Geisinger Health Insurance Coverage for Drug and Alcohol Rehab

Table of Contents

Does Geisinger Insurance Cover Drug or Alcohol Rehab?

Like most carriers’ addiction insurance coverage, Geisinger Insurance covers drug or alcohol rehab as part of its behavioral health benefits. The extent of coverage may vary depending on your specific Geisinger insurance plan. However, Geisinger generally offers comprehensive coverage for addiction treatment services, including outpatient and inpatient rehab programs. These programs aim to address substance abuse disorders and help individuals achieve lasting recovery.

Does Geisinger Cover Mental Health and Substance Abuse Treatment?

Yes, Geisinger Insurance covers both mental health and substance abuse treatment. Geisinger recognizes the importance of addressing mental health issues and substance use disorders and provides coverage for various treatment options. This may include counseling, therapy, medication management, and other evidence-based interventions to promote mental wellness and addiction recovery.

Will Geisinger Cover Dual Diagnosis Treatment?

Geisinger Insurance often covers dual diagnosis treatment, which addresses individuals with co-occurring mental health and substance use disorders. Dual diagnosis treatment integrates mental health services and addiction treatment to provide comprehensive care for those with complex needs. Geisinger aims to support individuals in their journey to recovery by offering coverage for specialized programs that address mental health and substance abuse issues.

Does Geisinger Cover Therapy for Addiction Treatment?

Yes, Geisinger Insurance covers therapy for addiction treatment. Therapy is a critical component of addiction recovery, helping individuals understand the root causes of their substance abuse and develop coping skills for a sustainable, drug-free life. Geisinger typically covers various therapeutic modalities, such as individual counseling, group therapy, cognitive-behavioral therapy (CBT), and motivational interviewing.

As with any insurance coverage, it’s essential to review your specific Geisinger plan documents or contact NuView Treatment Center to understand the details of your policy and the extent of coverage for addiction treatment and mental health services. This will help you make informed decisions about seeking treatment and accessing the necessary services for your well-being.

Geisinger Outpatient Rehab Coverage

Geisinger Insurance typically offers coverage for outpatient rehab as part of its behavioral health benefits. Outpatient rehab is a valuable treatment option allowing individuals to receive addiction treatment without needing residential stays. Instead, clients attend scheduled therapy sessions and counseling while maintaining their daily routines and responsibilities.

Geisinger’s coverage for outpatient rehab includes various levels of care to address individuals with different treatment needs. Some of the outpatient programs covered may include:

  1. Intensive Outpatient Programs (IOP): IOPs provide a structured treatment approach with more frequent therapy sessions and support, usually spanning several hours a day, multiple days a week.

  2. Partial Hospitalization Programs (PHP): PHPs offer a higher level of care than standard outpatient programs, providing intensive therapy and treatment during the day while allowing clients to return home in the evenings.

  3. Standard Outpatient Programs (OP): OPs involve regular therapy sessions, counseling, and support groups, providing flexibility for individuals with work or family commitments.

Geisinger recognizes the value of outpatient rehab as an effective and accessible option for individuals seeking addiction treatment. By providing coverage for these programs, Geisinger aims to support individuals on their path to recovery and wellness.

If you are considering outpatient rehab and have Geisinger Insurance, reviewing your specific plan documents is essential. NuView Treatment Center can also assist you in navigating your insurance benefits and exploring the available outpatient treatment options to meet your needs best.

How to Check Geisinger Rehab Coverage?

To check your Geisinger rehab coverage and explore treatment options, we invite you to fill out our convenient Insurance Verification Form. By providing some basic information, our team at NuView Treatment Center can assist you in understanding your specific coverage and guide you toward rehab options that align with your Geisinger insurance plan. If you prefer immediate assistance, please call us at (323) 307-7997, and our friendly staff will be ready to assist you. Don’t miss out on the opportunity to take the first step toward recovery. Fill out the form now and let us help you on your journey to a healthier, happier life.

Types of Geisinger Insurance Plans

Geisinger Insurance offers a range of health insurance plans to cater to the diverse needs of individuals and families. Some of the common types of Geisinger Insurance plans include:

  1. Health Maintenance Organization (HMO) Plans: HMO plans require members to choose a primary care physician (PCP) from within the Geisinger network. The PCP is the central point of contact for coordinating all healthcare services and referrals to specialists.

