First Health Network Insurance Coverage for Addiction Treatment

Northpoint the Evergreen accepts First Health Network insurance for alcohol and drug rehab, and can help clients figure out the type of coverage that they have. Those with insurance no longer need to live with an alcohol or drug addiction. They can easily find affordable addiction treatment services that will help them get their lives back on the right track. Sobriety is no longer as far away as it may appear.

First Health Network offers health insurance coverage in all 50 states. More than 96% of Americans are within 20 miles of a network provider. This national PPO network offers coverage for all types of addiction rehab services. They have partnered up with many other health care centers and hospitals, so policyholders can get the addiction treatment that they need when they need it.

“First Health Network is a national PPO network, with more than 5,000 hospitals, over 90,000 ancillary facilities and over 1 million health care professional service locations.”

Take a step towards recovery. Learn more about the First Health Network, as well as its various features.

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A Look at the First Health Complementary Network

First Health Network also has a broad national network that can offer members lower out-of-pocket costs even when seeking treatment outside of their primary network. Members can get lower costs by seeking in-network doctors and healthcare centers from secondary providers. 

First Health Complementary Network has also partnered with other PPO networks to offer a seamless interface. This means that First Health Network can handle all additional electronic claims transfer without charging clients any additional transaction fees. Another benefit of the complementary network is that First Health Network can control some of the out-of-network costs via downstream discounts.

First Health Network can also offer non-network negotiation services. Skilled experts will negotiate medical costs on policyholder’s behalf. They will work with the provider to negotiate a discount on each claim, so that members can enjoy further benefits. All of this is done automatically, so that policyholders do not need to worry about the paperwork or red tape surrounding with getting the treatment that they need.

Policyholders can also contact First Health Network for help if they are reaching any red tape in financing the addiction treatment that they need. The experts at First Health Network can help find solutions.

To find the most affordable addiction treatment program, it’s important to first consider the difference between First Health Network in-network and out-of-network providers. 

In-network providers have an agreement with First Health Network to accept a certain negotiated rate. Out-of-network providers, on the other hand, have not. Due to this reason, clients will generally pay more for out-of-network providers than in-network providers. 

For example, let’s say that the total cost of the addiction treatment services is $1,000. In-network providers may agree to offer First Health Network insurance members a $200 discount. First Health Network may cover $750 of the costs. Clients will be expected to pay the remainder, which is only $50. On the other hand, let’s say that the client has gone to an out-of-network provider. First Health Network will still cover $750 of the costs. However, this provider will not have any prior agreements or contracts with the insurance company. As a result, clients may be expected to pay the entirety of the remainder, which is $250. 

It’s important to note that a rehab center may advertise that it accepts First Health Network insurance; however, that does not necessarily mean that it is an in-network provider. Double check to determine whether there are any additional costs that need to be taken into consideration before choosing a treatment center.

Does First Health Network Cover Addiction Treatment?

Thanks to the Affordable Care Act, all private health insurance companies must offer insurance coverage that covers treatment for both drug and alcohol addiction. These health insurance plans cannot deny anyone coverage to a person for having a pre-existing condition, like a substance use disorder (SUD). Also, coverage for all treatment must begin the day that the coverage starts. 

87% of Americans had health insurance in 2014. These health insurance plans cover a range of addiction treatment services.” 

Another interesting addition is that health insurance companies can no longer put a yearly or lifetime dollar limit on addiction treatment coverage. The type of coverage that each individual has will differ depending on the policy. With that said, First Health Network may cover the costs of the following addiction treatment services: 

  • Alcohol and drug rehab services for all types of addictions. This includes inpatient treatment programs, where clients will move into the addiction treatment center, and outpatient treatment programs, where clients only travel to the rehab facility when they need treatment. 
  • Drug tests and assessments. Tests may be used to diagnose the addiction and determine its overall severity.
  • Medical detox services. This includes all types of medication-assisted treatment. It may include methadone treatment or even Vivitrol services. 
  • Maintenance therapy. This includes medication maintenance therapy and follow-up counseling. It all depends on the client’s needs. 
  • Co-occurring mental health treatment. Many addicts will often struggle with co-occurring mental health disorders and substance use disorders (SUDs). Dual diagnosis treatment is critical to a successful recovery. 
  • Family support therapy. Addiction affects everyone around the addict as well. Family therapy can help mend strained and broken relationships. 

Health insurance ensures that the above addiction treatment services have now become affordable. Addiction treatment is no longer a thing for the wealthy. Anyone can get help if they are willing to get clean. Some addiction treatment plans may even cover the cost of luxury rehab programs.

Approximate Cost of Addiction Treatment Services

Addiction treatment is costly, but not as costly and damaging as the addiction itself. With that said, it’s still a good idea to familiarize with the approximate cost of addiction treatment services. First Health Network insurance coverage will usually cover all, if not most, of the costs.

