Great-West Healthcare Insurance Coverage for Drug & Alcohol Rehab

If you or a loved one is struggling with addiction to alcohol or drugs and you have a Great West health insurance plan, you may be wondering whether the insurance plan will cover the cost of attending rehab. In most cases, the short answer to the question, “Is alcohol and drug rehab covered under my health plan?” is yes.

In the United States, almost all health plans, including those known formerly as Great-West Insurance (now GWH-Cigna) plans, are required by the federal law called the Affordable Care Act to provide coverage in some capacity for substance use disorder treatment.^{1, 2}

What type of plan you have may dictate the specific amounts of coverage you are afforded under your GWH-Cigna health plan. To find out more about your benefits and coverage, call the number on the back of your insurance card. You can also work with the rehab center directly to verify your benefits and coverage, as many of them can provide these details after you give them some information about your insurance plan.

Check Great-West Insurance Coverage for Addiction Treatment

GWH-Cigna health plans may help cover the cost of treatment for addiction. However, every plan differs in how it covers healthcare services, including those related to addiction treatment. As such, it’s important to verify your benefits and coverage before seeking care whenever possible to avoid surprise medical bills or high out-of-pocket costs for care that may not be covered.

American Addiction Centers, a leader in the nation’s addiction care industry, is here to help you get the care you need. We can also help you learn more about the benefits and coverage that you may have under Great-West (now GWH-Cigna) healthcare.

Call our confidential helpline today and speak to a person who can check your benefits right while you’re on the phone. You can also enter your information in the form below and instantly check your benefits and coverage, and find out whether AAC facilities are in-network with your plan.

What is Great-West?

Great-West Life & Annuity was an independent company that sold health and group insurance offerings.³ In November 2007, Cigna Corp announced it would be acquiring Great-West Healthcare for $1.5 billion.³

At the point of acquisition, Great-West served 2.2 million covered lives and 1.5 million medical members in the company’s employer health plan segments.³ The sale included all of Great-West’s healthcare products, including their traditional managed care plans (e.g., PPO, POS, HMO) and consumer-driven health plans (e.g., HSAs and HRAs).³

Today, Cigna Corp manages the plans formerly known as Great-West under the name GWH-Cigna.³

What will Great-West insurance cover?

What is covered under your Great-West insurance plan will depend on the type of plan you have, as well as where you seek care. Not all Great-West plans offer the same depth and breadth of coverage. Be sure to work with a GWH-Cigna representative to learn more about your specific plan’s details. You can ask the plan representative whether any of the following are covered under your plan:

• Inpatient or residential rehab. This type of rehab program involves a patient staying at a facility for the duration of their treatment, which could range from days to months. With inpatient and residential programs, patients receive round-the-clock, medically supervised care (e.g., detox) and a supportive structure on their path to recovery.^{4, Pg 8, “What types of treatment programs are available?”}
• Outpatient rehab or therapy. This type of rehab program often involves a patient going to 1 or 2 treatment sessions a week, but they don’t need to stay overnight. ^{4, Pg 10, Para 2}
• Intensive outpatient programs (IOP). This type of rehab program involves a patient attending a minimum number of hours of treatment each week, usually at least 9 hours, where they’ll receive the sessions they need in a less supervised and intensive format than traditional inpatient care.^{4, Pg 10, Para 3}
• Partial hospitalization programs (PHP). This type of rehab program involves a patient attending care at an inpatient facility for 4–8 hours each day, multiple days a week. No overnight stay is required.^{4, Pg 10, Para 1}

Just because these treatment methods are listed above doesn’t guarantee that they will be covered under your GWH-Cigna plan. Additionally, they may not be recommended for you on your path to recovery. Work with AAC or your mental health provider to discuss the best course of treatment for you.

Does Great-West Insurance Cover Mental Health Care Treatment Facilities?

The Affordable Care Act (ACA), mandates almost all health plans in the United States to provide some level of coverage for essential health benefits, including mental health and substance abuse services.¹ This means that your GWH-Cigna health plan should provide coverage in some capacity for substance use disorder treatment and mental health care services. The extent to which these services are covered and the cost-sharing requirements imposed may vary.

For you, whether you need stand-alone heroin rehab treatment or co-occurring disorder treatment, you may be able to use your health plan to cover some or all of the associated costs.

When someone has both a substance use disorder and mental illness, it is referred to as a co-occurring disorder or dual diagnosis.^{5, para 2} Those who have 1 condition are twice as likely to develop the other at some point in their life.^{6 “Does one cause the other?”} Because the conditions are interconnected, it’s recommended that the patient gets treated for both conditions at once.

How Long Does Great-West Insurance Cover Rehab?

The length of time that is covered under Great-West insurance plans in terms of rehab treatment varies. The plan you have, where you seek care, and the type and intensity of treatment you need may influence your plan’s coverage details. AAC can help you look up your GWH-Cigna plan’s details, or you can call the number on the back of your insurance card to find out the treatment times that may be covered under your plan.

Regardless of the length of time covered by your plan, it’s important to prioritize remaining in treatment for an appropriate amount of time. Generally speaking, longer treatment times are viewed as more beneficial. Research indicates treatment should last at least 90 days to improve overall positive outcomes.^{7, bullet 5} Please work with your mental health provider to determine how long you should personally be in treatment.

What if my Great-West policy does not cover rehab?

If your GWH-Cigna plan doesn’t cover the costs associated with rehab, there may be payment options available to you at the rehab center you choose to attend. There may be financing or payment plans available to you, as well as scholarship opportunities for which you can apply. These payment options can help you offset the out-of-pocket costs you may incur attending rehab. Remember, getting the treatment you need right now is critical rather than pushing it down the road.

Great-West In-Network vs. Out-of-Network Rehab Centers

A network refers to a plan that contracts with providers to provide healthcare services at a discounted rate.⁸ GWH-Cigna plans may require you to visit an in-network provider to have some or all of your care costs covered. However, some plans may provide coverage for out-of-network providers.

Call the number on the back of your insurance card to speak to a plan representative who can further explain network stipulations to you. You can also call the AAC to learn more about your coverage details and for help finding a covered facility near you.