Does Health Net Insurance Cover Opioid Rehab?
Health Net is a private insurance company offering various insurance plans to clients of any age, employment situation, income, or health status. These plans cover various health benefits including specialized drug rehab.1
However, depending on the policy and location, that coverage may vary. Under the Affordable Care Act, all private insurance companies are expected to cover the costs of mental health and substance abuse treatment and treat them in the same manner as any other medical procedure.2
If you are looking for an opioid treatment facility covered by your Health Net insurance, American Addiction Centers (AAC) can help by offering guidance, assistance, and in-network programs.
What Is Health Net Insurance?
Health Net is a private health insurance company in the United States. It was founded over 40 years ago and is based in Woodland Hills, California. The company provides health insurance to individuals, families, and small businesses. Health Net offers various health and insurance plans, such as Medi-Cal and Medicare. The company has over 3 million members and a network of 90,000 service providers across California.1
What Services Does Health Net Insurance Usually Cover for Opioid Treatment?
Health Net insurance covers evidence-based opioid rehab services that are considered medically necessary. This can include detoxification, inpatient rehabilitation, and outpatient rehabilitation services. Health Net insurance coverage also covers medication-assisted treatment, which can be an effective way to manage opioid addiction. Some of the services generally covered by private insurance include:2
- Detox services: Detoxification is often the first step in addiction treatment following intake. It helps rid the body of the toxins accumulated from using opioids such as heroin. Detox services can be provided in a variety of settings, including inpatient facilities and hospitals.
- Screenings: Opioid screenings can help identify people at risk for overdose or other adverse effects of opiates and opioids in general. Screenings can be conducted in a variety of settings, including the treatment facility.
- Interventions: Opioid interventions are necessary to prevent overdoses and other health complications. They’re intended to help people understand the severity of their opioid use problem and should be done in the presence of a professional interventionist.
- Inpatient rehab centers: Inpatient rehab centers provide around-the-clock care in a safe and focused environment. During their stay, patients will participate in various individual and group treatment, counseling sessions, and other activities aimed at promoting recovery.
- Outpatient treatment: Outpatient programs are a good option for those who want to recover from opioid addiction by getting treatment while continuing to live at home. These programs are generally more affordable and flexible than inpatient treatment, but also require patients to have stable living conditions and dedication to getting better.
- Behavioral therapies: Behavioral therapies help people who are addicted to opioids to change the way they behave. This is done to help them recognize what drives their addiction and how to change their behavior in triggering situations.
- Treatment for co-occurring disorders: Co-occurring disorders are defined as two or more disorders that occur simultaneously, including mental health and SUDs. Their treatment must address both issues for it to be successful.
Is There Something Health Net Rehab Coverage Doesn’t Usually Include?
There are a few things that insurance does not typically cover for opioid addiction. Non-medical amenities such as food deliveries, private rooms, private treatment, and recreational activities such as access to the gym, pool, or spa are generally not covered by insurance.2
Similarly, any non-evidence-based treatment, holistic treatment, and alternative therapies such as yoga, meditation, or reiki, are generally not covered by insurance.2
What’s the Cost of Opioid Rehab With Health Net Insurance Coverage?
The cost of opioid treatment is determined by how severe the addiction is, the treatment program’s length, location of the treatment facility, services offered, and other associated costs like therapy and medication.2
The goal of opioid use disorder treatment is to help the individual achieve and maintain abstinence and improve their quality of life. Treatment may consist of a range of clinical services, such as co-occurring disorder assessment, diagnosis, individual and group therapy, medication-assisted treatment, detoxification, relapse prevention, and access to community support resources and aftercare programs.3
The amount of your deductible and co-pay may vary depending on the Health Net insurance plan that you have. Make sure to ask your insurer for a list of preferred facilities or providers in your area to prevent unexpected costs.2
What Determines the Cost of Inpatient Opioid Treatment?
The cost of inpatient opioid rehab may vary depending on the length of the program, the types of services and medical treatment offered, and facility location. In-network treatment centers that accept Health Net substance abuse coverage will generally charge less than out-of-network facilities. Your insurance company may still set a treatment length limit or require authorization from a doctor before your treatment starts.4
What Determines the Cost of Outpatient Opioid Treatment?
The cost of opioid rehab is determined by the frequency and intensity of treatment. The frequency of care required depends on the program. Some programs may require daily attendance, while others have patients attend the program up to three times every week. Outpatient care may last from two months to one year.2
Outpatient treatment can be beneficial for people who are willing to attend medical appointments and therapy sessions regularly. It is important to have stable living conditions, a means of transportation, and support from family and friends to get the most out of outpatient treatment, since it does not involve around-the-clock care.2
What Determines the Cost of Partial Hospitalization Programs?
