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Does Sierra Health Cover Inpatient Alcohol and Drug Rehab Centers?

Sierra Health benefits vary in what they provide based on a person’s individual plan and policy.
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Sierra Health Coverage for Drug & Alcohol Rehab Treatment Near Me

When dealing with a substance use disorder, having access to Sierra Health rehab centers is of key importance to moving forward to recovery. However, they do offer a broad scope of medical and mental health solutions for policyholders. The main types of insurance plans provided by Sierra include:1

  • Preferred Provider Organization (PPO) Plan: This type of plan is popular because you can visit in-network and out-of-network providers. Most people may prefer to stay in-network because the insurance will pay for most services. Although you can go out-of-the-network for treatment, services are covered at a reduced rate. That means you’ll have to pay for part of it yourself. The amount you’ll have to pay depends on several factors. It’s best to consult with your policy plan to determine the exact amount.
  • Health Savings Account (HSA) compatible PPO plan: This type of plan requires that you fulfill your deductible before insurance will kick in and start paying. The deductible amount might be around $3,000. Prescriptions make it easier to reach your deductible. The other difference with this insurance plan is you can set up a tax-free health savings account for the money you save on healthcare.

You can contact your insurance provider directly to find out more information about Sierra Health’s medical insurance and network coverage. Call the number on the back of your insurance card for further details. An easier way to verify your Sierra Health rehabilitation coverage is to contact the rehab facility directly. They can tell you if your insurance will cover services at their facility.

What Will Sierra Health cover?

Sierra Health substance abuse treatment coverage and Sierra Health mental health are vital parts of your comprehensive insurance package. Sierra Health’s mental health services are provided under the Behavioral Healthcare Options (BHO).2These typically include:2

  • Substance use disorder programs.
  • Mental health services.
  • Crisis programs.
  • 24-hour, 7-day-a-week intervention services.
  • Educational resources and services.
  • Employee assistance programs.

These are the broader categories of service that you can expect. Once you are enrolled in a Sierra Health rehab, an admissions navigator will guide you in choosing the exact Sierra Health drug treatment program that is right for your needs. Treatment programs you might encounter include the following:3

  • Inpatient/residential rehab: Inpatient treatment gives security and peace of mind to those who have more severe substance abuse issues. You’ll have around-the-clock supervision and management of your symptoms as you detox from whatever substance you are taking. Licensed inpatient facilities employ certified clinicians who will ensure you get through this phase of recovery.
  • Partial hospitalization programs: Similar to an inpatient residential program, you receive professional treatment, including detox and therapy. The amount of time you spend in treatment each day is extensive, but you go home at night.4
  • Outpatient rehab: During an outpatient program, you participate in any of the many therapy programs available. Some people attend once a week, while others may attend more often. Usually, people participate in an outpatient program after they complete one of the other programs.3
  • Intensive outpatient programs: Outpatient rehab can be more intensive when needed. With an intensive outpatient program, you attend multiple hours a day, several times per week.3

Does Sierra Health Cover Mental Health Care?

When someone with a substance use disorder also struggles with a mental illness, they have what’s called a co-occurring disorder.5 This means both conditions occur simultaneously. A co-occurring disorder is quite common and can cause additional problems for those who are dealing with it. It is essential to work with a Sierra Health drug rehab that provides co-occurring disorder treatment for both conditions.

You can address both conditions together for best results with treatment at least partially covered by your Sierra Health coverage. Under the Affordable Care Act, insurance providers must provide for what is deemed “essential benefits.”6 This includes mental health care and substance abuse treatment.6

How Long Does Sierra Health Cover Inpatient Alcohol and Drug Rehab Programs?

You and your therapist or admissions navigator determine how long you stay in a Sierra Health drug treatment program. Every person’s needs will be unique to their situation. Some people start with an inpatient treatment program and gradually move to partial hospitalization and then to an outpatient program. This allows them to learn the skills and strategies they need before diving back into the real world again.

The amount of time you need will depend on your circumstances. Most clinicians recommend that you stay in drug rehab for at least 90 days.7 You will often stay longer because people normally transition to outpatient rehab.

What if My Sierra Health Policy Does Not Cover Inpatient Alcohol and Drug Rehab Programs?

Sometimes people may be concerned that they won’t have coverage for Sierra Health addiction treatment, and they wonder about the costs. If you don’t have insurance coverage, don’t give up. You still have options. Some rehab facilities offer sliding scale fees or financial grants. You can also check out a payment plan through the facility or obtain a personal loan. The main thing to remember is to not delay in getting the immediate treatment you need.

Sierra Health In-Network vs. Out of Network Inpatient Drug Rehab Centers

If you seek in-network Sierra Health drug rehab, it will be covered by your insurance. In-network rehab facilities are part of the Sierra group of providers and offer services at a discounted price. 1 If you are unsure whether a particular location is within the Sierra drug rehab provider list, contact the facility and receive insurance verification. You can also contact the rehab directly and talk to a representative, or call the number on the back of your card.

How to Find Sierra Health Covered Alcohol and Drug Rehab Program Centers?

Sierra Health insurance will provide treatment for most addiction and mental health services. You can begin your journey by contacting American Addiction Centers (AAC) to verify your insurance coverage. They will give you an immediate answer to your questions about coverage. Speak to our helpline representative by calling for more details.

AAC’s Desert Hope Treatment Center is one of the top drug rehabs in the nation. It offers a luxury rehab experience and many treatment options for people with substance abuse and co-occurring disorders. Contact our center today to get started on your recovery journey.

Sources

  1. Sierra Health and Life. (2021). How to use your health plan.
  2. Sierra Health and Life. (2021). Mental health and substance use benefits.
  3. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction drugFacts.
  4. 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.
  5. National Institute on Drug Abuse. (2018). Comorbidity: substance use disorders and other mental illnesses drugFacts.
  6. gov. (n.d.) What marketplace health insurance plans cover.
  7. National Institute on Drug Abuse. (2020). Principles of effective treatment.
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