Does First Health insurance Cover Alcohol and Drug Rehab? - Treatment Solutions

Does First Health insurance Cover Alcohol and Drug Rehab?

First Health Insurance Coverage for Alcohol & Drug Rehab Treatment

If you or a loved one are struggling with drug addiction, you may be wondering how you can obtain affordable drug rehab coverage. In many cases, your health insurance plan will provide partial or full coverage for drug rehab. However, it’s important to note that your coverage will vary greatly depending on your health plan, your location, and your provider network.

First Health Network plans, which are offered as a subsidiary of Aetna, provide coverage to many Americans across the country. There are 3 main offerings available through First Health Network, depending on your location:1

  • First Health Network: This national preferred provider organization (PPO) is a network that includes 5,500 hospitals, 115,000 clinics, and 1.5 million providers across the country.
  • Cofinity Network: This network, which is a PPO offered in Michigan and Colorado, provides many opportunities and choices to covered individuals.
  • First Health Complementary Network: Qualifying individuals can use this network as a secondary position to obtain additional savings for care outside of their initial network.

For more information about any of these First Health network plans, it’s best to call the number on the back of your insurance card. This will put you in touch with a representative who can inform you of your plan’s benefits and coverage details.

What Will First Health Insurance Cover?

Every health insurance plan is different and will vary greatly based on your level of coverage, your location, and whether the care you’re seeking is with an in-network or out-of-network provider. With that being said, there are a few things that all health plans must cover per the Affordable Care Act. This federal health law requires all health plans to provide coverage for 10 essential health benefits.2 Mental and behavioral health are determined to be one of these essential health benefits. That means treatment for a mental health or substance use disorder must be covered in some capacity under your First Health insurance.2

In many cases, your First Health coverage should provide full or partial coverage for the following treatments, which are often used in drug rehab:3

  • Inpatient or residential rehab: Inpatient or residential rehab typically involves a patient staying at a facility for a set amount of time to receive round-the-clock care and observation until they are discharged.3, “How are behavioral therapies used to treat drug addiction?” If you need inpatient or residential drug rehab treatment, it will most likely be covered in some capacity by your First Health Insurance plan.
  • Outpatient rehab or therapy: Outpatient rehab typically involves therapy and other services that are offered at a facility, but the patient doesn’t need to stay there overnight. 3, “How are behavioral therapies used to treat drug addiction?” If you need outpatient rehab or therapy, your First Health insurance plan will most likely cover it in some capacity.
  • Intensive outpatient programs (IOPs): This type of treatment is designed for those who need more care than traditional outpatient programs but don’t necessarily need round-the-clock care. 4 (under section after conclusion) IOPs are typically covered in some capacity under First Health Insurance plans.
  • Partial hospitalization programs (PHPs): Some patients may need a combination of treatments to overcome their drug addiction. PHPs combine inpatient and outpatient program components, often involving elements of a structured day program, and allow patients to return home at night.5 If you need a PHP treatment, your First Health Insurance plan will typically provide coverage in some capacity.

Please be sure to talk with your provider about treatment options, as what’s listed here may not be right for you. In addition, each health plan covers different treatments differently. Call the number on the back of your insurance card to verify your benefits and coverage.

Does First Health Insurance Cover Mental Health Care?

Per the ACA, all health plans must provide coverage for mental health or substance use disorders in some capacity.2 This mandate applies to your First Health Insurance plan. This means your First Health Insurance plan must offer some type of coverage for any behavioral health treatment, substance use disorder treatment, or inpatient care for mental and behavioral health.

This is important because it ensures that you’ll be able to receive coverage for treatment for either a co-occurring or stand-alone heroin rehab. Co-occurring disorders—when a mental health and substance use disorder are both present—are fairly common. According to the National Institute of Drug Abuse (NIDA),7.7 million Americans have a co-occurring disorder.6 If you have a co-occurring disorder, getting treatment for both disorders is essential for a full recovery.

How Long Does First Health Insurance Cover Drug Rehab?

First and foremost, please note that there is not a one-size-fits-all approach to treatment for mental health or substance use disorders. The length of your treatment should be determined by your mental health professional, not the insurance company. With that being said, it’s important to note that research indicates that for treatment to be as effective as possible, it should be at least 3 months long.7, (Numbered list number 5) Because there isn’t a standardized approach to treatment, there isn’t standardized answer for how long First Health Insurance will cover rehab.

Ultimately, the length and level of coverage will depend upon your personal health plan, your location, and whether the provider you’ve selected is an in-network or out-of-network provider. To find out this information, you should call the number on the back of your insurance card and speak to a representative. You can also ask the facility at which you’d like to receive care if they can verify your benefits for you. All American Addiction Centers staff are trained and ready to help you demystify your insurance and get the care you need.

What if My First Health Insurance Policy Does Not Cover Rehab?

In some cases, your health insurance may not fully or partially cover your drug rehab treatment. You’ll still be responsible for paying your bill, but don’t panic—there may be some things you can do. Please do not let the cost of care deter you from getting the help you need. Delaying treatment can be devastating to your health, and could cost you more money in the long run if you need to be in treatment for a longer period of time due to the delay.

If your First Health Insurance plan doesn’t cover the costs of treatment, be sure to ask the facility at which you’re receiving care if they offer financing plans. Many American Addiction Centers’ (AAC) locations do offer a payment plan or special financing options for those who don’t have insurance or whose insurance doesn’t fully cover the cost of care. In addition, you may qualify for a scholarship opportunity to cover the cost of your treatment. It’s important that you ask the AAC representative whether there are options available to you.

First Health Insurance In-Network vs. Out-of-Network Rehab Centers

Health insurance terminology can be confusing, especially if you’re not familiar with using it. However, it’s crucial to understand the difference between in-network and out-of-network facilities. Knowing the difference could help you save hundreds on your health care costs.

In-network providers have entered into an agreement with your insurance company to provide you with high-quality, low-cost care. In exchange for being partners, the insurance company reimburses the provider at a pre-negotiated rate, and you receive the highest level of coverage for your service. Out-of-network providers don’t have an agreement with your insurer. Because of this, their services aren’t covered to the same extent, if at all, as an in-network provider’s service may be.

To find an in-network provider, contact your First Health Insurance company representative today by calling the number on the back of your insurance card. If you’re wondering whether an AAC facility is an in- or out-of-network provider, please call your desired facility. An AAC admissions navigator would be more than happy to help you find out whether their facility is an in-network provider through your insurance company.

Check First Health Insurance Coverage for Addiction Treatment

If you are seeking addiction treatment for your substance use disorder, you’re in good hands. The team at AAC is ready to help you on your path to recovery. This includes helping you verify your benefits and coverage. Please give us a call today on our helpline so that a staff member can help check whether your First Health Insurance coverage applies to a treatment center, or call the number on the back of your insurance card.