Medica Insurance Options
Deciding on an insurance provider and plan to go with is a big decision. In Oklahoma ones of those providers is Medica Insurance, which covers some addiction treatment programs. Harmony by Medica is available only in select counties in Oklahoma. There are three levels of tiers available. This includes Gold, Silver, and Bronze. All the available tiers may offer substance abuse treatment coverage. However, copays, coinsurance, and deductibles may also apply. The plan also may have a lower monthly premium.
Don’t Count Out Medica Quest
Medica Quest is another insurance plan that is available throughout most of Oklahoma which covers some addiction treatment programs. There are three tiers of coverage. There is Gold, Silver, and Bronze coverage available. Copays, coinsurance, and deductibles may apply. All levels of coverage may offer coverage for substance abuse treatment. There may be a higher monthly premium on this plan. It is important to always speak with an insurance agent when deciding on going with a plan. Make sure that substance abuse treatment is covered on the plan you choose prior to going into treatment.
Another important part of insurance is deciding whether to go with a PPO plan or an HMO plan. An HMO plan tends to have lower monthly premiums. Individuals can expect to pay less overall out-of-pocket. However, on this plan individuals must stay within the network of providers in order to receive coverage for services. Going outside the network of medical professionals is not covered by insurance. However, with a PPO plan individuals have the option to go outside the network of providers. Coverage is still available out of network. Individuals may have to pay out of pock initially, however, and then seek reimbursement after. The monthly premium for a PPO plan tends to be higher. The out of pocket cost also tends to be higher on this plan. However, those on this type of plan tend to have more flexibility in terms of treatment options.
Medicare and Medicaid
When thinking about coverage for substance abuse treatment it is important to consider whether Medicare or Medicaid applies to you. Most cities across the country with accept Medicare and Medicaid when it comes to treatment coverage. When it comes to Medicare coverage for substance abuse treatment, it is usually covered when reasonable and necessary. Coverage for inpatient and outpatient treatment is available when needed. However, there is no specific benefit category for substance abuse treatment.
When it comes to Medicaid there are also coverage options available. Medicaid in Oklahoma covers substance abuse treatment for adults. This includes those suffering from drug and/or alcohol addiction issues. Outpatient and residential treatment options are covered as well as other services. When looking into coverage check the behavioral and mental health sections of insurance company websites to get a better idea of coverage. It is important to be aware of your options and your level of coverage. Have a specific treatment center in mind? Check your insurance company’s website to see if the provider is covered by the plan you have.
Other financial options are available for those that are in need of financial assistance. Many treatment centers offer payment assistance as well as a sliding fee scale. It is important to consider all the financial assistance options when deciding on treatment.