Westwind Recovery® understands that receiving quality behavioral health treatment can be expensive, and not all have out-of-network insurance or the resources to pay cash for it.
We are happy that we are able to accept in-network policies with Anthem, BCBS, and ComPsych. This gives us the ability to provide mental health and substance abuse treatment that is covered by insurance providers.
Common Questions Surrounding Health Insurance Coverage for Treatment Centers
If you’re reviewing your insurance coverage looking for answers and feel frustrated you’re not alone. Insurance information can be difficult to understand and make it harder for individuals to feel comfortable searching for healthcare providers. Here we answer some common questions that surround addiction treatment and mental health coverage.
Is Rehab Covered by Insurance?
Each insurance policy is different, and you may have coverage for some addiction treatment services but not for others. It’s important that you’re familiar with the coverage included in your insurance plan. Oftentimes there are drug and alcohol outpatient and inpatient rehab programs that are included in your insurance policy.
Will My Insurance Cover a Rehab Program Twice?
If you have already gone through a rehab program and are looking to go again, your health insurance provider may still cover it. This will depend on your individual policy and the types of benefits you have. It’s not uncommon that individuals need to attend addiction treatment more than once.
What Types of Rehab Services Does Insurance Cover?
Most insurance plans will cover the following types of behavioral health services:
Detoxification: the process by which toxic substances are removed from your body like drugs or alcohol.
Inpatient Rehab: This is when you stay at an addiction treatment facility and receive 24-hour care.
Outpatient Rehab: This is when you live at home and travel to an addiction treatment facility for the treatment process.
Partial Hospitalization: This is when you live at home but receive most of your treatment program at a rehab facility during the day.
Counseling or Therapy: Meetings with groups of recovery individuals or with licensed behavioral health specialists.
Medication-assisted treatment (MAT): Medications used to help someone stay clear of drugs or alcohol during recovery.
Aftercare Services: Programs and services to help people stay focused on recovery after treatment.
What is the Affordable Care Act?
The Affordable Care Act, also known as Obamacare, is a health insurance reform that was passed in 2010. One of the key aspects of this reform is that it requires all health insurance plans to cover certain essential health benefits, including mental conditions and substance abuse disorders.
There are 10 essential benefits that the Affordable Care Act covers:
- Outpatient care
- Emergency services
- Inpatient rehab
- Pregnancy and childbirth
- Mental illness and substance abuse disorders
- Prescription drugs
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
- Rehabilitative services and devices
Does the Affordable Care Act Cover Rehab or Therapy?
The Affordable Care Act (ACA) requires all ACA plans to provide essential health benefits, which must include mental health services and substance abuse disorders.
This means that if you have a plan through the Marketplace or another ACA-compliant plan, it must cover rehab services. However, each state has different laws about what rehab services must be covered by insurance, so some rehab services may not be available in your area.
What is the Mental Health Parity and Addiction Equity Act?
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that requires insurance plans to provide the same coverage for mental health and substance abuse disorders as they do for other medical and surgical conditions. This means that if your insurance plan covers rehab services, it must cover them to the same extent as it would cover any other medical treatment.
Does Insurance Cover Mental Health or Dual Diagnosis Services?
Most insurance plans are required to cover mental illness and substance abuse treatment under the Mental Health Parity and Addiction Equity Act. However, there are some plans that are exempt from this law, including grandfathered health plans, certain types of Medicaid plans, and certain types of TRICARE plans.
Does Medicaid or Medicare Cover Rehab Services?
Medicaid is a state and federal program that provides health insurance to low-income individuals and families. Each state has different rules about what services Medicaid covers, but most states cover rehab services for drug abuse and mental health care.
Medicare is a federal health insurance program for people who are 65 or older, people with certain disabilities, and people with End-Stage Renal Disease. Medicare does not cover rehab services for substance addiction or mental disorders.
Currently, Westwind Recovery® does not accept Medicaid or Medicare for behavioral health services.
How Can I Pay for Rehab Without Insurance?
If you don’t have insurance or your insurance doesn’t cover drug addiction treatment, there are other options for paying for drug and alcohol rehab. Many treatment facilities offer sliding-scale fees based on income, and some offer financing options. Some facilities also accept private pay. If you need help determining how to cover necessary treatment our admissions team can help.
Anthem Insurance Companies
In the United States, Anthem is a large insurance provider, and clients who have this coverage, whether it is an HMO, PPO, or EPO. Anthem allows its members to access the necessary life-saving treatment that they need.
By Anthem and Westwind Recovery® partnering, we are able to reduce or possibly eliminate out-of-pocket expenses for those that need treatment.
What is Blue Cross Blue Sheild Insurance?
Coverage with Blue Cross Blue Shield (BCBS) gives members access to the largest network of providers and facilities in the United States. By teaming up with BCBS, Westwind Recovery® is able to provide high-quality care at an affordable price for our clients.
