If you have found your way here, that most likely means you or a loved one are suffering from a substance use disorder. We are glad you’re here, seeking to better understand your insurance policy will save you stress in the long run. However, insurance can be extremely confusing. That is why here at Northbound Treatment we want you to be the most informed you can be. Needless to say, you should not be worrying about money when seeking to recover. We at Northbound have a team specifically designed to better help you understand your policy.
Insurance for Drug and Alcohol Treatment
Health Net is an insurance group that covers 5.9 million people across all 50 states through health maintenance organization (HMO), preferred provider organization (PPO), and point of service (POS) insurance benefits plans. There are options for individual, group, Medicare, Medicaid, Tricare, and Veterans Affairs programs available through Health Net. Those seeking behavioral and substance abuse treatment can use MHN, the company run by Health Net that manages these specific coverage needs. To see if you qualify for insurance, we will link a form at the bottom of this page.
Health Net functions in much the same way as other companies such as Blue Cross Blue Shield, Anthem, etc. What you need to understand is that the varying tiers of coverage will determine how much your treatment will be covered. Along with this, your location, specific needs, and type of treatment may affect the cost. Do not worry, we will break it all down below.
Policy Coverage for Substance Abuse with Your Policy
As previously stated, there are several tiers to the plans and policies offered by Health Net. Below we will be breaking down a ton of numbers. The percentage shown means you will pay that percentage of the coverage. For example, if the treatment costs $10,000, and your plan says you pay 25%, you will have to pay $2,500 of the treatment. The percentage does not change based on different levels of treatment, so you will still pay 25% whether the treatment costs 30,000 or 3,000.
- Bronze – 40 percent
- Silver – 30 percent
- Gold – 20 percent
- Platinum – 10 percent
While Platinum seems like the obvious choice, your monthly payment is more depending on your plan.
How Policies Work for Treatment Centers
Health Net uses the metal rating system for many insurance plans. Metal levels allow insurance shoppers to get an idea of how much they must pay for healthcare in the program. Bronze is the lowest metal plan level. Bronze plans typically come with higher deductibles and lower premiums. Bronze-plan clients can expect out-of-pocket expenses of 40 percent, with Health Net covering 60 percent of treatment expenses. Platinum-plan premiums tend to cost more but require less money out-of-pocket.
Health Net provides a variety of plan types, including:
- Health Maintenance Organization
- Exclusive Provider Organization
- Healthcare Service Plans
- Preferred Provider Organization
Does it Need to be In-Network?
The short answer, no. However, in-network means that the facility operates within Healthnet’s span of organizations and is covered under insurance. If you go out-of-network, there is no guarantee that a facility or treatment program will be covered, leading you to pay much more money out of pocket. Again, it isn’t impossible to an out-of-network facility to make an agreement with Healthnet, just less likely than in-network.
About Coverage for Detoxification
If you do not know what detox is, it is often the very first step on the recovery journey. It is the process in which all the chemicals and traces of the substance are flushed from your body. This leads to harmful withdrawal effects, which are unpleasant, painful, and sometimes dangerous. Sometimes facilities allow for prescriptions or drugs administered to ease the pain. Healthnet most likely covers detox but check your plan to see if it allows behavioral health.
Covers Inpatient Insurance
Healthnet offers a wide span of programs ranging from group therapy, group treatment, to individual approaches. Usually, it will cover inpatient. Health Net policies typically require either a copayment or coinsurance fee for residential addiction treatment. Copays are flat amounts that the insured pays out-of-pocket, while coinsurance fees are percentages of the entire bill. For example, if the inpatient costs come to 30,000 and your policy requires a co-pay of 10%, you will pay 3,000 of the bill.
Coverage for Mental Health Treatment
Mental health is also a topic that needs to be discussed involving insurance. Mental illness on its own is debilitating enough. However, when an addiction co-occurs with a mental illness it becomes a co-occurring disorder. We want you to get your whole self, mind, and body, treated. It can be challenging, but it is best to know which options are available, and what is able to be treated with Healthnet insurance policy. Some of the following are examples of mental illness.
- Post-Traumatic Stress Disorder
- Bipolar Disorder
- Eating Disorders
Recently laws have been passed that do not allow discrimination based on mental illness, thus if your policy covers something for addiction; it likely covers the same in regard to mental illness.
Helping You Understand Your Benefits
We know that it can be confusing being an Healthnet insurance holder, however that is why we want you to know that there are many benefits in partnering with Northbound treatment and Healthnet. We promise to thoroughly review your treatment plan and determine what substance abuse treatment is covered. We will also determine what methods of treatment are covered, and while Healthnet covers a vast majority of treatment facilities; we will show you which ones are covered.
The Northbound Addiction Treatment Services Promise
We won’t recommend a drug and alcohol rehab facility unless it meets or exceeds our own standards of what comprises an effective, comprehensive and client-centered program. At Northbound Addiction Treatment Services, we’ve been in your shoes and understand what you’re going through. Sometimes what you think you need for your recovery isn’t necessarily what’s going to work best.
It is not too late. We at Northbound Treatment are glad you are here, and we want you to know exactly what you are in store for in regard to your policy. The next step is to reach out. We want to talk to you, and get to know your situation. Please do not hesitate to contact us, and get help today.