Geisinger Health Plan insurance could cover substance abuse treatment and mental health services if they see these services as essential for your medical well-being. However, there could still be some out-of-pocket expenses. 

Regardless of which addiction treatment you need, we can help. We accept most major insurance plans, and we’ll work with you to offer payment arrangements for any out-of-pocket expenses. Call 1-800-626-1980 for more information or fill out the form to the right and a trained addiction counselor will verify your coverage for you. 

What Does Geisinger Insurance Cover?

Your coverage depends on your insurance plan. While substance abuse treatment isn’t guaranteed, usually, it’s covered.

Preauthorization is generally required to receive coverage from any insurance provider. This process is how the services, drugs, or medical equipment are declared medically essential. Even with this being the case, preauthorization does not guarantee your coverage.

While insurance might cover substance abuse treatment, there could still be some fees you’ll need to pay out-of-pocket. Deductibles are all too common, meaning there will be a sun of money to pay before your insurance company begins covering the cost of these services.

You might also have a fixed sum of money — a co-pay — you’ll need to pay when you receive covered services. The type of services you’re being given will determine how much you’ll need to pay for your co-pay.

Once you pay your deductible, you could be responsible for a percentage of the cost. This is called a co-insurance. The co-insurance you’ll need to pay will depend on the insurance plan you have.

For those receiving substance abuse treatment, a co-pay, co-pay, or co-insurance — or perhaps even a combination of these three aspects of health insurance — might be required of you. Reach out to your insurance provider to get a better idea regarding what these costs could look like.

Geisinger typically covers substance abuse treatment, as well as the majority of significant addictions. The following are the kinds of addictions this insurance generally covers:

• Heroin and other opioids — this can include prescription painkiller addictions.
• Inhalants — paint thinner, nitrous oxide, amyl nitrate, or gasoline, to name a few.
• Cocaine.
• Alcohol.
• Stimulant medication — Ritalin, Adderall, and others.
• Marijuana.
• Hallucinogens — Psilocybin mushrooms or LSD, for example.
• Benzodiazepines — Ativan, Xanax, and others.

Make sure to check and see whether your treatment provider is in the Geisinger network.

What If My Provider Is Not In The Insurance Network?

An insurance plan will usually insist that you get treatment with an in-network provider. In-network providers have an agreement to offer services for members of the insurance company at set prices.

Out-of-network providers don’t have this kind of contract, meaning there’s a good chance the insurance company will not cover the entire cost of your services. With this being the case, you could have to pay the entirety of the services rendered or have a higher cost than if you were to go to an in-network provider.

To see if your policy will cover treatment, please call 1-800-626-1980.