EmblemHealth Drug And Alcohol Rehab Coverage

EmblemHealth insurance benefits may provide coverage for drug or alcohol addiction treatment. This coverage may include important treatments which are required for detoxification and inpatient rehabilitation.

Drug And Alcohol Rehabs That Accept EmblemHealth Insurance

If you’re facing an addiction to drugs or alcohol, your health insurance coverage through EmblemHealth may help you to obtain substance abuse treatment. But before you can use your benefits to their full potential you need to understand exactly what your plan covers. The greater your understanding of your coverage, the greater the opportunity you have to use it to obtain the best treatment for your addiction.

EmblemHealth Is Focused On Affordable, Community Based Care

Healthcare, including drug and alcohol addiction treatment, can become expensive. EmblemHealth understands this and is committed to providing its customers with access to care which betters their health and their life at a reasonable price.

EmblemHealth provides services to the New York tri-state area, which includes New York City and the surrounding communities, coverage which extends to 3.1 million people. To these individuals and others interested in their insurance, EmblemHealth writes “Our mission is to create healthier futures for our members by championing access to high-quality, affordable care and building innovative partnerships in the communities we serve – because we believe that everyone deserves to be taken care of.”

Inpatient Drug Rehab Coverage With EmblemHealth

Under your insurance certain terms stipulate the length and type of treatment you’re able to utilize your benefits for. Understanding these guidelines can help to shape your treatment plan by identifying which programs accept your insurance.

Typically, a plan limits the number of days you can receive treatment for or places a cap on the amount of coverage provided per day. For instance, in regards to the former, an individual may only receive coverage for a short-term program, or for a portion of a longer program. In the latter case, there might be a set amount of coverage allotted per day or a certain percentage of the total cost which is covered, either on a daily basis or overall.

If you desire inpatient treatment, programs begin at 28 to 30 days and run upwards to one year or longer. Even if your insurance only covers short-term care, or a limited number of days, there are other ways to pay for treatment which may supplement your insurance coverage.

Though it might be tempting to select a short-term program due to restrictions on your coverage, keep in mind that for most individuals treatment outcomes improve during longer durations of care.

In order to use your benefits you may have to meet your yearly deductible. This is a set dollar amount which you have to meet before the insurance company will provide certain forms of coverage or monetary assistance. This amount can vary significantly per plan; because of this it’s important to know your deductible so you can anticipate the costs you’re responsible for as you outline your treatment needs.

Further, each plan has set copays or coinsurance which vary per procedure, treatment, or medication type. The individual is responsible for paying these amounts (typically a certain percentage of the total cost or a set dollar amount), while the insurance pays the remainder.

EmblemHealth works with Medicare and Medicaid, which may provide additional options for individuals receiving these forms of coverage.

Choosing Treatment Under Your EmblemHealth Coverage

Your insurance coverage may provide partial or full coverage for detoxification, outpatient treatment, and inpatient drug rehabilitation programs. Every person’s treatment needs vary according to their life, health, and the characteristics of their substance abuse. Selecting a program which meets these specific needs increases a person’s chance of success.

Inpatient drug rehabilitation programs are quite often the best choice for individuals in need of specialized, intensive drug addiction treatment, especially for those facing moderate to severe addictions or a serious return to drugs or alcohol (a relapse).

An addiction affects a person on a physical, mental, emotional, social, and even spiritual level. In order for treatment to be effective, it must address the ways addiction impacts a person on all of these levels. Outpatient treatment can make it difficult to meet these needs due to the limited time and access to treatment methods these programs offer.

Once enrolled within treatment, the use of certain medications may be required; these medications may be covered by your insurance. Medications play an important role during medically-supervised detoxification. Though not every person requires this stage of treatment, for those who do, having access to prescribed medications during this time can help to make withdrawal less painful and more comfortable.

If you need to learn more about what treatment lengths, services, and/or medications are covered by your plan, you can contact EmblemHealth directly or contact us and we’ll do the legwork for you.

