Does ConnectiCare Health Insurance Cover Addiction Treatment?
Does ConnectiCare Health Insurance Cover Addiction Treatment?
ConnectiCare Health Insurance
ConnectiCare, a company based in Connecticut, was originally known as ConnectiCare Holding. It was established as an independent HMO in 1982. This health insurance company serves over 240,000 members throughout the entire state of Connecticut, as well as surrounding areas.
In 2005, ConnectiCare Holding Company was acquired by the Health Insurance Plan of Greater New York (HIP). HIP’s goal was to expand its service area and ensure that members have access to the broadest possible range of treatment providers. Today, ConnectiCare members have access to more than 19,900 health care providers, ensuring that their options are not limited.
Addiction Treatment with ConnectiCare
All ConnectiCare plans provide coverage for substance use disorder treatment. ConnectiCare does not show preferential treatment to certain drug addictions over others. It does not matter which substance an individual is struggling with. If they have been diagnosed with an addiction, they have access to ConnectiCare’s high quality coverage. ConnectiCare health insurance plans cover a wide variety of addictions, including:
- Crystal meth addiction
- Marijuana addiction
- Benzodiazepine addiction
- Prescription stimulant addiction
- Heroin addiction
- Alcohol addiction
- Prescription opioid addiction
In most cases, rehabs are designed to provide broad and comprehensive treatment programs that can handle any addiction. However, some individuals insured with ConnectiCare may require more specialized treatment. In this case, ConnectiCare will provide coverage to specialized drug addiction treatment programs.
ConnectiCare and Substance Addiction Treatment Services
ConnectiCare recognizes that addictions generally exist on a spectrum, and that individuals with severe addictions often require a wide range of treatment services. As such, their substance addiction treatment coverage covers a diverse set of treatment programs. Policyholders insured through ConnectiCare have access to a variety of therapeutic modalities and rehabs. Common elements of an addiction treatment plan that are covered by ConnectiCare include:
- Outpatient rehab
- Medical detox centers
- Inpatient rehab
- Group therapy, individual therapy, and family therapy
- Psychiatric services
- Drug screening and drug testing
- Medication-assisted treatment (MAT)
ConnectiCare can help you determine what your treatment needs are. They will generally recommend a professional assessment to assess what type of addiction treatment will best meet your unique individual needs. Important factors that are taken into account by ConnectiCare clinical practitioners include:
- Motivation to recover
- The likelihood of relapse
- The extent of an individual’s need for withdrawal management
- The safety and supportiveness of their home environment
- Whether or not the suffer from comorbid physical or mental health disorders
What Does ConnectiCare Health Insurance Pay For?
ConnectiCare health insurance offers coverage for addiction treatment for its members. However, it is important to understand that the extent of such coverage differs from plan to plan. The specific plan a policyholder is enrolled in as well as their state of residence are the main factors that determine which programs ConnectiCare will pay for. Some plans are more likely to recommend certain rehabs over others, or offer members a wider range of in-network rehabs from which to choose. Plans with broader coverage are also more likely to pay for treatment for longer periods of time.
Most insurance plans require policyholders to pay a deductible. This term refers to a specific amount of money that members are required to pay themselves before their insurance begins to cover the cost of treatment. Policyholders are also generally responsible for paying coinsurance, either before or after meeting the deductible. Coinsurance is a term that refers to a percentage of the cost of treatment. Copays are also sometimes required; this is similar to a coinsurance fee, except that it is a fixed fee rather than a percentage. Deductibles, coinsurance, and copays vary from plan to plan.
ConnectiCare generally requires pre-authorization before policyholders can attend drug or alcohol rehab programs. In cases where treatment is urgently required, they sometimes waive this requirement and authorize treatment after enrollment in rehab. During the authorization process, ConnectiCare arranges a clinical assessment to make sure policyholders meet all the criteria for addiction.
As a general rule of thumb, however, rehabs that are within ConnectiCare’s network, such as NuView Treatment Center, are covered more comprehensively than out-of-network rehabs.
Outpatient Rehab with ConnectiCare
ConnectiCare offers especially good coverage for outpatient treatment programs. This is because outpatient rehabs are evidence-based programs that are appropriate for almost all addiction severity levels. They are also considerably cheaper than inpatient rehabs, due to the lack of a residency requirement. As a result, ConnectiCare is often willing to pay for outpatient treatment on a longer term basis than they would for other addiction treatment programs.
Outpatient rehabs are addiction treatment programs that participants attend once or several times per week. Unlike residential rehabs, they do not require that participants live on the premises. Instead, participants live at home — either with supportive family members, alone, or in sober living homes. As long as an individual has a safe and supportive living environment, outpatient programs can be enormously beneficial.
These flexible programs help residents develop new skills, coping tools, and stronger social support systems. Utilizing a wide range of therapeutic modalities, including group therapy and cognitive behavioral therapy, outpatient programs ensure that participants get all underlying issues addressed. Moreover, they work with every participant on an individual basis to help them meet their personal goals. Outpatient programs are inherently flexible, making them ideal for recent graduates of inpatient programs, people with families or careers, and people who have been sober a while who require additional support and guidance.
Outpatient programs are suitable for individuals getting sober for the first time, as well as recent graduates for more acute residential treatment programs. In fact, transitioning from inpatient rehab to outpatient rehab is generally recommended as the best way of staying sober. Research shows that individuals who attend addiction treatment programs for longer periods of time have the lowest rates of relapse.
