PPO Insurance Rehab Coverage for Drugs & Alcohol

What is PPO Insurance?

PPO, or Preferred Provider Organization insurance, is a type of insurance that covers a large network of physicians, doctors, and medical professionals and is more generally accepted than the typical HMO or EPO variety of policies.

A PPO form of health insurance usually does not require a referral when visiting doctors or specialists outside your primary care physician. This means you will be able to visit any doctor in-network with your PPO insurance coverage that you feel best suits your healthcare needs or any ‘PPO insurance rehab’ that works with your carrier as well.

Keep reading to find out why you should use your PPO policy coverage for addiction treatment, and the best ways of doing so effectively and confidentially!

Does PPO Cover Alcohol and Drug Addiction Treatment?

As with most other insurance providers, PPO policies typically offer some level of coverage for a number of different addiction treatment programs. This is due to The Mental Health Parity and Addiction Equity Act of 2006.

Under this act, addiction and mental health treatment coverage became a federal law, meaning it is now seen as a medical necessity. Your health insurance provider’s substance abuse treatment coverage will typically extend over various alcohol and drug rehab services, such as:

• Medical Detox Treatment
• Inpatient/Residential Treatment
• Outpatient Treatment
• Medication-Assisted Treatment
• Dual Diagnosis Treatment

 

While PPO plans may not offer full coverage for a lengthy rehab stay, these can still minimize your out-of-pocket costs, and will often allow for a wider selection of healthcare providers and treatment options when seeking recovery support.

Reasons PPO Insurance Coverage Works Well for Residential Drug and Alcohol Rehab

Inpatient and residential drug and alcohol rehab facilities help those struggling with addiction to overcome their habits in a highly structured and constantly supervised environment, allowing them to receive regular access to recovery tools and resources.

When receiving inpatient treatment, individuals will be removed from the external stressors and temptations that may make maintaining their abstinence more difficult. This will significantly reduce their risk for relapse, and make their recovery process far easier.

This level of drug and alcohol treatment will likely also offer various behavioral therapies and holistic recovery services for those struggling with an underlying mental illness, as well as provide a whole-health approach to treatment.

Of course, with these additional benefits, many insurance companies, including a Preferred Provider Organization, will offer less coverage for inpatient care. This means you may have more out-of-pocket expenses when choosing to recover through a residential treatment center.

Using PPO Substance Abuse Coverage for Outpatient Programs

For some individuals, they may choose to make an outpatient program their main form of addiction treatment. While less extensive and structured than inpatient options, outpatient care allows for more PPO coverage, meaning fewer out-of-pocket expenses for the recovering person.

Furthermore, these options will allow you to receive necessary addiction treatment and recovery support while still being able to continue to manage any external family, work, or school responsibilities, as you will not be living at a treatment facility.

When recovering with an outpatient treatment provider, individuals will likely participate in group therapy, recovery support groups and skill-building programs. While you may still have to pay out-of-pocket for some of this level of care, it will be significantly cheaper than inpatient options.

What Length of Substance Abuse Treatment Will a PPO Insurance Rehab Cover?

The length of time a person will spend receiving drug and alcohol treatment will vary based on several factors. These may include the severity of their addiction, the type of program they are being treated through, and any personal or external limits that may interfere with their recovery.

For many people, these limitations often come from a lack of necessary time and money to receive proper care for their substance use disorder. This, unfortunately, can prevent them from seeking professional treatment providers to help them overcome their drug and alcohol abuse.

On average, a person will generally spend between 30 to 105 days recovering through inpatient treatment, while those who choose to receive treatment through an outpatient center will do so over a period of around or over 120 days. In some cases, people searching for the right level of care will attend both inpatient and outpatient rehab settings in order to provide a better foundation for ongoing recovery.

In Network vs Out of Network PPO Rehab Providers

Most insurance companies will only provide coverage for a specific amount of this treatment process, especially if a treatment provider is not in-network. When it comes to addiction rehab coverage, PPO insurance companies may be more flexible with this.

Whereas private insurance companies may not cover drug and alcohol treatment services or a healthcare provider that falls outside of their network, a PPO insurance will often pay for rehab services such as detox, inpatient, and outpatient programs provided by out-of-network treatment providers.

In most cases, this may require the recovering individual to cover the costs of what is not included in their insurance plan. This, however, will still be far less expensive than if they were to receive treatment with less flexible insurance coverage, or without this assistance at all.

Covering Specialized Alcohol & Drug Rehab Through a PPO Insurance Provider

According to the Substance Abuse and Mental Health Services Administration (SAMSHA), an essential aspect of addiction treatment is dual diagnosis treatment, or the incorporation of various behavioral and holistic therapies in a person’s recovery process.

This allows their healthcare providers to take a whole-health approach to their drug and alcohol treatment process, addressing both the addiction itself, as well as its underlying causes and contributors.

With a PPO insurance policy, there are many essential health benefits that may come with these providers, including dual diagnosis services, as well as possible access to some luxury treatment options. Of course, these rehabs will be more expensive than other treatment centers.

This is because they will provide additional amenities that may not be provided through other treatment programs, such as various athletic services and facilities, equine therapy, art therapy, aromatherapy, and spa services.

While certainly more appealing and comfortable than other treatment centers may seem, luxury rehab facilities are not a necessary level of care for addiction recovery. For those who cannot afford these additional amenities, standard levels of care will work just as well with their needs.

How To Pay For What PPO Plans Will Not Cover

Unfortunately, many people will avoid seeking help for their alcohol and drug abuse due to the costs of rehab. This is why having a reliable health insurance policy can be so important in a person’s successful recovery from their addiction.

However, having reliable insurance coverage may not always be attainable for some people. Fortunately, there are several ways of paying for professional substance abuse treatment that do not require insurance or can help cover that which is not paid for by an insurance provider.

The most popular, of which, are installment plans. These allow recovering individuals to gradually pay for their treatment over time, rather than having to provide a large sum of money all at once. For many people, this can significantly ease the financial burden rehab may impose.

In addition to this, a person may also choose to seek out financial assistance from their friends, family members, or other loved ones. A close support system that wants to help ensure the individual’s well-being, can help reduce the treatment costs they have to cover on their own.

What Substance Abuse Treatment Services are Covered Under Your PPO Insurance Plan?

Knowing what types of addiction treatment services are covered under your PPO insurance plan and the exact coverage you will be able to receive can help give you peace of mind when seeking professional help in overcoming your drug and alcohol abuse habits.

You can easily find out this information just by calling our Find Addiction Rehabs hotline and getting an assessment of your coverage and options from our recovery representative team. The call will be completely confidential and protected by HIPAA laws and can give you a sense of what options are open to you within minutes and with no obligation whatsoever.

Verify Your Insurance Policy and Find the Best Treatment Centers Now!

If you or a loved one is struggling with addiction, this can be an incredibly difficult thing to deal with. However, it is important to know that you are not alone, and help IS available. At Find Addiction Rehabs, we are dedicated to getting people like you the recovery help they need.

Our hotline is available 24/7 to provide you with addiction treatment tools and resources, anytime you need them. You may also use our fast and easy insurance verification tool to help you determine which treatment options and rehab centers are covered by your insurance plan.

So don’t wait; reach out to a Find Addiction Rehabs recovery representative now, and we can help you figure out and verify your insurance coverage and take the first step on your recovery journey. A happier and healthier life is waiting for you or your loved one, so please give yourself a break and call today!

Medically Reviewed By