into tiers: Gold has higher monthly premiums and lower out-of-pocket costs, Bronze has lower monthly premiums and higher out-of-pocket costs, and Silver is a balance of the 2.^{4, gold, silver, bronze section} You can also save on hearing aids and receive health and wellness benefits.^{4, Hearing Health, Health and Wellness}

Medicaid and CHIP coverage in Texas is offered through FirstCare STAR, and offers the health coverage that lower-income families and pregnant women need.^{5, STAR Medicaid}

Finally, group health plans offered through employers are provided by the First Care parent company, Baylor Scott & White Health Plan.^{6, Group health plans}

What will First Care insurance cover?

When it comes to substance use treatment and rehab, what can you expect from First Care insurance rehab coverage?

The Affordable Care Act (ACA) requires all long-term health insurance plans, including First Care insurance plans, to cover 10 essential health benefits.^{7, top section} One of these benefits is mental health and substance use treatment, which means your insurance plan will cover at least some of the cost of the rehab you need.^{7, fifth bullet}

The specific treatment plan that’s right for you will be determined by your doctor, who will ask about your substance use, history, home environment, and more. Using that, your doctor will create a treatment plan specific to your needs.

There are a variety of treatment options for substance use, but some of the most common include:^8,9

• Inpatient Rehab. Residential (or inpatient) rehab is a full-time program where you live at the treatment center and receive one-on-one and group therapy, as well as family therapy if needed. You will learn new ways to manage your emotions and challenges so you can live a happy, healthy life.
• Outpatient Rehab. Outpatient rehab for substance use is a helpful option for those who can continue living at home while getting treatment. Treatment takes place a few hours per week and includes individual and group therapy. This type of rehab allows you to work and attend school while getting the help you need.
• Intensive Outpatient Programs (IOP). Intensive outpatient rehab (IOP) is a type of treatment that is more focused than regular outpatient care but less so than a residential program. With IOP, you receive more hours of therapy during the week, but you are still able to live at home. You may be able to work or attend school part-time during treatment.
• Partial Hospitalization Programs (PHP). PHP rehab is an option for those who need intensive treatment for their substance use but don’t want to live in a residential program. These programs offer several hours of treatment per day, five or six days a week, which can be more affordable than other rehab options.

Of course, one of the most important parts of your treatment is that you finish the program, including any step-down or aftercare programs. It’s common to feel better partway through treatment, but if you want to set yourself up for long-term success, you need to see the program all the way through to graduation.

Does First Care Insurance Cover Mental Health Care Treatment Facilities?

Some of the questions many people have about insurance relate to mental health. That’s not surprising since mental health and substance use often occur together, which is known as a co-occurring disorder. In fact, 50% of those who have substance use issues also have a mental health diagnosis.^{10, second paragraph}

What can you expect from First Care insurance mental health coverage? Because mental health is part of the 10 essential health benefits included in the ACA, you can be confident that your insurance will pay at least part of the cost of mental health treatment as well.^{7, fifth bullet}

What’s important is that you treat your mental health and substance use together in an integrated way. Studies have shown that integrated treatment is far more effective than treating just one issue or the other.^{11, first paragraph}

Of course, the specific coverage you will get varies depending on your plan, so be sure you verify your coverage before committing to a treatment program.

How Long Does First Care Insurance Cover Rehab?

How long is rehab? The answer will depend on the treatment program your doctor creates for you, but studies show that most people need at least 90 days to make a significant change in their substance use habits.^{12, fifth point} That’s why many programs are 3 months long.

You may need more than 3 months, depending on your history and how long you’ve been using substances. What’s important is that you fully complete the program you choose so that you can have a successful transition into a life without substance use.

Your insurance coverage will depend on your specific plan, so make sure you have all of the details before you begin rehab.

What if my First Care policy does not cover rehab?

As you research treatment programs, you may find that your First Care insurance behavioral health coverage only covers part of the cost of treatment or that the treatment program you are most interested in isn’t covered at all.

Don’t let that stop you from getting the substance use treatment you need. There are many ways to pay for rehab, and insurance coverage is only part of the picture. For example, you may be able to find a treatment program that has scholarships, or set up a payment plan.

There are also treatment centers that use a sliding scale of fees based on your income, or you could borrow money from friends or family to pay for rehab. Choosing treatment is the best decision you can make, and after you’re happier, healthier, and substance-free, you’ll be in a far better position to handle your financial obligations.

The key is to get treatment as soon as possible. Substance use has long-term health and legal consequences, and you want to break free before it’s too late.

First Care Insurance In Network vs. Out of Network Detox & Rehab Centers

As you look at the First Care Insurance mental health provider list, you’ll notice that some treatment centers are in-network with First Care insurance rehabilitation coverage and some are out-of-network. What does that mean?

All insurance plans have a group of medical providers that they create a contract with, where the provider agrees to treat plan members for a lower cost, and the plan agrees to encourage members to get care from that provider.^{13, p. 1 What’s a Provider Network} That group of providers is “in-network” for the insurance plan.^{13, p. 1 What’s a Provider Network}

When you use an in-network provider, you’ll get more coverage from your insurance plan and pay less out of your own pocket.^{13, p. 2, Why do some plans…} In fact, you may find that treatment facilities outside the network have no coverage at all from the plan, and you have to pay the full cost.^{13, p. 2, Why do some plans…}

In order to maximize your insurance coverage, stick to in-network treatment centers as much as possible. If you do have out-of-pocket costs, you can look at the different ways to pay for the treatment we discussed earlier.

The key is to get the treatment you need right away. Each day of substance use puts you at risk. You deserve a happier, healthier life free of substances. To take the first step, contact us today.