Does ConnectiCare Insurance Cover Alcohol and Drug Rehab?
Dealing with an alcohol or drug addiction issue can be overwhelming without treatment. If you have ConnectiCare insurance, you can start the process of seeking rehab by contacting the number on the back of your card. With a ConnectiCare insurance plan, you can start the process of recovery through a detox rehab program. ConnectiCare mental health provides support for people dealing with a substance abuse problem. Your plan makes you eligible for treatment and resources to assist with the recovery process. 1( 1st para)
Check ConnectiCare Insurance Coverage for Addiction Treatment
You can simplify the process of finding out about your ConnectiCare coverage by contacting the rehab facility directly. They can quickly and confidentially verify your insurance over the phone by calling . If you would rather find out more information online, you can fill out the form on this page and get an immediate answer about whether you’re in-network or not.
What Is ConnectiCare?
As a leading health plan provider in Connecticut for 40 years, ConnectiCare provides healthcare solutions for members. 2(top) Connecticare is a part of EmblemHealth and provides state, regional, and national care for its members.2(1st) Clients who select ConnectiCare insurance have a range of options when it comes to health plans and services.
When joining the ConnectiCare family of members, you may have a plan in one of the three following categories:
- Individuals and families: These include the Access Health CT and SOLO plans, which are Marketplace plans.3
- Medicare Advantage: The ConnectiCare Medicare plans are HMO-type plans.4
- Medicare Supplement: This supplements original Medicare.5
What Will ConnectiCare Insurance Cover?
ConnectiCare works with Optum insurance to provide access to the mental and behavioral health care you may need. 1 As part of this insurance, you will have coverage for services for substance use disorder. 1 Optum’s program for substance abuse is managed through their Behavioral Health Program and is typically pre-authorized. 6 (1st box)
Once you have pre-authorization, you are eligible to use your ConnectiCare insurance plan to pay for addiction treatment. The level of coverage you have may vary depending on your specific plan, but some of the programs you may be eligible for include the following:
- Residential detox treatment program: A residential treatment program indicates the patient will reside within the facility until treatment is complete. This provides a more closely monitored environment. A trained clinician will assist with any side effects from withdrawal. 7(long-term)
- Partial hospitalization program (PHP): For patients who need the benefits of doctors and therapists throughout the day but still need to go home at night, a PHP may be ideal for them.8
- Intensive outpatient program (IOP): During IOP, patients will participate in therapy sessions several times a week for several hours.9
- Outpatient treatment program and therapy: This program is your standard outpatient therapy, with meetings one or two times a week.9
Does ConnectiCare Insurance Cover Mental Health Care?
As mentioned above, ConnectiCare provides individual and family plans through the Marketplace.3 All Marketplace plans follow the guidelines of the Affordable Care Act (ACA) and comply with the mandate to provide essential benefits.10(1st para) Stated within the ACA essential benefit guidelines is the coverage for mental health disorders and substance use disorders.10(1st para)
Since it is common for people to simultaneously have a substance use disorder and mental health disorder, it is a good idea to be assessed for any comorbidities.11(top) Comorbidities will be best treated with a comprehensive treatment program. 11(who gets treat) Whether you are dealing with depression and heroin abuse or anxiety and alcohol use disorder or some other comorbidity, the ACA guidelines allow for you to treat these conditions together.10 There is no need to go to two separate facilities. You can contact the number on the back of your card to find ConnectiCare providers near you.
How Long Does ConnectiCare Insurance Cover Rehab?
The length of time you will need ConnectiCare drug rehab treatment may be a pressing question on your mind. You might be trying to make plans for your future and want to know how long you should expect to be in rehab. Each individual need is unique, so the specific details about the length of time your plan will cover are not known until you check a representative.
You can verify your benefits with a rehab facility to get a better idea of how long your specific plan will cover your drug rehab treatment. However, the length of time your plan will cover and the length of time that is recommended may not be the same. Most experts say that a minimum stay of three months is best.12(#5) You should ensure you take advantage of treatment recommendations so that you get the best outcomes.
What If My ConnectiCare Policy Does Not Cover Rehab?
If you check with ConnectiCare and find out that you do not have adequate coverage to get you through the entirety of your treatment or that your policy doesn’t cover the type of rehab you need, you can explore other options. The Substance Abuse and Mental Health Services Administration (SAMHSA) recently launched a new initiative that is designed to assist everyone in need of rehab to find a way to receive it. You can check with a rehab near you to inquire about scholarships, grants, sliding-scale fees, or other discounts.
ConnectiCare In-Network vs. Out-of-Network Rehab Centers
ConnectiCare works with doctors and other healthcare facilities that participate in the insurance plan’s network.13(in) They are considered “in-network.” 13(in) These doctors and facilities accept the negotiated payment amount and then pass that on to their members, meaning you will pay less out of pocket. 13(in)
If you use doctors and providers who are not in the network of providers, you are going outside the network. 13(out) Doing so can lead to higher costs on your end. 13(out)
ConnectiCare Health Plans
ConnectiCare individual and family plans for addiction treatment include four metal levels from which to choose. These include:3
- Platinum plans
- Gold plans
- Silver plans
- Bronze plans
In addition, plans will be either EPO/HMO, HSA, or POS.3 For specific details on what your deductible and out-of-pocket costs might be for rehab, be sure to contact a representative or verify your insurance with a rehab facility.
- (2020). Mental Health.
- (2021). About ConnectiCare.
- (2021). Health plans for individuals and families.
- (2021). Medicare advantage.
- (2021). Medicare supplement.
- (2020). Clinical Information.
- National Institute on Drug Abuse. (2020). Types of treatment programs.
- Definition of partial hospitalization. The national association of private psychiatric hospitals and the American association for partial hospitalization. (1990). The Psychiatric hospital, 21(2), 89–90.
- National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
- gov. (n.d.). What marketplace health insurance plans cover.
- National Institute on Drug Abuse. (2018). Comorbidity: Substance use and other mental disorders.
- National Institute on Drug Abuse. (2020). Principles of effective treatment.
- (2021). Glossary.