Northpoint the Evergreen Is Now In Network with USA Managed Care Organization Insurance

Northpoint the Evergreen accepts USA Managed Care Organization insurance for drug and alcohol addiction rehab. In fact, we are now an in-network provider. Clients can learn more about the types and amount of coverage that their insurance plan offers below.

Only about 10% of addicts will seek treatment for their addiction. Some people don’t believe that they have a problem and are in denial. Others may simply feel that they can sober up on their own.

However, there is a portion of addicts who hesitate to get treatment not because they don’t think that they need it, but because they think it’s too costly. These individuals are under the assumption that getting treated would cause them to go bankrupt. Or, they simply don’t have the financial means to even look for help.

Nowadays, there are actually many options. 85% of Americans have health insurance, and all health insurance plans cover addiction treatment. Those who not have health insurance can always rely on Medicare, Medicaid or other federal or state-funded programs. Many addiction treatment centers have also partnered up with insurance companies to offer lower addiction treatment costs.

Do You Have Questions About Addiction? Call Our Recovery Experts Now.

What’s the Difference Between an In-Network and Out-of-Network Provider?

The fact that Northpoint the Evergreen has become an in-network provider of USA Managed Care Organization Insurance is exciting news. It means we are able to offer more affordable addiction treatment services to policyholders with insurance from this company. 

An in-network provider is one that has already come up with an agreed upon discount or rate with the insurance company. This means that clients pay less for the same type of services. Out-of-network providers, on the other hand, do not have any agreement. Due to this reason, the cost of treatment can vary significantly. It’s important to note that some insurance policies may not cover out-of-network providers, and some other policies may offer less coverage for treatment obtained from out-of-network providers versus in-network providers. 

Another interesting thing to keep in mind is that an addiction treatment center may not necessarily be an in-network provider even though it may accept USA Managed Care Organization insurance. The two are very different.

Do USA Managed Care Organization Insurance Plans Cover Addiction Treatment Services?

Prior to 2014, not all health insurance plans offered insurance coverage for addiction treatment services. However, due to increased alcohol abuse and illicit drug use rates, the government had to step in and make sure that all health insurance plans offered sufficient coverage for policyholders to receive the treatment that they need. 

The Affordable Care Act (ACA) put in place comprehensive reforms that were able to: 

  • Make health insurance not only available to more Americans
  • Lower overall health care costs
  • Ensure more health care options
  • Enhance the overall quality of all health care services 

It also put in place ten elements of essential health benefits. Treatment for substance use disorders (SUDs) is one of them. This means that all health insurance plans that are sold on Health Insurance Exchanges or provided by Medicaid must offer some type of coverage for addiction treatment services. 

Take a look below to see some of the addiction treatment services that USA Managed Care Organization insurance plans may cover. Note that each insurance policy is different. Due to this reason, each client will have a different amount of coverage.

Medical detox is among one of the most important addiction treatment services out there. It’s usually the first part of any alcohol or drug addiction treatment plan. 

Drug detox uses a cocktail of different addiction medications to ease withdrawal symptoms, both physical and psychological. The type of medications that clients need will vary depending on the type and severity of addiction that they have, as well as the severity of the withdrawal symptoms. 

Common medications that are often covered under most health insurance plans include: 

  • Opioid addiction medications, like methadone, Suboxone and Vivitrol
  • Alcohol addiction medications, like acamprosate and disulfiram 

Some health insurance plans will also cover other types of medications that can treat specific symptoms. For example, Baclofen may be used to treat seizures and tremors. It’s a GABA-B agonist that relaxes muscles. 

Many health insurance plans will cover a specific type of medication or a specific treatment plan. Some health insurance plans may require pre-approval. Clients will need to submit a request for the medications ahead of time. Otherwise, the medications may not necessarily be covered under the plan.

Coverage for alcohol and drug rehab programs are what most clients look for. Fortunately, almost all health insurance plans offer coverage for rehab. The level of care that is covered, however, will vary from one policy to another. The different types of rehab programs include: 

  • Residential inpatient treatment programs. These programs offer the most intense type of care, as clients will move into the addiction treatment facility for anywhere from 28 to 90 days. Some health insurance plans may only cover a portion of inpatient care. Others may specify the number of days that they would cover in one calendar year.
  • Outpatient treatment programs. These programs allow clients to continue on with their lives while getting treatment. Clients will travel to the rehab facility whenever they need treatment. Most health insurance plans offer the most coverage for outpatient treatment. Outpatient programs can take anywhere from several months to over a year to complete. Clients can choose the number of hours that they would like to dedicate to treatment every week. Different types of outpatient programs include Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs)

The right type of rehab program can make a world of a difference. Understanding which one is covered by insurance and which one may be better tailored to one’s lifestyle is crucial. Speak with one of our addiction specialists to get a better idea of what’s needed.

