MHNet Insurance for Drug and Alcohol Addiction Treatment Services

MHNet Insurance is accepted at Evergreen for addiction recovery treatment. Founded in 1985 by doctors, MHNet Insurance offers national coverage to over 5 million Americans. This network provides some of the highest quality of care around, and has received the highest credentials from the National Committee for Quality Assurance.

Those who have MHNet Insurance will have coverage for addiction treatment services. In the past, many drug addicts and alcoholics were hesitant in seeking help. They were worried that they would not be able to afford drug or alcohol rehab. In recent years, health insurance plans are mandated by the government to offer some type of coverage for substance abuse treatment.

There’s no reason for anyone who is struggling with addiction to avoid getting help. Addiction treatment is no longer as unaffordable and expensive as before. Many addiction treatment services are now covered by health insurance plans. Below, we’ll take a look at the types of addiction treatment services that are covered by MHNet Insurance. Note that coverage will vary based on each policyholder’s insurance policy.

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Addiction Treatments Covered by MHNet Insurance

So, what addiction treatment services are covered by MHNet Insurance? The amount and type of coverage will vary from one policy to another. With that said, all MHNet insurance plans cover some type of substance use disorder (SUD) treatment thanks to the Affordable Care Act. 

Health insurance companies cannot deny coverage due to a pre-existing condition. This includes pre-existing SUD conditions. Coverage must also begin the day that coverage starts. Another important thing to note the health insurance plans may not put a yearly or lifetime limit on addiction treatment. This is to ensure that policyholders get the treatment that they need. 

Let’s take a look at the type of coverage that MHNet Insurance policyholders may have.

Almost anyone who struggles with a drug or alcohol addiction will need to go to rehab. Those who try to recover at home are more likely to fail. They are also more likely to experience intense and overbearing withdrawal symptoms. MHNet Insurance covers the cost of all types of alcohol and drug rehab programs. Policyholders may be covered for: 

  • Residential inpatient treatment services. Inpatient treatment programs offer the highest intensity of care possible. Clients will need to move into the rehab facility for anywhere from 28 to 90 days. Depending on one’s policy, there may be a limit on the number of days that clients are covered for at a time. The type of program that clients can choose may also vary. For example, there are some premium insurance plans out there that cover the cost of luxury rehab programs. Most insurance plans do not cover this. 
  • Outpatient treatment programs. These rehab programs offer the most flexibility in regards to treatment times. There are many different types of outpatient programs. Some health insurance plans may vary in the type of outpatient care that is covered. Some of the more popular outpatient programs include Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs)

Some policies will cover the cost of transitioning from an inpatient treatment program to an outpatient one. Each policy is different.

Medical detox is a critical component of any substance abuse treatment plan. Most MHNet Insurance policies will cover some type of medical detox. This includes drugs like: 

  • Methadone, Suboxone and Vivitrol for treating an addiction to opioids and opiates
  • Acamprosate and disulfiram for treating an addiction to alcohol 

MHNet Insurance plans may also cover the cost of maintenance therapy. This is for any medications that clients may need to take after completing an addiction treatment program. Medication maintenance therapy can be quite long for some drugs. For example, some heavy users may rely on Methadone Maintenance Therapy (MMT) for more than 10 years.

MHNet Insurance policies may also cover an assortment of important addiction treatment services. It all depends on the policy, as well as recommendations from addiction experts and doctors. Some of the other types of addiction treatment services that may be covered include: 

  • Drug testing and assessments. These medical assessments may be absolutely necessary to determine the extent of the addiction. These tests may also be used to determine the physical and mental condition of each client.
  • Aftercare treatment. This can include different types of behavioral therapies and counseling. Both of these treatments can help prevent relapses by treating psychological withdrawal symptoms. Some insurance policies may even cost some of the costs of staying in a sober living home.
  • Family support and therapy. Addiction often ruins families. The addict is not the only individual who is affected by the addiction. Family support and therapy can begin the healing process. These services can help mend strained and even broken relationships. They can also help family members learn how to approach the addict and how to interact with him or her. 

Clients are often surprised at the amount of extra addiction treatment services that are covered by health insurance. These services can improve the client’s quality of care or help them deal with other issues surrounding the addiction.

In-Network vs. Out-of-Network Insurance Providers

When seeking addiction treatment, it’s important to consider whether the healthcare provider is an in-network provider or an out-of-network provider. The difference between the two can heavily affect the amount that clients pay. 

In-network providers have an agreement with MHNet Insurance to provide discounted rates to their clients. Out-of-network providers, however, do not have any agreement with MHNet Insurance at all. As a result, they can generally charge more for their services. 

