ComPsych Insurance Coverage for Substance Abuse Treatment

Does ComPsych Insurance Cover Alcohol and Drug Rehab?

ComPsych insurance isn’t a traditional health insurance program, per se. Rather, it’s the largest provider of employee assistance programs (EAPs) in the world.¹ Moreover, under its GuidanceResources brand, it’s the leader of fully integrated EAPs with other workplace programs like behavioral health, HR, FMLA and absence management services, work-life, and wellness.¹

Over 56,000 companies from 190 countries are provided services from ComPsych, and, specifically, 127 million individuals throughout the United States receive ComPsych services.¹ If you have a ComPsych EAP or other resource through your employer, you may be able to use it to gain full or partial coverage for alcohol and drug rehab. Coverage varies, so it’s important to check before receiving care. To verify your benefits and coverage, call the number on the back of your insurance card. You may also call a rehab center to see whether their staff can help you check your coverage.

Check ComPsych Insurance Coverage for Addiction Treatment

Checking your ComPsych plan may seem like a difficult task, but it doesn’t have to be. There are a few simple ways that you can go about checking your plan details for addiction treatment coverage. Here are a few ways you can do so:

• Call the number on the back of your plan card to talk to a representative who can help explain your coverage details.
• Log in to your member portal online to review plan details.
• Call the rehab center and ask to speak to a staff member who can help verify your plan details. If the facility is an American Addiction Centers (AAC) facility, staff have experience working with insurers and can help you verify your benefits information. Call the AAC helpline and speak to a real, live person who can check your benefits while you’re on the phone.
• Enter your plan information in the form below and immediately check your coverage.

What Is ComPsych?

ComPsych is an international corporation that specializes in providing EAPs that integrate with other workplace programs, including behavioral health programs.¹ The company was founded in 1984 and has since been used by employers to develop workplace wellness and support programs to help employees lead their healthiest and happiest lives.¹ It is a URAC certified health care management company that uses its GuidanceResources platform to help employers fully integrate EAPs with behavioral health programs and other work-life offerings.¹

What Will ComPsych Insurance Cover?

What your ComPsych plan will cover will vary depending on how the plan is structured. It may cover some or all of the cost of the following common treatment methods:

• Inpatient/residential rehab—This type of care program, which takes place at a facility or hospital, may include detoxification or other rehab services and involves the patient staying at the facility overnight for a certain period of time.^{2, Pg 14 “What types of treatment programs are available, Para 2}
• Outpatient rehab/therapy—This type of care program often involves a patient visiting a facility or hospital to receive care, which often includes therapy, but then they return home in the evening.^{2, Pg 16, Para 2}
• Intensive outpatient programs (IOP)—This type of care program is more intensive than basic outpatient programs and involves a patient receiving between 9-20 hours of care per week for 2 months to 1 year.^{2, Pg 16, Para 3}
• Partial hospitalization programs (PHP)—This type of care program involves a patient receiving care for 4-8 hours each day but doesn’t include overnight stays.^{2, Pg 16, Para 1}

It’s important to check your coverage details before seeking care to avoid surprise medical costs. To do this, you can call the number on the back of your insurance card. Or, you can ask the rehab center of your choice to verify your benefits for you.

Does ComPsych Insurance Cover Mental Health Care?

Under the Affordable Care Act (ACA), which is the federal health care reform law, most health insurance plans are required to cover mental and behavioral health services in some capacity.³ This means that both co-occurring disorder treatment and stand-alone heroin rehab fall under this mandate. A co-occurring disorder is when a mental health disorder and substance use disorder occur together.^{4, Para 2} With a co-occurring disorder, each condition contributes to the other, and it’s considered beneficial to treat both disorders in a comprehensive manner.^{5, “Diagnosis and Treatment”, First sentence}

However, because ComPsych isn’t a traditional health plan, it isn’t subject to these mandates. This means that coverage isn’t required or mandated. Despite this, ComPysch’s behavioral health care services are designed to provide savings for behavioral health programs.⁶ To achieve this, ComPsych’s experts help employers match employees to the right programs and manage their cases to help achieve ideal outcomes.⁶ Specifically, ComPsych’s behavioral health services cover:⁶

• Integration with the employer’s EAP and other work-life services.
• 24-hour pre-authorization.
• Large, worldwide network of providers.
• Claims and utilization management services.
• Program outcome reporting.

How Long Does ComPsych Insurance Cover Rehab?

How long your ComPsych plan will cover rehab will depend on your plan, and may also depend on your traditional health plan coverage, too. That’s why it’s important that you look up your coverage details prior to receiving care to ensure you’re prepared for the health care costs you may incur during your rehab treatment.

Despite this variance, most experts and research indicate that staying in treatment for longer durations is the most effective course of treatment. Most treatment should last at least 3 months to help the patient reduce or stop drug use and improve outcomes ^{7, Bullet #5} To find out how long your ComPsych plan will cover treatment, call the number on the back of your plan card.

What if My ComPsych Policy Does Not Cover Rehab?

It is possible that your ComPsych policy does not cover the full or partial cost of rehab. But, you should not let this delay getting care, as getting the treatment you need right now is critical rather than pushing it down the road. Some rehab facilities offer financing or scholarship opportunities to help offset the costs of care. Be sure to ask the facilities you may attend whether this is an option for you.

ComPsych In-Network vs. Out-of-Network Rehab Centers

Whether a facility is in-network or out-of-network will have a huge impact on the cost of care and level of coverage. A network refers to the group of providers, suppliers, and facilities that are under contract with your plan to provide care to you.⁸ In most cases, receiving in-network care is less expensive for you than receiving care from an out-of-network provider.

To check whether a facility is in-network or out-of-network, call the number on the back of your insurance card or ask the rehab facility staff to check your insurance benefits.

ComPsych Plans

ComPsych offers a variety of work-life services, which include EAPs and behavioral health program services.⁹ These plans can help you gain coverage for addiction treatment. These plans are typically provided by your employer, so it’s important to ask your employer whether these benefits may be available to you.

Sources

1. (n.d.). About ComPsych Corporation.
2. Substance Abuse and Mental Health Services Administration. (2014). What is substance abuse treatment? (Original work published 2004).
3. gov. (n.d.). Mental health & substance abuse coverage.
4. Substance Abuse and Mental Health Services Administration. (2020, April 30). Mental health and substance use disorders.
5. National Institute of Mental Health. (March 2021). Substance use and co-occurring mental disorders.
6. (n.d.). Behavioral health programs.
7. National Institute on Drug Abuse. (2018 January). Principles of drug addiction treatment: A research-based guide (third edition), principles of effective treatment.
8. gov. (n.d.). Network.
9. (n.d.). The GuidanceResources Solution.