EmblemHealth Insurance could cover drug rehabilitation services, but it might require hospitalization for detox prior to getting addiction treatment. As you seek prior approval and hospitalization at a facility in EmblemHealth’s network of approved providers, keep in mind that the insurance will cover your hospital stay in accord with your insurance benefits.
Regardless of the kind of substance abuse treatment you need, we’re here to help. We accept EmblemHealth Insurance and other insurance plans. Follow the link to check if your specific policy covers treatment.
What Does EmblemHealth Insurance Cover?
Your insurance plan should have a layout of what it covers. Even though addiction treatment isn’t always a guarantee, this insurance provider usually covers it. Copays and deductibles vary and are based on the kind of plan you have.
As a privately-held, non-profit insurance company, EmblemHealth offers personalized health insurance products. Each plan offers something different for members. However, the Affordable Care Act requires insurance companies to cover drug and alcohol rehabilitation services at rates comparable to other medical procedures and services.
EmblemHealth has a network of mental health professionals ready to assist patients with their addictions. As a patient, you’ll get to choose from this network to receive the assistance you need. These network contracts ensure you can find local drug rehabilitation providers with ease.
EmblemHealth Drug & Alcohol Detox Coverage
EmblemHealth insurance plans usually cover inpatient detox. You’ll use an in-network facility that has been proved beforehand, ensuring your hospital stay is covered.
You might have to pay some out-of-pocket costs for drug or alcohol detox. If you have the basic plan, you’ll have a zero percent coinsurance for detox following the deductible. The bronze plan offers 50 percent coinsurance following the deductible. For anyone who has a silver, gold, or platinum plan, you’ll only need to pay the copay at the specialist’s office.
EmblemHealth Inpatient Rehab Coverage
Inpatient rehabilitation could be covered by EmblemHealth, although you’ll need to contact them to learn the exact information regarding this coverage. Even though some EmblemHealth plans include inpatient rehab, you’ll need preapproval beforehand.
EmblemHealth Outpatient Rehab Coverage
Your EmblemHealth plan could cover some of the costs associated with outpatient drug and alcohol rehabilitation. As long as you stay within the EmblemHealth network, patients usually have coverage without needing prior authorization.
Basic or bronze plans limit the number of days outpatient rehab is covered. With this in mind, silver, gold, or platinum plans do not limit how many days outpatient rehab is covered. However, these patients must pay copays.
What If My Provider Is Not In The EmblemHealth Network?
While choosing in-network treatment centers or hospitals is the more affordable option, you can still opt to pay more to receive out-of-network treatment. To see if your EmblemHealth insurance policy will cover your treatment, please contact us today by calling 800-626-1980.