Outpatient programs covered by ConnectiCare include a wide range of levels of care. These include:
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Outpatient programs (OPs)
- Aftercare planning
Does ConnectiCare Cover Medication for Addiction?
In some cases, addiction treatment requires pharmaceutical interventions. When prescribed by a physician, ConnectiCare offers coverage for medications. The best way to obtain such coverage is to enroll in an in-network outpatient rehab. Outpatient rehabs employ medical professionals who are qualified to prescribe medications when necessary.
During addiction treatment, medications are most commonly prescribed when an individual suffers from severe opioid addiction, alcohol addiction, or benzodiazepine addiction. Certain medications can mitigate the symptoms of withdrawal and reduce cravings. This can make the withdrawal process far easier, lower the likelihood of relapse, and help outpatient rehab participants gain more from behavioral therapies.
Medications commonly prescribed to treat alcohol withdrawal include:
- Disulfiram (Antabuse)
- Naltrexone (Vivitrol, Revia)
- Acamprosate (Campral)
Medications that can help with opioid withdrawal include:
In most cases, ConnectiCare approves these medications when they are prescribed in the context of a medication assisted treatment (MAT) program. Medication assisted treatment refers to a treatment approach that combines pharmacological interventions along with behavioral therapies. At an outpatient addiction treatment program like NuView Treatment Center, medication assisted treatment is available for those who need it.
Out-of-Network Coverage with ConnectiCare
ConnectiCare offers a wide range of addiction treatment programs and service providers within its network. For individuals who prefer to see a provider or attend a rehab outside of ConnectiCare’s network, coverage may be significantly lower – or even nonexistent. Individuals are free to select any provider they want. Nonetheless, it is important to recognize that those who choose to see out-of-network providers are generally responsible for far higher out-of-pocket expenses. The extent of these expenses varies from plan to plan.
ConnectiCare Health Insurance and the Affordable Care Act
The Affordable Care Act is a piece of legislation that has radically changed the way health insurance companies operate in the United States. Not only has it dramatically expanded the number of people covered by health insurance plans, it has also guaranteed that those who suffer from addiction can get the care they need. The Affordable Care Act specifies that addiction treatment is an “essential health benefit.” In practice, this means that insurance companies are legally obligated to provide some degree of coverage for addiction treatment.
The Affordable Care Act also requires health insurance companies to follow a policy known as parity. Parity means that the costs of seeing a provider for addiction treatment can be no higher than the costs of a comparable treatment for a physical health problem. Seeing a doctor because you suffer from a cold and seeing a doctor because you suffer from opioid withdrawal symptoms will have the same out-of-pocket expenses.
Health insurance companies, including ConnectiCare, can also not deny people coverage simply because they suffer from substance use disorders. In the past, insurance companies sometimes argued that individuals with addictions were potential liabilities, due to the expenses associated with treatment. They would use that argument to deny people coverage. The Affordable Care Act, however, stipulates that addictions are not pre-existing conditions. For this reason, anyone with an addiction can sign up with ConnectiCare and receive high quality and comprehensive coverage.
What Does ConnectiCare Cover For Me?
It can be confusing figuring out exactly what rehabs and treatment programs are covered by your health insurance plan. While ConnectiCare offers addiction treatment coverage for all members, the extent of this coverage varies from plan to plan. One may wonder exactly what kinds of deductibles, coinsurance fees, and copays one is expected to pay. Furthermore, it may not always be clear exactly which rehabs and treatment programs are considered in-network. Determining coverage levels can be confusing.
In most cases, you can get specific questions answered by calling your insurance representative. Their phone number is usually listed on the back of your health insurance card. However, it is often even more helpful to have an advocate work on your behalf.
If you or a loved one suffers from a drug and alcohol addiction and want to get the best treatment possible, contact NuView Treatment Center today. Our staff members are available for confidential consultations. Our outpatient rehab is considered in-network with ConnectiCare, and we can easily work with your insurance plan to get you treatment as soon as possible. Even if our program is not right for you at this time, we will help connect you to the resources or services you need. Contact us at (310) 984-1730.
Outpatient Treatment at NuView Treatment Center
NuView Treatment Center, an outpatient rehab located in Los Angeles’ Westside, offers modern facilities and evidence-based treatment. Our staff work with clients who are suffering from a wide range of addictions and mental health disorders. It is our goal to ensure that our clients not only develop the tools they need to stay sober, but the skills and behaviors they need in order to live the best possible lives in sobriety.
Our programs cover all levels of care, including partial hospitalization programs, intensive outpatient programs, outpatient programs, and aftercare. In many cases, clients benefit from moving from one level of care to a less acute level of care as they develop stronger foundations in recovery.
At NuView Treatment Center, we believe that addiction treatment is not one-size-fits-all. Our highly trained and compassionate staff develop individualized treatment plans for each client. All clients have distinct needs and underlying issues. These can include comorbid mental health disorders, conflictual family dynamics, and even legal and financial problems. Our individualized treatment plans incorporate a wide range of evidence-based treatment modalities to ensure that every aspect of their addiction is addressed.
No matter how bad things seem now, addiction recovery is possible. NuView Treatment Center is in-network for ConnectiCare policyholders, and it is our goal to make beginning treatment as smooth and seamless as possible. If you are ready to begin your recovery journey, contact NuView Treatment Center today