  2. Preferred Provider Organization (PPO) Plans: PPO plans offer more flexibility in choosing healthcare providers. Members can visit both in-network and out-of-network providers, although they typically receive better coverage and lower out-of-pocket costs when using in-network providers.

  3. Exclusive Provider Organization (EPO) Plans: EPO plans combine features of both HMO and PPO plans. Members must use in-network providers for coverage, except for emergencies or urgent situations.

  4. Point of Service (POS) Plans: POS plans allow members to choose a primary care physician and get specialist referrals. While POS plans focus on in-network coverage, they may provide limited out-of-network coverage in certain circumstances.

  5. Medicare Plans: Geisinger offers various Medicare plans designed for eligible individuals aged 65 and older or those with certain disabilities. These plans include Medicare Advantage (Part C) plans, Medicare Supplement (Medigap) plans, and Medicare Prescription Drug (Part D) plans.

  6. Medicaid Plans: Geisinger also offers Medicaid plans for individuals who qualify for state-run Medicaid programs, providing essential healthcare coverage to low-income individuals and families.

Each Geisinger Insurance plan type comes with benefits, coverage options, and costs. It’s crucial to review the specifics of each plan and choose the one that best fits your healthcare needs and budget. For guidance and assistance in understanding Geisinger Insurance plans, you can contact NuView Treatment Center.

Geisinger Substance Abuse Coverage

Geisinger Insurance typically provides coverage for a variety of substance abuse addictions. Some of the addictions commonly covered by Geisinger plans include:

  • Crystal Meth Addiction

  • Prescription Opioid Addiction (including Fentanyl, Oxycontin, and Vicodin)

  • Alcohol Addiction

  • Marijuana Addiction

  • Benzodiazepine Addiction (such as Xanax and Valium)

  • Cocaine and Crack Cocaine Addiction

  • Heroin Addiction

  • Adderall and Other Prescription Stimulant Addictions

It’s essential to review your specific Geisinger plan documents or contact NuView Treatment Center to understand the extent of coverage for these specific addictions and associated treatment services. This will help you effectively determine the available options for addressing your substance abuse needs.

What Is Geisinger Insurance & How Does It Work?

Geisinger Insurance is a health insurance provider offering various coverage options to individuals and families. It operates as a health maintenance organization (HMO), preferred provider organization (PPO), and point of service (POS) plans. Geisinger Insurance provides policyholders access to a network of healthcare providers, including doctors, specialists, hospitals, and rehab facilities.

Here’s how Geisinger Insurance works:

  1. Coverage Options: Geisinger offers different types of insurance plans, such as HMO, PPO, and POS plans, each with varying levels of flexibility and cost. Policyholders can choose a plan that best suits their healthcare needs and budget.

  2. In-Network Providers: Geisinger has a network of healthcare providers with whom they have negotiated discounted rates. When policyholders seek medical services from these in-network providers, they typically pay lower out-of-pocket costs.

  3. Out-of-Network Providers: While Geisinger encourages policyholders to use in-network providers, they also offer coverage for services received from out-of-network providers. However, the out-of-pocket costs are generally higher for such services.

  4. Co-payments, Deductibles, and Coinsurance: Like other health insurance plans, Geisinger requires policyholders to pay co-payments, deductibles, and coinsurance for certain medical services. These costs vary depending on the specific insurance plan.

  5. Preventive Care: Geisinger Insurance emphasizes preventive care, covering services like vaccinations, screenings, and wellness visits without requiring policyholders to pay out-of-pocket costs.

  6. Specialty Care and Treatment: Geisinger also provides coverage for specialty care, including mental illness and substance abuse treatment, prescription medications, and other essential medical services.

  7. Health Management Programs: Geisinger offers various health management programs, including disease management and wellness initiatives, to support policyholders in maintaining their health and managing chronic conditions.

  8. Customer Support: Geisinger has customer service representatives who can assist policyholders with their insurance questions and help them navigate their coverage options.

Overall, Geisinger Insurance aims to provide comprehensive and accessible healthcare coverage for its policyholders, promoting preventive care and supporting individuals in managing their health and well-being.

How To Find Rehabs That Take Geisinger Insurance Near Me?

