Paying for addiction treatment is often a big concern for people in search of rehab. They feel confused or overwhelmed about how to get their health insurance company to cover the costs. In most cases, it’s ideal for them to pick rehab centers within the network for their policies. However, sometimes it’s better to use out of network insurance benefits instead.
What Out of Network Insurance Means
Out of network insurance refers to a certain set of insurance benefits. These apply to health care providers who aren’t included in the network for a policy.
The providers within a network vary from policy to policy. Health maintenance organizations (HMOs) typically require people to only get addiction treatment from a limited network of providers to receive benefits. Preferred provider organizations (PPOs) have broader coverage areas and usually offer benefits for visiting providers outside of the network. Point of service (POS) insurance plans have limited networks and coverage for visiting out-of-network providers.
How Out of Network Insurance Costs Differ
One of the biggest cost differences between providers inside and outside of the network is a fee schedule. In-network providers follow a fee schedule for how much they charge for each service. Out of network insurance providers, however, don’t have a fee schedule. Because of that, they can charge whatever they want for their services.
With predetermined prices, insurance companies cover more of the cost when people visit in-network providers. If they offer out-of-network coverage, they’ll cover some of the expense based on maximum allowable amounts. This coverage will be less than what they pay for in-network coverage. Also, the policy may pay more when people meet their deductible or out-of-pocket maximum for the coverage period.
For instance, say that a policy offers 100% coverage for getting lab tests at an in-network provider. People with this policy won’t pay anything for those tests. However, the policy might only cover 60% of the bill at an out-of-network provider, meaning prospective clients have to pay the remaining cost.
Covering the Remaining Cost
When people choose out-of-network rehab centers for addiction treatment, their insurance likely won’t pay for everything. However, there are a few ways that they can cover the remaining bill. Financing through the rehab centers is one option.
Many places partner with financial institutions or offer payment options themselves to help patients pay for care. Covering the bill is usually a matter that facilities discuss with patients during the admissions phase.
Asking family and friends for help might be possible, but individuals should show a genuine desire to recover. When loved ones have trust issues with lending the money, they could send the money directly to the facilities. Home equity loans are another option. They have lower interest rates than standard loans and credit cards because the homes are collateral.
Reasons to Choose Out-of-Network Rehab Centers
Despite having to pay for some of the addiction treatment programs, out-of-network rehab may be better for some people. One of the top reasons is to get away from negative environments. Sometimes all of the rehab centers in an area are within an insurance network. However, it’s worth it for the patients to go outside of that network and away from home to recover.
In other cases, there aren’t any in-network providers who offer the specialized treatment that people need. One form of specialized care is dual diagnosis treatment. Treating co-occurring disorders is essential to a successful addiction treatment program. Going out of the network may be necessary for that.
Life-threatening situations may even take people out of their insurance network. If they suffer an overdose, for example, out-of-network rehab centers may be their only option. At this point, the most important goal is to save their lives.
Get Help for Drug Use at Ashley Addiction Treatment
If you need help paying for rehab, Ashley Addiction Treatment can help. We partner with financing programs so that everyone can afford care. Our facility is also in network with most commercial insurance policies. We offer a wide range of substance abuse programs, including:
As part of our programs, Ashley Addiction Treatment offers medical, clinical and mental health care services. Gender-specific pathways are available for those who need focused treatment. Our team also provides several holistic options, including acupuncture, massage, meditation, and art and music therapy.
Don’t let your addiction go untreated just because you don’t have insurance coverage. Let us help you get the care that you need to overcome your addiction. Call us now at 866-313-6307 to start your recovery.