Clinical drug treatment is the best way to get clean if you’re struggling with an addiction. While it can be expensive, Blue Cross Blue Shield PPO insurance for rehab provides many addicts with the coverage they need. Whether you require detox, outpatient treatment, or a full-fledge inpatient program, you may be able to get extensive funding from Blue Cross. If you’re an addict in need, it’s imperative that you understand these important details about your insurance.
The Managed Care System
A preferred provider organization is one of the primary types of arrangements under the managed care system of health insurance. Managed care benefits both customers and doctors by coordinating certain networks of healthcare providers. Customers gain access to extensive coverage and low out-of-pocket costs – as long as they seek treatments within their companies’ networks. The hospitals and clinics in those networks also benefit from the high likelihood of patronage from contractees.
The Advantages of PPO Insurance
PPOs provide a variety of benefits over health management organizations. For instance, HMOs require customers to designate primary care physicians, who then refer their patients to specialists. This can make it more difficult for addicts to get coverage for drug treatment, since rehab is typically considered a specialty service. On the other hand, PPO customers don’t need primary physicians, and they can generally get coverage for any critical in-network procedures.
Another benefit of Blue Cross Blue Shield PPO insurance for rehab is that customers can often get coverage for treatments outside their networks. Most PPOs will still cover large percentages of the costs, and some states actually require them to. This is excellent for people who want to attend specific clinics, or who have special needs that can only be met at certain facilities.
PPOs do tend to charge higher monthly premiums and deductibles, but their flexibility is often worth the higher costs. Plus, you may not need to worry about the higher prices if you contract through your employer.
Your Rights under the Mental Health Parity Act
If you contract for insurance through your employer, then you should also understand your rights under the Mental Health Parity Act. This law requires that large companies provide as much coverage for mental health services as they do for medical or surgical care. Although the current understanding of addiction makes this distinction somewhat problematic, the act effectively mandates that employers provide psychiatric and rehabilitative services for addicts. The Health Parity and Addiction Equity Act of 2008 further solidifies this requirement, and it may even help you to get additional coverage for out-of-network care.
Unfortunately, Mental Health Parity does not apply to smaller companies or people who are self-employed. If you fall under one of these categories, you may incur greater out-of-pocket costs. Still, it’s possible to get extensive coverage if you’re married to someone whose employer is required to provide mental health services.
Blue Cross Blue Shield PPO insurance for rehab is one of the best ways to get coverage for rehab, but even knowledgeable contractees can have trouble understanding their options. If you want to learn more about how to pay for treatment, fill out the insurance verification to the right of this page now. We’ll help you find out what programs are available to you.