When you’re ready to enter an addiction treatment center, you have to answer one very important question. The question is, “How will I pay for this?” Most rehabs offer several payment options. For example, paying for treatment out of pocket is always an option. However, this is not a viable option for everyone. Those who do not have the financial means to pay for addiction treatment completely themselves will have to turn to other options. For example, if you are insured by UnitedHealthcare, your insurance may cover your addiction treatment. If you are not privately insured, you may receive treatment through Medicare or Medicaid. Although we don’t know each person’s exact situation, we want to help you learn how insurance can help you. If you have more questions about insurance and addiction treatment, please call us at 901-403-7925.
UnitedHealthcare Insurance Plans
In Tennessee, UnitedHealthcare offers several plans. First, they offer short-term health insurance. This plan is designed to bridge gaps in coverage. Therefore, this plan doesn’t provide coverage for long stretches of time. In this plan, deductibles and coinsurance may apply. Unfortunately, this plan may not cover substance abuse treatment in Tennessee. Next, TriTerm Medical Insurance provides coverage for three years. Typically, TriTerm provides lower copays.
Also, TriTerm often provides coinsurance. In coinsurance, the insured person pays a share of the payment made against a claim. Unfortunately, TriTerm may also not cover addiction treatment in Tennessee. Also, UnitedHealthcare offers Fixed Indemnity Insurance. In this plan, there is no deductible. Further, this plan offers first-dollar coverage. This means that the insurance company starts covering costs on the first dollar claimed. Typically, this plan is more expensive than other plans. Although this plan generally covers more than other plans, this plan may not cover all addiction treatment options in Tennessee. For more information on your specific plan, visit UnitedHealthcare’s website.
Medicare and Medicaid in Tennessee
In several cities in Tennessee, many treatment centers accept both Medicare and Medicaid. In several cities in Tennessee, many treatment centers accept both Medicare and Medicaid. Medicare is the US federal healthcare plan for people who are ages 65 and older. Medicaid, however, is the US federal healthcare plan for those who are economically disadvantaged. Although Medicare and Medicaid aren’t for everyone, these options can help those who aren’t covered through private insurance.
Information on Medicare
Medicare, the federal health insurance program, serves the following people. Medicare serves those who are 65 or older, some younger people who have disabilities, and people who have End-Stage Renal Disease (ESRD). ESRD is a permanent kidney failure that requires dialysis or a transplant. Further, Medicare’s services come in four distinct parts. Here are the four parts:
- Hospital Insurance, Medicare Part A
- Medical Insurance, Medicare Part B
- Medicare Advantage, or all-in-one coverage, Medicare Part C
- Prescription drug coverage, Medicare Part D
To help you better understand Medicare, we will further explain these services.
Medicare Part A
Part A is hospital insurance. Therefore, Part A covers care in a skilled nurse facility (such as an assisted living center), hospice care, inpatient hospital visits, and home healthcare in some situations.
Medicare Part B
Part B is medical insurance. Consequently, Part B covers outpatient care, some doctors’ visits, medical supplies, preventative services, and some doctors’ services.
Medicare Part C
Part C is a combination of Part A, Part B, and (most of the time) Part D. This means that those covered by Part C have access to hospital care, medical care, and prescription services.
Medicare Part D
Part D covers prescription drug coverage. This means that those covered by Part D can receive their medications at a lower cost than they normally are.
Information on Medication
Millions of people in the US receive healthcare through Medicaid. Primarily, Medicaid serves those who are economically disadvantaged. People with disabilities, pregnant women, children, and adults can all receive coverage from Medicaid. Through Medicaid, people can receive care who would not otherwise have the means to do so. States administer Medicaid, and the program is funded by states and the federal government.
Coverage of Inpatient, Outpatient, and Residential Treatment
Although there are no specific benefit categories for addiction treatment, Medicare covers those types of services when providers deem the services reasonable and necessary. Therefore, Medicare could potentially cover inpatient, outpatient, and residential treatment. Further, Tennessee’s Medicaid also covers addiction treatment for adults with alcohol or drug dependency. Medicaid’s coverage includes outpatient and residential services, among other treatments.
Here is some information about the difference between outpatient, inpatient, and residential treatment. Outpatient treatment is part-time, usually between 10 to 12 hours a week, meaning that the recovering user comes to the facility, but they do not stay in the facility. These programs usually run between three months to one year. Ultimately, outpatient treatment is right for those who have more mild addictions.
Inpatient treatment means the person stays at a facility for a period of time—usually between three weeks and six months. While staying at the facility, they undergo intensive treatment. Inpatient treatment has a higher success rate than outpatient treatment, but it is also more expensive. Further, inpatient treatment interrupts daily life. Ultimately, inpatient treatment is especially effective for those who have undergone serious addictions.
Residential treatment means that patients live in a residence with other patients. Treatment staff transports the patients to the treatment center each day. In this way, they experience the benefits of both inpatient and outpatient treatment. Residential treatment is best for those who want to keep their treatment and living areas separate, but they still want to separate themselves from their toxic environments.
How to Find Information
Behavioral and mental health sections of insurance company websites often contain information about substance abuse treatment. If you are looking for a specific facility, check your insurance company’s website to make sure the provider is covered by your plan. Many facilities in Tennessee offer payment assistance and/or offer their services on a sliding fee scale.
More Information on Insurance Plans
Ultimately, you can find the treatment and help you need. To review, UnitedHealthcare insurance offers both short-term insurance and long-term insurance plans. This means that whether you are between insurance plans or secure in an insurance plan, you can find the treatment you need. Further, those who do not have insurance through UnitedHealthcare can find help through either Medicare or Medicaid. In summary, Medicare is federal healthcare. Further, Medicare covers those over the age of 65, as well as certain people who have disabilities. Also, Medicare covers those who have ESRD. Therefore, Medicare can be a good option for people who fall into those categories. Additionally, Medicaid is a federal program designed to serve people who are economically challenged. Therefore, people who have severe financial constraints may qualify for Medicaid.
Another element of insurance to be aware of is the types of plans offered. Most insurance companies offer a Health Maintenance Organization (HMO) plan or a Preferred Provider Organization (PPO) plan. HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. However, PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of the network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan. Clearly, you have a lot of options when it comes to deciding which method of payment is right for you. If you would like more information about HMOs, PPOs, or UnitedHealthcare insurance, please call us today. Contact us at 901-403-7925.