Aftercare programs are critical to a successful recovery. Fortunately, these programs are also often covered by health insurance plans. Continuing care can include services like: 

  • Sober living arrangements. These housing arrangements encourage recovering addicts to stay sober. They are in an environment that is conducive to recovery and can offer a significant amount of support.
  • Medication Maintenance Therapy (MMT). Some addictions, like opioid addictions, may require MMT. This means that recovering addicts may need to take medications, like methadone, for an extended period of time even after they have completed an addiction treatment program.
  • Continuous counseling and therapy. Psychological withdrawal symptoms and mental health conditions may still linger around after getting treated. Additional counseling and therapy can really help encourage some recovering substance abusers to stay on the right path. 

The type of counseling services and medications recommended for each client will vary. It all depends on the addiction. Most addiction rehab facilities will work with insurance companies to figure out what treatment is covered under each client’s plan.

Depending on each insurance policy, USA Managed Care Organization insurance plans can cover a wide range of other addiction treatment services. Some other addiction treatment services that are often covered include: 

  • Family support and therapy. This type of service helps loved ones cope with the addiction. It can also help the alcohol or drug abuser mend strained or broken relationships with family members.
  • DUI assessments, as well as other assessments and testing. One of the most critical parts of recovery is figuring out whether one has an addiction or not. This can all be determined through various assessments. 

Knowing what each insurance plan cover can help many people determine the type of treatment that they need. Many health insurances require pre-approval for addiction treatment services. The requirements will vary, but most rehab facilities will ask for documentation from addiction experts and physicians.

Deductibles, Premiums, Coinsurance and Copayments

So, how does health insurance work? What exactly do policyholders pay out of their own pockets. In order to have insurance, policyholders must pay a monthly premium. This premium will vary depending on the amount of coverage that beneficiaries want, as well as the total cost of other features of the insurance plan. This includes deductibles, coinsurance and copayments. 

USA Managed Care Organization Insurance for Rehab

What do all these features mean? Let’s take a look below: 

  • Deductible. This is the amount that policyholders must pay out of their own pockets before the insurance policy kicks in. For example, if the deductible is $500, policyholders must pay $500 either for addiction treatment services or for any other medical expenses before they can start relying on their insurance.
  • Coinsurance. This is a percentage of the total cost that is paid by policyholders. The percentage will vary from one insurance plan to another. For example, if an individual has a coinsurance of 20%, he or she will pay 20% of the total cost of the services rendered. The remaining 80% is covered by the health insurance company.
  • Copayments. This is a fixed amount that policyholders pay for services. This amount can vary depending on the type of service that beneficiaries receive. For example, the copayment for medications may be different from the copayment for counseling sessions. 

Whether an insurance plan has a coinsurance or copayment feature can vary. It all depends on the policy. Some people prefer health insurance plans with a copayment feature whereas others may prefer one with a coinsurance feature. 

Another thing to note is that low monthly premiums often come with higher deductibles, coinsurance and copayments. On the other hand, high monthly premiums come with lower out-of-pocket costs.

Paying for Out-of-Pocket Expenses

Out-of-pocket expenses can quickly add up. This may cause some substance abusers to feel wary of getting treatment. Thankfully, there is a cap on the amount of out-of-pocket expenses that policyholders should pay. For the 2019 plan year, the out-of-pocket expense limit is $7,900 for individual plans and $15,800 for family plans. This limit will change each year. 

There are many different ways that clients can pay for out-of-pocket expenses. Those who already have the funds ready can pay for out-of-pocket expenses in cash, by credit cards or debit cards, with money orders and wire transfers, or by cheque. 

Clients who are unable to fork the money out right away can also consider getting grants from the government or negotiating with the addiction treatment center. Some drug and alcohol treatment facilities offer sliding scale fee discounts based on a client’s income. Depending on one’s income, some addiction treatment centers may even offer addiction treatment services for free to clients. Clients may also be able to work out a monthly payment plan.

Northpoint the Evergreen

Discover the Amount of Coverage that You Have

Here, at Northpoint the Evergreen, we want to help substance abusers afford the treatment that they need to get sober. Verify your insurance with us to see what type of coverage you have. We will work with your insurance provider to get you covered. Also, we will bill your health insurance directly, so you won’t have to worry about a thing. 

Let us help you get started on the road to recovery. We are able to offer a wide range of addiction treatment services, and can point you towards the right addiction resources. If you need additional information, please don’t hesitate to get a free addiction assessment from us, no strings attached. Everything that you share with us will be kept confidential.

All content on this website, including graphics, texts and other materials, are to be used for informational purposes only. This information should not be used as a substitute for medical advice, diagnosis or treatment. Do not put off seeking medical attention or help for any information found on this website. Those who rely upon this information are doing so at their own risk. Further questions can be addressed by a qualified healthcare provider. Call 911 immediately when dealing with a medical emergency. This website does not recommend any tests, physicians, products or procedures.

Talk to a Rehab Specialist

Our admissions coordinators are here to help you get started with treatment the right way. They'll verify your health insurance, help set up travel arrangements, and make sure your transition into treatment is smooth and hassle-free.

(425) 629-0433 Contact Us