Health Net Insurance Coverage for Drug and Alcohol Rehab Treatment

Does Healthnet Insurance Cover Alcohol and Drug Rehab?

Based in Los Angeles, California, Healthnet has been operating for over 40 years and now covers over 3 million members.^{1 (Paragraph 1)} Healthnet provides health plans for individuals, families, businesses of all sizes, people with Medi-Cal, and those with Medicaid.^{1 (Paragraph 1)} They are committed to health equity and are accredited by the National Committee for Quality Assurance (NCQA).^{1 (“NCQA Accreditation”)}

Healthnet rehab options are available should you or your loved one need them. Rehab centers can check your coverage if you simply provide them with your information. You can also call the number on the back of your insurance card to find out the specifics of your current insurance plan through Healthnet.

Check Healthnet Insurance Coverage for Addiction Treatment

Healthnet plans can cover addiction rehab. There are Exchanges (otherwise known as Marketplace) plans that provide coverage, as well as Commercial and Medicare plans and Medi-Cal—and, as mentioned, they are all NCQA accredited.^{1 (“NCQA Accreditation”)} Through their Managed Health Network (MHN), you can find treatments that meet your needs. You can get appointments with psychologists, psychiatrists, and therapists as well as receive inpatient treatment or alternate levels of care.²

Again, if you’re uncertain about whether your plan covers therapy sessions or inpatient rehab, you can get help. Reach out to American Addiction Centers (AAC) for assistance verifying your insurance. You can use the form to input your information and see whether your provider is in-network or not. You can also call the AAC helpline to speak with a representative who can verify your insurance and answer your questions right over the phone.

What Is Healthnet Insurance?

Founded in 1979, Healthnet is a California-based health insurance provider that serves nearly 1 in 12 Californians.^{1 (Paragraph 1)} With over 3,000 employees and 85,000 network providers, they can provide extensive medical coverage for every stage of life.^{1 (Paragraph 2)} They partner with local organizations to combat violence and poverty and to encourage healthy living.^{1 (Paragraph 2)} They also offer behavioral health services and substance abuse programs through Health Net and its subsidiaries, all of which are subsidiaries of the Fortune 500 company Centene Corporation, which provides health coverage to over 20 million Americans.^{1 (Paragraph 4)}

Today, Healthnet is committed to providing health care equity. Its model includes assisting people with a variety of abilities as well as those from various ethnic backgrounds.^{1 (“Our Health Equity Model in Action”)} They are NCQA accredited and have earned accolades from multiple state agencies for their dedication to equity.^{1 (“How does our model work?”, paragraph 1)}

Healthnet Plans

Healthnet offers multiple plans for individuals and families that allow you to choose between a PPO or HMO, depending on what works best for you, and you can qualify for financial assistance if needed.³ Treatment coverage for substance use will depend on which plan you have. For example, if you have the Platinum 90 PPO, substance use disorders are covered with inpatient services in-network having a 10% deductible and 50% out-of-network deductible.^{4 (Page 2)} If you are using outpatient services, an office visit will cost you $15 for an in-network provider (with a 10% deductible up to $15 for anything other than an office visit) and a 50% deductible for an out-of-network provider.^{4 (Page 2)}

However, if you have the Platinum 90 Ambetter HMO plan, substance use disorder services will cost $250 per day for up to five days at a facility with an in-patient physician visit costing $0.^{5 (Page 1)} Outpatient office visits cost $15 with there being no charge for anything other than an office visit.^{5 (Page 1)} Seeing as how these plans can have different deductibles and copays, it is always a good idea to check your specific plan’s details before selecting a rehab facility.

What Will Healthnet Insurance Cover?

A Healthnet plan can cover some or all of the costs of inpatient (or residential) rehab, outpatient rehab (or therapy), intensive outpatient programs (IOP), and partial hospitalization programs (PHP). Through their Managed Health Network subsidiary, Healthnet helps to cover behavioral health solutions.² You will receive coverage for outpatient sessions with psychologists, psychiatrists, and therapists plus inpatient care, partial hospitalization, or intensive outpatient care.² Any follow-up and aftercare you receive will have some degree of coverage as well.²

If you are enrolled via Exchanges in a Health Net plan, you receive these same benefits as they are considered Essential Health Benefits.^{6 (“The Exchanges”)} It is important to note that, if you have Medi-Cal, substance use disorder benefits are considered the county’s responsibility. ^{(“Expanded Mental Health Benefits Under Medi-Cal”)}

Does Healthnet Insurance Cover Inpatient Mental Health Care Facilities?

There are roughly 9.2 million American adults with co-occurring disorders – a coexistence of a mental health condition and a substance use disorder.^{7 (Paragraphs 1-2)} No exact combination of these disorders exists; however, bipolar disorder, mood and anxiety disorders, and major depressive disorder are all relatively common in their co-occurrence with substance use disorders.^{7 (Paragraph 5)}

After the Affordable Care Act was enacted, there was expanded Medicaid coverage as well as more coverage established by providing subsidiaries for coverage purchase in the non-group market. ^{8 (“The Affordable Care Act and Behavioral Health”, paragraph 1)} In turn, more people with co-occurring substance use disorders were eligible to get help from rehab facilities. ^{8 (“Medicaid Expansion”, paragraph 4)} This essentially means that health insurance providers had to make room in their plans for treating co-occurring disorders.

How Long Does Healthnet Insurance Cover Rehab?

Healthnet insurance coverage and costs will depend on the length of your stay in rehab, and that itself can be subject to your recommended treatment plan. Studies show that positive rehab outcomes are associated with an adequate duration of treatment.⁹ Participation of 90 days or longer has a more significant efficacy than stays lasting for a shorter period, showing that longer stays help maintain more positive outcomes.^{9 (Paragraph 1)}

With numerous plans and policy tiers, as well as Medi-Cal and Medicare coverage, it is important to learn what your plan covers before scheduling your rehab treatment. You may use the information on your insurance card to look up your plan’s coverage specifics.

What if My Healthnet Policy Does Not Cover Inpatient Rehab?

Healthnet rehabilitation might not cover all of your stay in a rehab facility, but you might be able to access financial assistance through scholarships, grants, or other types of special funding. You can also check with local faith-based charities and churches to see if they can offer any assistance. You might also want to contact the facility of your choice to see if they offer financial assistance.

Waiting for treatment might not be ideal for you and getting help now is important. That is why it is important to explore your options and know how much your plan will cover for you.

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

Healthnet insurance California has covered Healthnet detox and rehab centers found in-network. This means that these facilities already work with Healthnet. An out-of-network Healthnet rehab center does not currently take Healthnet plans. You can check to see if your intended facility is in-network or not by checking with your insurance provider, with the facility, or by allowing AAC to validate your health insurance coverage.