HMO VS. PPO PLAN
There are many things to consider when getting insurance in the Oklahoma area for substance abuse treatment. One of the first things for addiction treatment to consider is whether you or a loved one wants an HMO or a PPO policy like what Bright Health Insurance offers. There are a few differences between the two. HMO policy stands for health maintenance organization. With an HMO plan, individuals go through their primary care provider in order to get referrals in the HMO network. All doctor visits must be through the HMO network. This policy has lower monthly premiums and typically the out-of-pocket payment is less. However, any services done out of the network will not be covered under this policy.
What Does A PPO Plan Mean?
The other option is a PPO plan. Bright Health insurance offers a PPO plan for addiction recovery. There are three tiers of coverage. All three of them may cover substance abuse treatment but copays, coinsurance, and deductibles may apply. Overall, PPO plans tend to have higher monthly premiums. There also tends to be higher out of pocket medical costs. However, a PPO plan doesn’t require any referrals in order to receive services from medical professionals. Patients can go to any doctor or hospital that they choose. In some cases with a PPO plan patients may have to pay the doctor and then submit a claim to get reimbursed after.
Medicare And Medicaid Coverage
Do you or your loved one qualify for Medicare or Medicaid? If so it is important to know what coverage is available. When it comes to treatment Medicare and Medicaid are both accepted in most major cities. Centers will mostly likely accept both for coverage. There is not a specific category for coverage when it comes to Medicare. However, those that truly need substance abuse treatment can get the coverage they need. This coverage applies to both inpatient and outpatient treatment. No matter what type of treatment an individual is in need of they most likely will be able to find coverage. Medicaid also covers substance abuse treatment for adults. This includes coverage for outpatient and residential services. To find out more check the insurance company’s website under the behavioral and mental health sections.
OUR TEAM OF PROFESSIONALS CAN HELP
Still worried about being able to afford treatment? Many centers in Oklahoma offer payment assistance and sliding scale fees. Finances should never be a reason you or a loved one doesn’t seek treatment. There are always options available. Talk with a treatment center about different treatment options and pricing. Always talk with your insurance as well about the best plan that is available for you.