GEHA Health Plans Insurance Coverage for Drug & Alcohol Rehab

Does GEHA insurance cover Alcohol and Drug Rehab?

If you’re a government employee struggling with substance use problems, where can you turn? One of the best options is your health insurance coverage, which can help pay some or all of the cost of rehab.

If you have GEHA healthcare, you might wonder what coverage you could get for rehab. Fortunately, GEHA offers medical plans that can help you get the assistance you need. GEHA insurance is exclusively for federal employees and federal or military retirees and their families.^{1, first paragraph} The plans are specifically designed for your health needs and include a large network of providers across the U.S.^{1, second paragraph}

This guide will help you understand how to use your GEHA medical insurance to get the care you need. If you have any questions, be sure to reach out — we’re here to help.

What is GEHA?

Government Employees Health Association (GEHA) was founded in 1937 in Kansas City.^{1, second paragraph} GEHA was one of the first organizations to provide health coverage to federal employees under the Federal Employees Health Benefits Act of 1959, and today covers more than 1.8 million members.^{2, third and fourth paragraph}

There are a variety of benefit plans available for both medical and dental coverage, and some of them even reward you for healthy behavior.^{1, third and fourth paragraph} GEHA also offers plans that work alongside Medicare to help you cover your medical needs after age 65.^{1, made for Medicare}

What are GEHA Coverage Levels and Plans?

There are 5  EHA insurance coverage options for medical needs in 2022.^{3, Medical plans} The lowest cost plan is called Elevate and includes perks for healthy habits.^{3, Medical plans}

Next is a high deductible plan, which has low premiums and allows you to set money aside for medical costs with a health savings account.^{3, Medical plans} The standard plan is in the middle, with traditional coverage at affordable rates, followed by the Elevate plus, which has no deductibles.^{3, Medical plans} Finally, those who are eligible for Medicare can select the High plan, which includes low copayment amounts and reimbursement for part of your Medicare Part B deductible.^{3, Medical plans}

Each plan has its own coverage benefits and costs, so it’s important to know the details of what’s covered before you commit to a treatment program. You can verify your coverage by calling the number on the back of your insurance card or by contacting American Addiction Centers (AAC) by phone or online chat. We can review your insurance plan and let you know what to expect in just a few minutes.

Which States Do GEHA Operate In?

GEHA operates in every state in the United States in order to provide coverage to federal employees and retired federal or military staff.^{4, filter by state} The nationwide coverage and large network allow members to access both in-person doctors and telehealth providers so they can get the care they need anywhere, anytime.^{1, large network}

You can trust that GEHA will provide at least some coverage for substance use treatment due to the Affordable Care Act (ACA). The ACA requires that all long-term health insurance plans cover 10 essential health benefits, and one of these benefits is mental health and substance use treatment.^{5, fifth bullet}

What will GEHA insurance cover?

When it comes to getting treatment for substance use, what does GEHA rehabilitation coverage provide? Insurance companies focus on providing medically-necessary care that uses proven approaches, so the first step to answering that question is to work with your doctor.

Your doctor will ask questions about your substance use history, what substances you use, your home environment, and more. With that information, they will create a recommended treatment plan.

There are a variety of treatment options, but some of the most common include:^6,7

• Inpatient/Residential Rehab: During inpatient treatment, you live at the facility full-time while getting the help you need. The staff at inpatient facilities can provide support and guidance to help individuals get and stay sober by helping them learn how to live without substances, cope with triggers and temptations, and develop healthy coping and life skills.
• Outpatient rehab: Outpatient treatment is one of the most common types of treatment for substance use. It can involve a variety of different interventions, such as counseling, therapy, and medication management. Outpatient treatment is typically less intensive than inpatient treatment, and patients can continue living at home while receiving treatment.
• Intensive Outpatient Programs (IOP): In an IOP, you get more intensive treatment than in a normal outpatient program, but you still live at home. You will get personalized therapy, participate in activities, and more. The goal is to help you develop new habits and coping mechanisms so you can live a successful life without substances.
• Partial Hospitalization Programs (PHP): A PHP is a full-time program that doesn’t require you to live at the facility. You attend intensive, individualized therapy sessions every week for several hours each day, but you go home at night. This can give you intensive care without requiring you to completely disrupt your relationships and routines.

Finding the right program for your needs is essential, but so is finishing the program completely. You won’t get the full benefit of the treatment if you leave early, even if you feel like you’re doing better. So make sure you find a program that meets your needs and then see it through all the way to graduation.

Does GEHA Insurance Cover Mental Health Treatment Facilities?

It’s very common to have mental health concerns alongside a substance use problem. In fact, studies show that 50% of those who misuse substances also have a mental health diagnosis, which is known as a co-occurring disorder.^{8, second paragraph}

Can you use GEHA coverage for mental health as well? You can, because the ACA includes mental health care in the list of essential health benefits.^{5, fifth bullet} GEHA mental health benefits will vary depending on your specific plan, so be sure to review your coverage before getting treatment.

Research shows that it’s significantly more effective to treat mental health and substance use at the same time instead of treating only one or the other.^{9, first paragraph} If you have a co-occurring disorder, look for treatment programs that can help you with those needs at the same time so that you can get the best results.

How Long Does GEHA Insurance Cover Rehab?

Every person has different needs when it comes to substance use treatment, and there’s no single plan that works for everyone. However, it’s important to go to treatment long enough to make a real change in your habits and substance use.

Studies show that most people need at least 90 days of treatment to make a significant change in substance use habits.^{10, fifth bullet} Your insurance plan will also look at your doctor’s recommended treatment plan when deciding how long to cover rehab, so it’s important to be honest with your doctor when describing your substance use.

Each GEHA plan will have its own rules and limits, so be sure you verify your coverage before you move forward with a treatment program.

What if my GEHA policy does not cover rehab?

You might find that your GEHA insurance plan will only cover part of the cost of treatment or that the program you’re interested in isn’t covered by your plan. Don’t let that stop you from getting the treatment you need. Instead, look into the many ways you can pay for rehab. For example, some programs have scholarships that are available to participants, or you might be able to set up a payment plan.

Some people are able to get a personal loan or borrow money from friends or family in order to afford substance use treatment. Getting free of substance use helps you get back on your feet financially, mentally, and emotionally, which puts you in a much better position to manage any loans you might have.

You deserve a life free of substance use. It’s the best gift you can give yourself — a happier, healthier life where you’re truly free.

GEHA In Network vs. Out of Network Rehab Centers

Insurance plans contract with specific medical providers and specialists who agree to provide care to plan members at a lower price.^{11, What’s a provider network?} That allows members to pay less out-of-pocket when they choose in-network providers.^{11, Why do some plans cover…}

However, many insurance plans don’t provide any coverage if you choose a medical provider outside the network.^{11, Why do some plans cover…} As a result, it’s important to choose a substance use treatment program that’s within the GEHA network if you want to maximize your coverage.

Fortunately, GEHA has a broad network that extends across the whole country, so you’re likely to find a great program that accepts GEHA coverage.^{1, large network}

Check GEHA Insurance Coverage for Rehab

Ultimately, going to rehab is about getting the help you need to live a better life. Your GEHA coverage can help you cover the cost of your substance use treatment.

You deserve a life where you can be productive, happy, and healthy. You can take the first step in getting treatment today. Simply contact us to get started.