Navigating the recovery process can be overwhelming. Whether you or a loved one is entering treatment for a substance use disorder, it can be overwhelming trying to navigate the process. Figuring out the details of your insurance plan and benefits for substance abuse treatment can easily add to the stress of entering recovery. Substance abuse treatment can be expensive, so that’s why Pinelands Recovery Center of Medford New Jersey accepts a multitude of insurance carriers.
The insurance specialists at Pinelands have a vast array of knowledge when dealing with insurance and treatment coverage. They will work on your behalf to communicate with your insurance provider to determine how much your insurance plan will cover. Additionally, case managers and treatment specialists keep detailed clinical
documents to ensure that if a patient needs more treatment than initially expected, the insurance coverage should not be an issue. Unfortunately, many insurance companies will reject extended lengths of stay or additional treatment modalities if the correct diagnosis, prognosis or verbiage is not used.
Major Insurances Accepted
Aetna: Aetna offers a variety of substance abuse plans, including open-access, copay-only and high deductible. Depending on the specific plan, the coverage options and out-of-pocket expenses vary drastically. Aetna screens all of its network programs to ensure that they provide the best quality of care, adhere to modern principles of substance use disorder treatment and provide excellent follow-up. Depending on your specific coverage, Aetna may cover the following: detoxification, residential treatment, partial care treatment, intensive outpatient treatment and continuing care. Aetna believes that substance use disorder is a disease that requires ongoing support to avoid relapse, and the individual should be treated for their condition, not by a predetermined treatment program that has the same treatment plan for every patient.
AmeriHealth: AmeriHealth serves over 265,000 individuals and has been providing health coverage to people in New Jersey and Pennsylvania since 1995. AmeriHealth provides substance abuse coverage if it is deemed medically necessary. Once AmeriHealth pre-authorizes you for substance use disorder treatment, you will receive at least partial coverage for residential treatment, partial care hospitalization, intensive outpatient, detoxification and outpatient treatment. Out-of-pocket expenses will be necessary to pay for music therapy, art therapy and equine therapy.
Beacon Health Options (formerly Value Options): Beacon Health Options prides itself on providing the most affordable coverage for substance abuse treatment and co-occurring mental health disorders. Beacon works with hundreds of national treatment centers and hospitals, and with Plan I membership, detoxification and residential care are fully covered. For example, Beacon offers coverage strategies that generally provide 100% of a patient’s residential treatment for the first 30 days. After the initial 30 days, most programs under Beacon will cover approximately 90% of the additional programs. This makes it possible to receive residential treatment for 30 days without having out-of-pocket expenses. Beacon will usually only cover short-term rehab for individuals with a substance use disorder.
Cigna: Cigna is one of the leaders for substance abuse treatment coverage. Along with its mission to provide affordable healthcare for basic needs, the company takes pride in its substance use disorder coverage. To better support those who face drug or alcohol use disorder, Cigna started a behavioral health division. In addition to providing articles, tools and podcasts for individuals and family members, the division now includes an education series. Coverage for substance use disorder treatment varies widely depending on the type of plan and state in which the client resides in. The plans range from bronze and silver to gold and platinum, with each level allowing a specific ratio of co-insurance. Cigna provides coverage for residential treatment, group therapy, family therapy, individual therapy, intensive outpatient treatment, detoxification and medication-assisted treatment.
Horizon: Horizon Blue Cross Blue Shield of New Jersey provides multiple levels of coverage for substance use disorder treatment. They offer a mobile platform, OneHealth, that provides members and their families around-the-clock support, education and tools to help them in their substance abuse recovery journey. They offer coverage for multiple levels of care, including residential and outpatient, and recently developed a prescription medication safety program to help reduce the number of opioid prescription use disorder.
Other accepted insurance providers:
- Allied Trades
- HMC HealthWorks
- Lower Hudson Valley E.A.P.
If you do not see your insurance on this list, please reach out at (609) 308-3114 and our representative will provide you with free insurance verification.
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