Intensive partial hospitalization programs offer a wide range of benefits, but they may be more expensive than outpatient treatment. However, a sustained, low-intensity partial hospitalization program may be more cost-effective for some people. Partial hospitalization entails attending a treatment facility for around 20 hours every week, which falls somewhere between inpatient and outpatient care.5
What Determines the Cost of Medication-Assisted Treatment?
Medication-assisted treatment costs are mainly determined by the prescribed length and type of treatment. There are a number of FDA-approved medications that can be used to treat opioid addiction. These medications are usually more successful when combined with counseling and behavioral therapies. The three most commonly used medications are methadone, buprenorphine, and naltrexone.2
- Methadone is a long-acting drug that reduces withdrawal symptoms and opioid cravings by preventing short-acting opioids such as heroin from producing euphoric effects. The average cost of methadone treatment is $126/week.2,6
- Buprenorphine works similarly to methadone, controlling withdrawal symptoms and preventing cravings. The average buprenorphine treatment cost is $115/week. 2,6
- Naltrexone prevents the effects of opioids: inducing euphoria and eliminating pain. An initial period of withdrawal of 7-10 days is required before starting naltrexone. On average, naltrexone treatment at a certified Opioid treatment program may cost $1,170 per month.2,6
How Do Treatment Costs Compare to Costs of Opioid Addiction?
Opioid abuse is a significant drain on the US economy. Opioid abuse inflicts damage on individuals and their loved ones and has a harmful effect on national health and safety.3
In 2007, Illicit drug use cost the country an estimated $193 billion. This includes costs related to public health, criminal justice, and lost productivity.3
Additionally, nearly 50,000 people die from opioid overdose annually, and over 10 million people abuse them each year.7
In 2010, an estimated 23.1 million US citizens aged 12 or older needed treatment for substance use. However, only 2.6 million received treatment at a treatment facility in 2009.3
Considering that a study in California demonstrated that people who receive SUD treatment for 60 days or more can save over $8,200 in healthcare costs and lost wages, the benefits of early intervention and treatment should not be underestimated.3
Health Net Insurance: How Long Does It Cover Addiction Treatment?
Health Net and other insurance companies cover various lengths of both inpatient and outpatient treatment programs. Outpatient treatment length is generally determined based on the patient’s individual needs and may last from a few months to a few years. Inpatient treatment usually lasts 30, 60, or 90 days.8
If you are addicted to opioids and have other mental health problems, your treatment will likely need to be longer. Health Net‘s policies usually cover extended treatment that may be necessary, but it’s best to verify your insurance coverage by calling the number on the back of your insurance card and talking to an insurance company representative.2
Are Inpatient Programs Better Than Outpatient Treatment for Opioid Addiction?
Inpatient treatment is usually more effective than outpatient treatment for opioid addiction because it provides more structure and support. It can be more difficult for people to stay clean and sober when they are not living in a supportive environment, away from potential triggers. Inpatient facilities also provide access to medical care and counseling, which can be essential for people recovering from addiction.8
Inpatient treatment is often more expensive than outpatient treatment, but it may be worth the investment if it means a better chance of long-term recovery. If you are considering inpatient treatment for opioid addiction, talk to your doctor or mental health professional about what options are available and whether inpatient treatment is right for you.8
How Can I Use Health Net Insurance to Finance Opioid Rehab?
Reach out to the Health Net helpline if you need help finding appropriate drug addiction treatment for you or other insured members of your family. Health Net staff can give you detailed information about in-network practitioners and facilities, the intake and referral process, eligibility, available payment options, and Health Net rehab coverage benefits. Their dispatchers can also schedule an appointment for general consultations with experienced psychiatrists about the possible treatment for co-occurring disorders for Health Net members.9
You can also ask American Addiction Centers to verify your Health Net insurance coverage. You can reach out to their alcohol and drug abuse hotline and get any information regarding finding in-network facilities, insurance coverage, and additional financing methods available.
During your call, the admissions navigators may ask you a few questions and will gladly answer some of yours, such as whether a treatment center offers same-day admittance or whether couples’ addiction treatment is available. These questions are meant to help you determine whether the facility and services offered there are a good fit. Since the call is completely confidential and will not be reported to law enforcement, feel free to be as honest as possible.2
Finding a Health Net Substance Abuse Treatment Facility
The admissions navigators at AAC can help verify your Health Net insurance coverage and discuss other private pay policies, as well as provide any additional information such as which local centers are in-network with your preferred provider. You can reach out to the AAC team either by calling a specialized opioid and prescription drug hotline or by filling out a contact form online.