If you’re struggling with substance abuse or addiction and you’re wondering how in the world you’ll ever pay for treatment, you aren’t alone. Here’s some good news for you: if you’re a Bright Health member, your insurance will cover at least a good portion of the bill. Bright Health Individual and Family Life Insurance is available in at least thirteen states, including Florida.
Before the enactment of the Affordable Care Act (Obamacare) in 2010, insurance providers weren’t required to cover addiction treatment or behavioral healthcare. Now, treatment for addiction and mental health issues is considered an Essential Health Benefit. This means that all insurance companies are required to pay for a certain level of treatment, as long as it’s considered medically necessary. However, the length of treatment and the level and type of coverage varies substantially depending on your particular insurance plan.
What Treatments Are Covered by Bright Health?
Bright Health pays for a range of treatments for substance abuse and addiction, but Bright Health works only with top-tier treatment facilities that meet specific requirements. To be considered, treatment programs must be proven effective, evidence-based, and approved by a physician. Bright Health coverage doesn’t include experimental, unproven, or investigational treatments, or those that aren’t yet approved by the U.S. Food and Drug Administration (FDA).
Some treatment centers may offer alternative or complementary therapies such as herbal medicine, hypnotherapy, aromatherapy, reiki, or tai chi. While these treatments may be helpful for some people, they aren’t included in your Bright Health coverage.
It’s also important to note that Bright Health may not cover all of your treatment program costs. For instance, some plans may cover only inpatient, while others pay for outpatient treatment. Your plan may cover the entire cost of treatment after you’ve met a deductible, or you may be required to pay copays for some or all services.
Regardless of your plan, treatment must be deemed medically necessary and approved by a physician. Substance abuse programs must be certified and licensed. However, your Bright Health drug rehab coverage is there for you, whether your treatment is voluntary or court-ordered.
Treatments typically covered by Bright Health include:
- Assessment and diagnosis
- Treatment planning
- Standard outpatient treatment
- Intensive outpatient treatment, consisting of at least nine hours per week
- Inpatient treatment (semi-private room)
- Residential treatment
- Medical, inpatient, or outpatient detox when required for treatment of addiction
- Partial hospitalization programs (PHP), consist of at least twenty hours per week, but not more than 12 hours in a 24-hour period
- Prescription medicines
- Medically-assisted treatment (MAT)
- Treatment of depression, anxiety, or other co-occurring issues that often underlie addiction or substance abuse
- Short-term family therapy
- Referrals to other services
What Is Medication-Assisted Treatment, and What Are the Benefits?
A doctor may prescribe certain FDA-approved medications to help curb cravings and ease the painful withdrawal from drugs or alcohol. This relatively new form of treatment, known as medication-assisted therapy, is highly effective when combined with standard treatments such as counseling, behavioral therapy, support, and education.
Commonly prescribed drugs include naltrexone, suboxone, methadone, acamprosate, and disulfiram. Bright Health may also pay for meds to help with symptoms of depression, anxiety, trauma, PTSD, bipolar disorder, and other mental health issues that frequently accompany substance abuse and addiction.
Medication-assisted treatment helps people stay in treatment longer, makes it easier for patients to retain the skills learned in counseling, and significantly reduces the risk of relapse. It also improves the survival rate for people addicted to opioid drugs or alcohol while improving overall health and mental clarity.
Florida Addiction Treatment In-Network With Bright Health
What is “in-network,” and exactly what does it mean for you? Essentially, working with an in-network treatment provider ensures you receive quality care. You save a great deal of money because the participating treatment center has agreed to offer treatment at a fair, competitive price.
Bright Health may cover a smaller percentage of out-of-network treatment, depending on your plan, although copays and other out-of-pocket costs may be higher. Some plans may not cover out-of-network treatment under any circumstances, but you can rest assured that Bright Health will cover emergency treatment or crisis intervention, even when it’s out of network.
Will I Need a Prior Authorization?
Some programs, including inpatient treatment, may require approval or preauthorization. The goal of prior authorization is to ensure treatment is medically necessary and that it’s the best treatment for you. In the long run, this step saves you money and offers treatment targeted to your particular situation.
Prior authorization may take up to a couple of weeks in Florida. However, the treatment center can request an expedited review to be completed within three days if your situation is urgent.
Navigating the Specifics of Your Bright Health Plan
Navigating any insurance plan is enough to make your head spin, but Bright Health uses technology to simplify health insurance and eliminate confusion so things run as smoothly as possible. The quickest way to determine your plan’s specifics is to ask the treatment facility or rehab for a review. Alternatively, you can sort it out by calling Bright Health Member Services at the number listed on your membership card. Bright Health’s Member’s Hub is also a good source of information.
We’re Proud to Partner With Bright Health
At 1st Step Behavioral Healthcare in Pompano Beach, Florida, we are pleased to partner with Bright Health to offer the finest treatment for substance abuse or addiction. You can verify your insurance information here, or give us a call or text at (866) 971-5531 and we’ll sort out the details of your plan together. Your confidentiality and privacy are always guaranteed. You can also contact us online.