Making Your EmblemHealth Coverage Work For You

Becoming familiar with your EmblemHealth Insurance coverage can make planning for treatment an easier process. Using your plan benefits as a guide, this information can help you to narrow down your treatment options to those which are more cost-advantageous. While cost is surely a concern, it’s important to make sure you select a program which offers the individualized care options which suit your life’s specific needs.

Before you can enroll in a rehabilitation program or utilize your insurance benefits you may have to provide proof that addiction treatment is necessary and that a valid medical need is present; in other words that treatment is medically necessary.

To fulfill this request, certain insurance providers require that you supply medical records and other documentation from doctors and medical professionals who have witnessed the scope of your addiction. If your treatment plan includes a medically-supervised detoxification this request may be even more common.

Should this be required of you, it’s important to start the process right away so that you can begin treatment as soon as possible. Fortunately, a clinical assessment, which is frequently integrated into the intake process for treatment, often fulfills this need.

Finding The Best EmblemHealth Addiction Treatment Program

An assessment not only outlines your need for treatment, it details the specific areas within your life, health, and addiction which require specific attention during treatment. This information helps the treatment facility and their staff to better create and execute a plan which offers care customized to your needs. For this reason, it’s to your advantage to undergo this evaluation in a timely manner.

Here’s some questions which will likely be covered during this assessment. Keeping these questions (and their answers) forefront in your mind as you’re planning for treatment can help you to stay on track and focused on what’s most important: building the strongest recovery. A strong recovery begins with effective treatment, treatment which may be easier to obtain with the help of your EmblemHealth insurance.

Important circumstances which influence treatment needs include:

  • What is the drug of abuse?
  • How long has the individual been using this substance for?
  • How severe is the addiction?
  • Are there any health or medical concerns which may influence treatment needs or living arrangements while within treatment?
  • Does the individual have a co-occurring mental health disorder (mental health disorder which accompanies addiction, such as depression or anxiety)?
  • Does the individual have an ample support network?

These answers, along with other information, inform the treatment staff of the type and level of care you need while in treatment.

Does EmblemHealth Cover Drug And Alcohol Detoxification?

The exact drug, or drugs, which a person is addicted to can alter the course of treatment. For instance, certain drugs build intense physical dependencies. Examples include alcohol, benzodiazepines, and opioids. Many individuals working to overcome an addiction to these substances start treatment with a medically-supported detoxification.

Detoxing in a medically-supervised environment, by the aid of highly-trained and compassionate medical professionals and clinicians, promotes safety and greater success during this transitional time. Choosing a detoxification program prior to treatment will help you to be more comfortable as your body cleanses the drug from its system.

If you require detoxification, this is a critical step you shouldn’t skip. Detoxing at home can jeopardize your safety and place you at a greater risk of relapsing back to drugs or alcohol. But beyond this, choosing a residential program which offers both a detoxification and rehabilitation program on site offers you greater stability within the treatment and recovery processes.

Find The Right Rehab Center That Accepts EmblemHealth Today

Not every treatment program is the same. Some rely heavily on 12-step programs, such as Alcoholics Anonymous, while others build their treatment plans around evidenced-based scientific treatments. Therapies and counseling offer healing and work to resolve negative and dysfunctional emotional and mental states, while various alternative therapies which promote mind-body-spirit balance may also be offered.

These are just a few examples of treatment methods which may be utilized within an addiction treatment program. Choosing a program is a deeply personal choice, one which may be made easier by the flexibility provided by your EmblemHealth insurance coverage.

If you’d like to find out more about how your EmblemHealth insurance coverage could make your treatment needs a reality, contact us today.

Questions About Treatment?

Contact us for:

  • Access to top treatment centers
  • Caring, supportive guidance
  • Financial assistance options
(888) 407-2072

Or fill out this form

Your information is 100% confidential