First Health Network Insurance for Rehab

According to a study conducted in 2011, here are some average treatment costs: 

  • $1,707 per day for medical detox. This includes various types of medications, like methadone and buprenorphine for treating opioid addictions, and acamprosate and disulfiram for treating an addiction to alcohol.
  • $19,067 for a 28-day residential treatment program. With that said, the cost of a 28-day residential drug or alcohol treatment program can cost up to $32,000. Luxury rehab programs can cost upwards of $80,000.
  • $6,863 for a 10-week intensive outpatient program (IOP). Depending on the amenities and services offered, some of these programs can cost upwards of $10,000 per month. 

Addiction treatment costs have only risen in recent years. As a result, alcohol and drug abusers can expect slightly higher medical bills. The cost of the addiction treatment will also depend on the quality of care that the rehab center can provide. 

Depending on the individual’s plan, their First Health Network insurance policy may require them to pay copayments. Or, they may need to pay a deductible first. It is critical for policyholders to fully understand the details of their plan to get a better idea of how much addiction treatment may cost.

Copays vs. Deductibles

Both copays and deductibles are common features of health insurance plans. These features will require policyholders to pay some of the costs out of their own pockets. These two features are completely different, but they are, unfortunately, often mistaken for one another. 

In general, health insurance plans with lower monthly premiums may have higher copayments and deductibles. On the other hand, pricier health insurance premiums ten to come with lower copayments and deductibles. Let’s take a look at the differences between the two below.

Deductibles

A deductible is a fixed amount that must be paid before First Health Network insurance coverage kicks in. After the deductible has been met, beneficiaries may need to pay a copayment for any services that they receive.

For example, let’s say policyholders have a $1,000 annual deductible. Clients must pay for the full cost of any treatment that’s below $1,000 until they have reached this deductible amount. If every day at the addiction treatment center costs $250, clients are expected to pay for the first four days out of his or her own pocket. Once the deductible is met, insurance will cover the costs of any additional treatment services.

Copayments

Copayments,are also known as copays. They are a fixed amount that the policyholder is expected to pay for treatment. Usually, copayments are paid after paying the deductible.

Copayments can vary for different addiction treatment services. For example, the copay for medication-assisted treatment (MAT) may be only $10, while the copay for behavioral therapy may be $50. The cost of the copay will vary depending on each policyholder’s plan. Insurance companies will pay the remaining balance after the copay has been covered. This payment is fixed, so policyholders will pay $10 every time they receive MAT or $50 every time that they see a behavioral therapist.

Some First Health Network insurance plans may have coinsurance. This is different from copayments and from a deductible. 

Coinsurance is a percentage that is paid after the deductible has been met. For example, an individual's coinsurance may be 80/20. This means that the policyholders will be expected for paying for 20% of the addiction treatment costs by themselves. The insurance will cover the rest of the 80%. This percentage usually does not change regardless of the amount of treatment that policyholders receive.

What About Out-of-Pocket Costs?

Depending on one’s health insurance policy, some addiction treatments costs may not be covered by insurance. This means that clients will need to pay for these costs out of their own pockets. Clients, who can afford these costs, can pay for these costs via cash, money order, debit card, money transfer or credit card. 

If these costs are still too high for some clients, they can speak with the addiction treatment center to see whether they can:

  • Work out a monthly payment plan. This would make it easier for clients to afford the substance abuse treatment that they need. Some addiction treatment centers are willing to spread out the costs over several months and, even, up to a year.
  • Offer clients a scaling fee discount. Depending on the client’s income, some addiction treatment centers may offer a scaling fee discount. Low-income clients may be able to enjoy steep discounts.
  • Recommend any other options. Some addiction treatment centers will even go as far as checking whether clients may be eligible for any state or federal grants. These grants may help cover some of the addiction treatment costs. 

The last thing that most addicts want when seeking treatment is surprise charges. Experts at the addiction treatment center can easily find out the amount of out-of-pocket costs that clients can expect. They can also help determine whether there are any ways to lower these costs to make treatment more affordable.

Northpoint the Evergreen

Verify Your Insurance Coverage with Northpoint the Evergreen

If you have insurance with the First Health Network, you may be covered for addiction treatment services at Northpoint the Evergreen. Figuring out whether your insurance covers the cost of your treatment, as well as the paperwork involved, can be an absolute headache. It can be difficult to understand what everything means. 

We have made verifying your insurance as simple and easy as possible. Simply fill out our online form, and we’ll get back to you with a detailed breakdown of what your insurance will and will not cover. We’ll also help you figure out what your copay, coinsurance or deductible may be. From here, we can easily get you into the right substance abuse treatment program that’s most affordable. We will even work with your insurance provider to make sure that you get everything that you need. 

If you have any further questions, please don’t hesitate to contact us. We’re here to help in any way that we can.

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