So, how does this all work? Let’s take a look at an example. 

Let’s say that a day of treatment costs $500. An in-network provider may have already agreed to offer MHNet Insurance members a discount of $100. MHNet may cover $250 of the total cost. As a result, policyholders may pay a total of $150 out of his or her own pockets. Out-of-network providers, however, do not have this agreement. As a result, policyholders may have to pay the entire $250 out of their own pockets. They are not entitled to any discounts. With that said, the experts at MHNet Insurance may be able to help clients negotiate a lower out-of-pocket cost. 

An important factor to consider is that drug and alcohol rehab centers may advertise that they accept MHNet Insurance. However, this does not necessarily mean that they are in-network providers. Clients are encouraged to choose in-network providers. With that said, if they are more interested in seeking an out-of-network provider, other arrangements can be made.

Copayments, Coinsurance and Deductibles

To gain a better understanding of how much addiction treatment can cost, it’s important to fully dive into the difference between copayments, coinsurance and deductibles. All three are features commonly found in almost all health insurance plans. Understanding the differences between the two can help policyholders gauge how much the treatment is going to cost.

MHNet Insurance for Rehab
Deductible

The deductible is the amount that clients must pay before their health insurance plan kicks in. Clients must meet the deductible first. It doesn’t matter whether all of the costs are for addiction treatment services.

For example, let’s say a client has a deductible of $1,000. He or she may have spent $500 throughout the year seeing a doctor and on prescription medication. This means that the client will need to pay $500 out of his or her own pockets for addiction treatment. Health insurance kick ins after that.

Please note that most policyholders will then either have a coinsurance or a copayment feature to their plan.

Coinsurance

A coinsurance kicks in after policyholders have already paid the deductible. A coinsurance means that policyholders will have to pay a certain percentage of the overall addiction treatment costs. MHNet Insurance will cover the rest of the costs.

For example, let’s say a policyholder has a coinsurance of 20%. This means that he or she will have to pay 20% of the addiction treatment costs. MHNet Insurance will cover the rest of the 80%.

Copayments

A copayment is a fixed amount that policyholders pay for treatment. This fixed amount may vary depending on the type of addiction treatment services that clients receive.

For example, a session with a behavioral therapist may come with a copayment of $50. On the other hand, addiction medications may have a copayment of $10. Clients will pay the copayment every single time that they pick up medication or see a behavioral therapist. The rest of the costs are covered by their insurance plan.

In general, higher insurance premiums are often associated with lower copayments, coinsurance and deductibles. Those with lower insurance premiums can usually expect higher copayments, coinsurance and deductibles.

Paying for Out-of-Pocket Expenses

At the end of the day, clients may have some out-of-pocket expenses that are not covered by MHNet Insurance at all. This means that clients will have to figure out how they’re going to pay for these added expenses before getting treatment. Those who can afford to pay these added expenses can pay with cash, money orders, wire transfers, debit cards or credit cards. 

Unfortunately, not everyone can pay for the out-of-pocket expenses upfront. Those who may not necessarily be able to afford the extra expenses should consider reaching out to the addiction treatment center. 

Many addiction treatment facilities will work with clients to come up with a feasible payment plan. Others may offer a sliding scale fee discount based on the client’s income. Others may even have grants at their disposals. 37.8% of rehab facilities offer free addiction treatment to some clients and a sliding scale fee to others. 

It’s important to note that there is an out-of-pocket maximum set by the government. For 2019, health insurance plans may have an out-of-pocket limit of $7,900 for individual plans and $15,800 for family plans.

Northpoint the Evergreen

Northpoint the Evergreen Can Verify Your Insurance for You

Many alcoholics and drug addicts hesitate to get help because they think that they can’t afford it. Drug and alcohol rehab services are not only for the wealthy. Anyone with health insurance may be able to easily afford treatment. Figure out how much the addiction treatment that you need will cost by verifying your insurance with us. We’ll figure out the details, so you don’t have to. 

We’ll get back in touch with you once we figure out what your insurance plan covers and don’t cover. Afterwards, you can work with one of our addiction specialists to determine the type of treatments that you need for a successful recovery. 

Northpoint the Evergreen primarily offers outpatient addiction treatment services. If we’re an in-network provider with your insurance company, you’ll enjoy even lower costs. 

Don’t let an addiction control your life anymore. Speak with one of our addiction experts to get a better idea of what to expect. We can help customize a treatment plan for you based on your needs. Our only goal is to help you get the treatment that you need to get sober.

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