Contact NuView Treatment Center

Our team at NuView Treatment Center is here to assist you in finding a rehab facility near you on your behalf that accepts Geisinger Insurance. Call us at (323) 307-7997, and our knowledgeable staff will happily answer your questions and guide you through the process. Alternatively, you can fill out our insurance verification form to provide us with the necessary details, and we will promptly review your information to determine your coverage options. We are committed to helping you access the appropriate treatment resources for your recovery journey.

Geisinger Insurance Statistics

  1. Geisinger Health Plan has approximately 580,000 members.

  2. J.D. Power has ranked Geisinger Health Plan as the best commercial health plan in Pennsylvania for three consecutive years.

  3. Geisinger Health Plan began in 1972 as a rural, prepaid health plan offered as a pilot program.

Out-of-Network Rehabs Through Geisinger

Geisinger Insurance typically offers coverage for out-of-network rehabs, but it’s essential to be aware of the differences in costs and benefits compared to using in-network providers. If you choose to seek addiction treatment at an out-of-network rehab facility, Geisinger may cover a portion of the expenses, but you will likely have higher out-of-pocket costs, such as:

  1. Out-of-Network Deductibles: Your insurance plan may have higher deductibles for out-of-network services, meaning you’ll need to pay more before the insurance starts covering your treatment costs.

  2. Coinsurance or Co-payments: For out-of-network rehab services, Geisinger may require you to pay a higher percentage of the treatment costs as coinsurance or co-payments.

  3. Balance Billing: Out-of-network providers may bill you for the difference between their standard charges and what Geisinger covers. This is known as balance billing, which can result in higher costs.

  4. Prior Authorization: Before seeking treatment at an out-of-network rehab, you may need authorization from Geisinger. Please get authorization to avoid reduced coverage or denial of payment for services.

It’s essential to understand your specific Geisinger insurance plan’s out-of-network coverage details, including the level of coverage and potential additional costs. When considering an out-of-network rehab, it’s advisable to contact NuView Treatment Center to understand what’s covered and what financial responsibilities you may have. If you have any questions or need assistance with your addiction treatment options, NuView Treatment Center can help you navigate your insurance coverage and explore the available resources.

Geisinger and the Affordable Care Act

Geisinger Insurance operates within the Affordable Care Act (ACA) framework, also known as Obamacare. The ACA is a federal law designed to improve healthcare access, enhance healthcare services, and reduce healthcare costs for individuals and families.

As a result of the ACA, Geisinger Insurance plans must comply with specific provisions to ensure they provide comprehensive and essential health benefits to policyholders. Here are some key aspects of how Geisinger and the ACA work together:

  1. Essential Health Benefits: The ACA mandates that health insurance plans, including those offered by Geisinger, cover essential health benefits. These benefits include various services, such as preventive care, prescription drugs, mental health and substance abuse treatment, and more.

  2. Pre-existing Conditions: The ACA prohibits health insurance companies from denying coverage or charging higher premiums based on pre-existing conditions. This ensures that individuals with pre-existing conditions, including mental health and substance abuse disorders, have the same coverage and benefits as those without such conditions.

  3. Preventive Services: Geisinger plans must cover preventive services without requiring policyholders to pay co-payments, coinsurance, or deductibles. This includes screenings, vaccinations, and counseling to promote preventive care and early intervention.

  4. Health Insurance Marketplace: The ACA established health insurance marketplaces where individuals and families can shop for and purchase health insurance plans, including those offered by Geisinger. These marketplaces provide a platform for comparing different plans, exploring coverage options, and accessing financial assistance through subsidies for those who qualify.

Overall, the ACA has significantly impacted the healthcare landscape, including the plans offered by Geisinger. It has expanded access to essential health benefits, including mental health and substance abuse treatment services, promoting preventive care, and addressing healthcare disparities.

What Does Geisinger Cover For Me?

Geisinger Insurance offers a range of coverage options to meet the healthcare needs of its policyholders. The specific benefits and services Geisinger covers depend on the insurance plan you selected. However, in general, Geisinger plans typically provide coverage for the following:

  • Preventive Care: Geisinger covers various preventive services, such as vaccinations, screenings, and wellness check-ups, without requiring you to pay out-of-pocket expenses like co-payments or deductibles.

  • Hospital and Medical Services: Your Geisinger plan will cover hospital stays, surgeries, doctor visits, and other medical services, either through in-network providers or with partial coverage for out-of-network providers, depending on your plan type.

  • Prescription Drugs: Geisinger typically includes coverage for prescription medications, with varying co-payments or coinsurance depending on your plan.