ComPsych is one of the world’s largest employee assistance programs (EAP) and provides comprehensive mental health and addiction treatment services to organizations and individuals. ComPsych provides confidential counseling and support to help employees overcome personal issues that may be affecting their job performance or overall well-being.
Common Insurance Terms and What They Mean
If you’re curious if rehab is covered by insurance, here is a list of common insurance terms and what they mean in relation to your policy, coverage, and costs. By understanding these terms you can make a more informed decision regarding your behavioral health options.
What is a Deductible?
A deductible is the amount of money you have to pay out-of-pocket for your health care before your health insurance starts to pay. For example, if your deductible is $1,000 and you have a $5,000 hospital bill, you will pay $1,000 and your health insurance will pay the remaining $4,000.
What is a Health Savings Account?
A Health Savings Account (HSA) is not technically insurance, it is a way to save money for medical expenses. An HSA allows you to put away money from your paycheck into an account that you can use to pay for health care costs. The money in the account is tax-free and can be used to pay for things like deductibles.
What is a Premium?
Your deductible is the amount of money you have to pay for your health care before your insurance company starts to pay, and your premium is the regular amount of money you have to pay for your health insurance. Your premium is usually paid monthly and can be taken directly from your paycheck if you have employer-sponsored health insurance.
What is a Copayment?
Your deductible is the amount of money you have to pay for your health care before your insurance company starts to pay, your copayment (or copay) is a set amount that you pay for a particular service, such as a doctor’s visit, every time you receive it. For example, you might have a $20 copay to visit your regular physician.
What is Coinsurance?
Coinsurance is the percentage of covered medical costs that you pay after you’ve met your deductible. So, if you have a $1,000 deductible and 20% coinsurance, you’ll pay $1,000 plus the remaining 20% of your medical bill.
What is an Out-of-Pocket Maximum?
Whichever insurance provider you have, it’s important to be aware of your out-of-pocket maximum. This is the most you’ll have to pay for covered services in a given year. Once you reach your out-of-pocket max, your insurance will cover 100% of the costs for covered services.
What's the Difference between an In-Network vs an Out-of-Network Service Provider?
We are an in-network provider with ComPsych, Anthem, and Blue Cross Blue Shield. That means we have a contract with them to provide services to their members at a negotiated rate. Being out-of-network means that rehab facilities do not have a contract with your insurance company.
However, this doesn’t mean that your insurance won’t cover any costs if you are enrolled in any PPO plans. A PPO, or Preferred Provider Organization, is a type of health plan that contracts with medical providers, giving you the freedom to see any provider you’d like without a referral.
We Can Check & Verify Your Insurance For You Or A Loved One
You can call our Anthem treatment center at 855.340.8832 and one of our admissions specialists will be happy to help you. You can also send us a message or you can send your insurance information to us.
Navigating through this process can be very difficult, whether you are seeking help for yourself or a loved one. At Westwind Recovery®, we are BCBS and ComPysch approved and have direct access to Anthem agents who can make this as easy as possible.
This is especially true since dealing with substance use and mental health conditions is always time sensitive, and the goal is always to get help as soon as possible.
Why Choose Westwind Recovery® Center?
Westwind Recovery® believes that every life is valuable. Every individual has the potential to create positive change and make our world a better place. When one of us gets caught up with substance use or a mental health disorder, we lose the ability to bring these gifts to the world. Addiction causes us to lose our capacity to love, hope, help, and heal. We lose ourselves, often with tragic results.
Our goal is to help every person who walks through our doors connect with a newfound sense of discovery and healing. We are not just a treatment center. We are a community of people who have joined forces to fight substance abuse, mental health disorders, and dual diagnoses one beautiful life at a time.
Each one of us is here to affect positive change in our families, our communities, and beyond. At Westwind Recovery®, clients learn about addiction treatment and how to forge healthy, life-long, supportive friendships and connections.
We are a clinically driven treatment center, with the top experts in the field on Westwind’s staff. We also combine traditional treatment with holistic therapies to produce the best results for lasting recovery.
At Westwind Recovery®, we provide year-round care. We can help you stay sober during holidays as well as help you support a loved one during the recovery process.
We are licensed by the State of California’s Department of Health Care Services, Accredited by the Joint Commission which is a hospital-level accreditation as well as having our IMS (Incidental Medical Services) certification.
Contact us today if you are looking for more information on the policies we accept.
Dr. Deena is the Chief Clinical Officer of Westwind Recovery®, an award-winning outpatient treatment center in Los Angeles where she oversees the clinical and administrative program and treatment methods. Dr. Deena is a doctor of psychology and licensed clinical social worker since 1993. LCSW #20628. Originally from the East Coast, Dr. Deena has worked running treatment centers, worked as a therapist in psychiatric hospitals as well as school settings and currently has a thriving private practice in the LA area. Dr. Deena has appeared regularly on the Dr. Phil Show as an expert since 2003. She has also been featured on many other TV shows, podcasts and has contributed to written publications as well as podcasts.