The Addiction Treatment Providers Insurance Program was created in 2005 by NSM Insurance Group, the national market leader in the development and distribution of industry-specific insurance programs and wholesale distribution for more than 30 years. In fact, behavioral healthcare is all Addiction Treatment Providers focuses on every day. It is this commitment and passion that differentiates us in the market place, making the program the largest in the country for behavioral healthcare.
Full Answer
What is the most common form of treatment for addictions?
Counseling and other behavioral therapies are the most commonly used forms of treatment. Medications are often an important part of treatment, especially when combined with behavioral therapies. Treatment plans must be reviewed often and modified to fit the patient's changing needs.
Is addiction considered a pre existing condition?
Under the ACA, addiction is no longer considered a pre-existing condition for insurance purposes.
Is therapy covered by insurance?
Services such as therapist visits, group therapy, and emergency mental healthcare are typically covered by health insurance plans. Rehabilitative services for addiction are also included. Therapy can be expensive, with or without insurance.
What pre-existing conditions are not covered?
Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either.
How to learn more about addiction treatment options?
Call the Member Services department at your insurance company to learn more about addiction treatment options. Have ready your insurance card and membership identification number ready. Take notes and write down the name of the member representative who you are speaking to and the date of the call. Do not be afraid to ask questions and clarify new terminology.
What is EPO insurance?
Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency ).
What is a bill in healthcare?
A bill (or invoice), typically in a standardized form, containing a description of care provided, applicable billing codes and a request for payment, submitted by the provider to the patient’s insurance company (or the plan’s third party administrator).
Does insurance cover addiction treatment?
Insurance for addiction treatment is complex (to say the least). Based off insurance deductibles and amount of coverage included in any particular plan, insurance providers will cover widely variable amounts of overall addiction treatment costs. This can lead to varying coverage of: lengths of stay (day limits), stages of treatment (detoxification vs. on-going or continuing care), levels of care (inpatient vs. outpatient), and contacted providers (in-network vs. out-of-network status and a facilities individual insurance acceptance policy). See glossary of terms below that you will want to familiarize yourself with BEFORE calling your insurance company.
Can healthcare providers disagree with insurance companies?
Healthcare providers often disagree with insurance companies on coverage. Before filing for an appeal, check to see if your provider has had a “peer-to-peer” direct conversation with the insurance medical director who made the denial.
Major Credit and Debit Cards
We accept Visa, MasterCard, American Express and Discover to help pay for your care.
Payment Plans
Depending on your situation, we may be able to provide financing options and payment plans to help pay for care. To discuss your needs, please chat with us or call
How much does rehab cost?
The cost of rehab varies depending on the patient’s level of treatment, length of stay, insurance coverage, and other unique factors. Read more.
Does insurance cover rehab?
Health insurance plans will cover treatment for addiction and mental health disorders. With the passage of the Affordable Care Act, more Americans now have access to these forms of treatment.
How much does drug rehab cost with insurance?
The amount of coverage or insurance acceptance is based on the insurance policy that each patient is covered by. This means out-of-pocket expenses will vary. Read more.
How to bill insurance for substance abuse treatment?
People with addictions and insurance should use their coverage to the fullest in order to get the care they need. Talking to your insurance plan administrator by calling the number on the back of your insurance card is a great place to start.
How to get financial assistance for substance abuse treatment?
Financial assistance for substance abuse treatment can come from federal, state, and local governments. There are also grants available through SAMHSA, as well as insurance options for certain populations, such as veterans or low-income families. Read more.
Specialized insurance coverage for behavioral health
With a full range of insurance solutions, we offer all the coverages that organizations in the behavioral healthcare industry need to protect themselves — whether it’s from slips and falls, automobile accidents or more severe claims involving professional liability, sexual abuse and wrongful death.
Coverage details
Interested in learning more about our insurance coverage for behavioral healthcare organizations? Get more details in our coverage overview and please contact us with any questions.
Krista Mayes, Program Director
A respected leader in the behavioral healthcare industry, Krista Mayes leads the ATP team in its unwavering commitment to serving agents and their clients with best-in-class specialty insurance and risk management solutions.
