Does Beacon Insurance Cover Addiction Treatment?
Getting proper treatment for a substance use disorder is crucial for individuals who hope to recover from the devastating effects of addiction. Substance addiction is a legitimate mental health disorder that can rarely be managed through sheer individual will power alone. Professional help in a rehab can help people develop the coping tools they need to avoid relapse. Addiction treatment facilities help people address underlying issues that may be behind their substance abuse. More importantly, clients at rehabs are supported as they take active steps toward rebuilding their lives. Fortunately, for people who are insured through Beacon, quality addiction treatment is only a phone call away.
While Beacon offers a wide range of health insurance plans, the vast majority of them cover alcohol and drug addiction treatment. The specific healthcare policy that an individual has, however, is the main determinant of their upfront costs and out-of-pocket payments. Beacon is legally required to pay for addiction treatment, as a consequence of the Affordable Care Act. The type of coverage a person has, however, leads to considerable variation in terms of what their addiction treatment actually entails. In most cases, Beacon will cover outpatient addiction treatment programs — including NuView Treatment Center, which is in-network for Beacon.
Beacon’s official name is Beacon Health Options. This behavioral health solutions company based in Boston, Massachusetts, is the largest company of its type in the United States. Its clients number over 50 million, and the company itself employs over 4,700 people. Beacon Health Options was formed after a merger between Beacon Health Strategies and ValueOptions in 2014. As a result, it has enormous health care resources at its disposal.
In delivering health care coverage, Beacon Health Options specializes in individualized solutions tailored to the needs of its clients. To that end, Beacon Health Options has formed partnerships with external health plans numbering over 100. Most notably, Beacon actually emphasizes behavioral health and substance use disorder treatment far more than most health insurance providers. They have set themselves out to be the preeminent insurance company for people suffering from addiction. Their active involvement in addiction management, wide range of resources, and relationships with external health plans make them the ideal insurance company for anyone suffering from a substance use disorder or mental health condition.
Beacon and Addiction Treatment
In an effort to meet the needs of people suffering from addiction, Beacon Health Options employs clinical staff 24 hour a day and 7 days a week who are available to answer questions and offer support. Beacon has developed an extensive structure and network of treatment professionals who work in tandem to help people recover from substance addiction. These include a wide variety of inpatient and outpatient rehabs, therapists, psychiatrists, and physicians who are all highly experienced in addiction recovery.
Beacon has also made it its mission to reduce the stigma around substance use disorder. Only two thirds of people with addiction fail to seek treatment because of the shame associated with substance addiction — or because they fear that asking for help makes them weak. To ensure that people who require treatment actually reach out for help, Beacon runs a program called Stamp Out Stigma. The quality of the treatment facilities covered by Beacon is unquestionable; the Stamp Out Stigma campaign aims to remove the final impediment to recovery: shame.
Substance Abuse Treatment Coverage Through Beacon
Beacon Health Options offers a wide range of health insurance plans and policies. These plans vary considerably in terms of what coverage they provide and the out-of-pocket expenses associated with treatment. Out-of-network coverage varies from plan to plan as well. While all health insurance plans with beacon cover substance abuse treatment, some Beacon Health Options insurance plans are designed specifically for people with substance use disorders. These specialized insurance plans are often created in partnership with external health insurance providers, enabling clients to have access to a wider variety of resources and facilities.
Beacon health insurance offers treatment coverage for people suffering from a wide range of addictions. These include:
- Cocaine addiction
- Alcohol addiction
- Prescription opioid addiction (including fentanyl and oxycodone)
- Heroin addiction
- Marijuana addiction
- Benzodiazepine addiction (including Valium and Xanax)
- Methamphetamine addiction
- Prescription stimulant addiction
Beacon Health Options does not distinguish between types of addictions. It does not matter what substance an individual is primarily addicted to. Nor does it matter how severe their addiction is. In fact, Beacon recognizes that substance use disorders are progressive conditions that tend to get worse over time if left untreated. As such, they make it their mission to help people get treated as soon as possible in the early stages of their disorder. Beacon Health Options provides coverage for distinct treatment programs that are designed to tackle substance use disorders of a wide range of severity levels.