  • Mental Health and Substance Abuse Treatment: Geisinger provides coverage for mental health services and substance abuse treatment, which may include counseling, therapy, and addiction treatment programs.

  • Maternity and Newborn Care: Geisinger plans often cover maternity care and newborn services, including prenatal visits, delivery, and postnatal care.

  • Emergency Services: Geisinger covers emergency medical services, ensuring you can receive essential care in critical situations.

  • Laboratory Tests and Diagnostic Services: Your Geisinger plan should cover laboratory tests, X-rays, and other diagnostic services needed for your healthcare.

Additionally, Geisinger insurance typically provides coverage for medication-assisted treatment, including medications used to treat substance abuse disorders. It’s essential to review the specific details of your Geisinger plan, such as the deductible, co-payments, coinsurance, and any limitations on coverage, to understand precisely what services and medication-assisted treatment are covered for you. If you have questions about your plan or the available benefits, NuView Treatment Center can assist you in navigating your insurance coverage and accessing the services you need for your healthcare journey.

How Can I Pay The Costs Not Covered By My Geisinger Plan?

If you have costs not covered by your Geisinger insurance plan, there are several options available to help you manage those expenses:

  1. Out-of-Pocket Payments: You can pay for the uncovered costs directly using your personal funds or credit cards.

  2. Health Savings Account (HSA): If you have a Health Savings Account, you can use the funds in your HSA to pay for qualified medical expenses not covered by your insurance.

  3. Flexible Spending Account (FSA): If you have a Flexible Spending Account, you can use the funds set aside in your FSA to cover out-of-pocket medical costs.

  4. Payment Plans: Some healthcare providers offer payment plans that allow you to spread out the cost of treatment over time, making it more manageable.

  5. Medicaid or State Programs: Depending on your income and circumstances, you may qualify for Medicaid or other state-run programs that can provide additional financial assistance for healthcare costs.

  6. Scholarships or Grants: Some organizations and foundations offer scholarships or grants to help individuals with the costs of specific medical treatments.

  7. Appeal or Negotiation: In some cases, you can appeal a claim denial or negotiate with your healthcare provider to reduce the cost of treatment.

It’s essential to explore these options and discuss your situation with the NuView Treatment Center or the healthcare provider to find the best solution for covering the costs not covered by your Geisinger insurance plan and to understand the available resources for financial assistance.

Questions about treatment options for substance addiction?

Our admissions navigators are available 24/7 to listen to your story and get you started with next steps.

Frequently Asked Questions

  • What is the preauthorization process for addiction treatment under Geisinger insurance?

    The preauthorization process for addiction treatment with Geisinger insurance typically involves obtaining approval from the insurance company before starting specific treatments or services. To ensure coverage for addiction treatment, you may need to work with your healthcare provider to submit the necessary information and documentation to Geisinger for review and approval.


  • Are there any co-payments or additional costs associated with addiction treatment through Geisinger insurance?

    The specific co-payments and additional costs for addiction treatment with Geisinger insurance can vary depending on the type of insurance plan you have and the services or treatments you receive. Reviewing your insurance plan documents or contacting NuView Treatment Center to understand the cost-sharing details for addiction treatment services is essential.


  • Does Geisinger insurance provide coverage for medications related to addiction treatment?

    Geisinger insurance typically provides coverage for medications related to addiction treatment, such as medications for opioid use disorder or other substance abuse disorders. However, the extent of coverage and any specific requirements may vary based on your insurance plan. Reviewing your plan documents or contacting NuView Treatment Center will help you understand the coverage details for medications related to addiction treatment.


  • Is there a case manager available to help me understand my Geisinger insurance and its benefits at an addiction treatment center?

    Geisinger may offer case management services to help policyholders navigate their insurance benefits and understand their coverage options at addiction treatment centers. Case managers can assist you in accessing the appropriate services, coordinating care, and addressing any insurance-related questions or concerns you may have. You can inquire about case management services by speaking with the staff at the NuView Treatment Center.


  • How can I determine if NuView Treatment Center accepts my Geisinger insurance?

    At NuView Treatment Center, we accept most major health insurance plans. To find out if your specific Geisinger insurance is accepted, please call our office at (323) 307-7997. Additionally, you can fill out this insurance verification form. Our staff will be more than happy to answer any questions you may have and help determine the best plan for your treatment.

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