We are here to help
Call us at 800.970.9778 or send a submission and request more information.
Does HealthPartners Offer Services For Addiction?
Yes, HealthPartners offers services for addiction. The organization provides a directory of addiction medicine specialists on their website, and HealthPartners health insurance plans provide coverage for a variety of Programs for Change recovery centers located in Western Wisconsin.
Does HealthPartners Offer Services For Mental Health?
HealthPartners does indeed provide mental health treatment, with a wide network of mental health and behavioral health centers scattered across their coverage area. Mental health conditions for which treatment is available include but are not limited to:
Is Inpatient Treatment Covered?
Yes, inpatient or residential treatment is covered by HealthPartners insurance plans. Services offered at a residential treatment center may include detoxification services, medical and behavioral therapy, group therapy, and more. The length of stay can vary, as can the services offered by each individual treatment center.
Is Outpatient Treatment Covered?
HealthPartners does cover outpatient treatment as well. According to HealthPartners’ own website, “Outpatient treatment is a therapeutic, educational and supportive program that meets several times a week.
What Perks Are Available Through HealthPartners?
HealthPartners offers several perks that could be useful to the individual in recovery. These perks include discounts available for:
Getting Care Now
If you have HealthPartners insurance, you have access to many quality care providers. Don’t wait to contact a treatment provider to talk through what your options are. Taking the next step in your recovery from a substance use or mental health disorder is only a phone call away.
Does Insurance Cover Rehab?
The passage of the Affordable Care Act (ACA) extended insurance coverage to millions of Americans. It also included many reforms that prohibited companies from barring coverage for certain conditions, including substance use disorders (SUDs).
Which Insurance Providers Cover Alcohol & Drug Rehab at AdCare?
AdCare facilities, located in Massachusetts and Rhode Island, provide various levels of care, with some facilities offering medical detox and inpatient rehab and others providing outpatient therapy. Your insurance plan may cover one or more of these levels of care, depending on your plan.
What is rehab in addiction?
Rehab, or addiction treatment , is meant to help those suffering from a substance use disorder (s). Some programs are inpatient, meaning that you would live at the facility while receiving treatment. Other programs are outpatient, where you attend treatment or therapy 2 to 3 times per week for a few hours per day. The level and intensity of services depend on your individual needs.
What is the ACA? What are the benefits?
The Affordable Care Act (ACA) is a federal statute that was enacted in 2010 to make health insurance available to more people. With this program, people who make a certain percentage below the federal poverty level can receive assistance in paying for their health insurance premiums. Under the ACA, each health insurance company offering benefits has to provide a certain minimum level of benefits, including substance abuse treatment. These core benefits are called Essential Health Benefits (EHB). Any plan offered through the ACA must cover some form of substance abuse treatment.
How much does insurance cover?
Once your deductible is met, insurance typically covers 80% of the cost and you would be responsible for the remaining 20% as an out-of-pocket expense.
Does insurance cover addiction treatment?
Most plans cover outpatient treatment, as well as inpatient treatment for certain situations. A typical challenge you might face when seeking coverage is getting the level of treatment you desire to be covered by your insurance company, whether small or large.
Addiction Treatment Insurance Coverage
Contacting Your Insurance Company Pre-Treatment
- Call the Member Services department at your insurance companyto learn more about addiction treatment options. Have ready your insurance card and membership identification number ready. Take notes and write down the name of the member representative who you are speaking to and the date of the call. Do not be afraid to ask questions and clarify new terminology. In speaking t…
Appeals to Insurance
- More than 20% of appeals in denial of coveragecases are successful in favor of the covered individual. While first level appeals to insurance providers have low success rates, those rates of success increase with subsequent appeals. Generally, an appeal must be officially denied before one will be eligible to appeal services or treatment at a higher level. Individuals should preserve …
Glossary of The Top 20 Insurance-Related Terms
- Adverse Determination
1. Any action by a health plan that denies or limits payment for the requested behavioral or medical treatment or services. - Appeal
1. A legal right for an insured individual, their provider or an authorized representative to seek relief against a health plan or third party determination to deny or limit payment for requested behavioral or medical treatment or services.