What Will Beacon Pay For?
Beacon Health Options plans vary considerably, but in general they cover the most important and common aspects of addiction treatment. Common elements of a a Beacon-covered treatment plan include:
- Evaluations and assessments
- Outpatient rehab
- Inpatient rehab
- Medical detox
- Medication-assisted treatment (MAT)
The types of coverage, out-of-pocket expenses, and coverage limits depend upon the specific plan of each policyholder as well as their state of residence. In almost all cases, however, outpatient addiction treatment is covered.
Out-of-Network Rehabs Through Beacon
The vast majority of Beacon Health Options plans require policyholders to seek treatment using in-network facilities and providers. While policyholders certainly have the option of receiving treatment out of the network, in most cases they will have to pay for their own treatment out of pocket. However, certain Beacon plans, especially plans that involve partnerships with other providers, offer more significant out-of-network coverage. Moreover, Beacon recognizes that emergency situations sometimes call for specialized treatment services. In these cases, Beacon is often willing to make allowances and approve treatment at out-of-network facilities.
Outpatient Addiction Treatment with Beacon
Beacon Health Options covers a wide variety of addiction treatment programs, including outpatient rehabs. Outpatient rehabs are evidence-based treatment facilities where individuals can receive psychotherapy, learn coping strategies to avoid relapse, address underlying issues, and take steps toward rebuilding their lives in sobriety. Outpatient rehabs do not require residents to live on the premises, making them ideal for people who have outside commitments at work or with their families.
Outpatient programs covered by Beacon include a wide range of programs that address the needs of clients suffering from addiction at different levels of severity. Most outpatient programs are generally grouped into the following categories:
- Partial hospitalization programs (PHPs)
- Intensive outpatient program (IOPs)
- Outpatient programs (OPs)
- Aftercare services
Clients who receive Beacon-covered treatment often progress from more acute levels of outpatient care to less acute levels. This allows them to increase their flexibility and autonomy gradually as they become more confident in their recovery. Moreover, research shows that engaging in addiction treatment for longer periods of time is associated with lower rates of relapse down the line. Beacon Health Options is committed to supporting policyholders as they take the time necessary to achieve long term sobriety.
Beacon’s health plans generally emphasize outpatient treatment as a core element, and it is highly likely that someone covered through Beacon will have the option of attending an outpatient rehab. Nevertheless, it is important to mention that not all outpatient rehabs are covered by Beacon. Fortunately, NuView Treatment Center has a strong relationship with Beacon Health Options and is an in-network facility for most Beacon health plans.
Cost of Outpatient Treatment
The exact cost of an outpatient addiction treatment program will depend upon the facility itself as well the specific Beacon plan. In most cases, Beacon Health Options only provides coverage to people who choose in-network rehabs, except in emergency situations. For people who use in-network outpatient rehabs, Beacon provides significant coverage. However, depending upon one’s plan, policyholders are generally expected to pay copays and meet deductibles.
Copays are the fees that policyholders are expected to pay for a treatment service before their insurance kicks in. The cost of copays depends upon the health insurance plan being used. Plans with higher monthly premiums are often associated with lower copays, and vice versa. In all cases, however, copays with Beacon are only a small fraction of the actual cost of treatment — of which Beacon covers the majority.
A deductible is the amount of money a policyholder is expected to pay before their insurance kicks in. If a policy has a $2000 deductible, for instance, that means that clients can expect their insurance to contribute only after they have covered $2000 worth of treatment themselves. As with copays, deductibles are generally lower for people with more comprehensive plans.
In general, outpatient rehabs are less expensive than inpatient treatment centers. This is because clients do not have to pay for residency or 24/hour services. As such, Beacon and other health insurance providers are often willing to pay for outpatient services partially or even in full.
Beacon and the Affordable Care Act
Beacon Health Options, like other insurance companies, is required by law to act in accordance with the Affordable Care Act. The Affordable Care Act, which is sometimes known by its acronym ACA, was designed to help more Americans get access to quality healthcare coverage. It also helps ensure that people who suffer from addictions or other mental health disorders are able to get the treatment and coverage they need.
The Affordable Care Act stipulates that addiction treatment must be considered an “essential health benefit.” As a result, health insurance companies, like Beacon Health Options, are legally required to cover services related to addiction treatment.
The passing of the Affordable Care Act also prevents health insurance companies from classifying addictions are pre-existing conditions. Pre-existing conditions are sometimes used as a pretext for denying someone coverage, especially when insurers claim that the presence of these conditions will make treatment both inevitable and expensive. The ACA guarantees that addiction treatment is a basic human right — and no insurance company can deny someone coverage just because they suffer from a substance use disorder. Importantly, this right to coverage applies just as much to people with highly developed addictions as it does to people who are only just beginning to suffer the consequences.
Treatment for Comorbid Mental Health Disorders
It is common for people suffering from substance addiction to experience symptoms of mental health conditions as well. Individuals who have substance use disorders as well as co-occurring mental health disorders are known as dual diagnosis clients. Beacon Health Options recognizes that a high percentage of clients are dual diagnosis. In fact, according to the National Institute on Drug Abuse, roughly 50% of people with addiction develop a mental health disorder, and approximately half of people with mental health disorders develop addictions. These conditions are often deeply intertwined.
The Affordable Care Act includes legislation covering mental health treatment. The ACA has not only made addiction treatment an essential health benefit, but mental health treatment as well. As such, people with comorbid conditions can expect to get coverage for both.
Beacon Health Options ensures that dual diagnosis clients get the comprehensive coverage they need. They recognize that in most cases, people with comorbid conditions can only recover if they receive treatment for both conditions simultaneously. As such, Beacon provides extensive coverage for outpatient programs that specialize in integrated treatment. Integrated treatment is a comprehensive therapeutic modality that helps clients address their mental health needs while simultaneously helping them recover from substance use disorders.
What Does Beacon Insurance Cover For Me?
For individuals covered by one of Beacon’s many health insurance plans, addiction treatment is available at countless in-network outpatient treatment centers, including NuView Treatment Center. For many policyholders, however, navigating the ins and outs of their particular treatment plan can be confusing and overwhelming. Each plan has its own unique coverage levels, deductibles, copays, and in-network providers. In many cases, basic questions can be answered by calling the Beacon insurance representative listed on the back of your insurance card.
For those who want a deeper understanding of their addiction treatment options, it can be helpful to talk to an outpatient program directly. At NuView Treatment Center, our staff are always available to discuss your treatment needs and help connect you to the services you need. We can help determine your coverage levels and find out if our program — or even another program — is right for you. Contact us at (310) 984-1730 for a free and confidential evaluation.
Addiction Treatment at NuView Treatment Center
NuView Treatment Center is in-network with Beacon Health Options. Our outpatient rehab is centrally located in West Los Angeles, in the midst of Southern California’s thriving recovery community. At NuView Treatment Center, clients benefit from evidence-based therapeutic modalities, compassionate staff, and effective recovery programs that help people tackle both addictions and mental health disorders.
At NuView Treatment Center, we believe that the recovery process goes well beyond mere physical sobriety. Our highly trained staff develop individualized treatment plans for every client. Addiction treatment is not one-size-fits all. Instead, we work with individuals to help them address their unique personal needs, address their underlying issues, and learn new coping skills for life in sobriety.
If you are ready to achieve freedom from drugs and alcohol, contact us today. We are covered by a wide variety of Beacon health insurance plans, and we can help you determine your options if you have a different insurance plan.