HMO Drug Rehab

Whether you are addicted to a prescription drug or an illegal substance, the addiction has the power to ruin your life. You may find yourself failing at work, experiencing problems in your personal life and even dealing with chronic health issues. To overcome a drug addiction, professional treatment is often required. However, drug addiction treatment can be expensive. Fortunately, if you have an HMO insurance policy, you may not be responsible for all of your treatment expenses.

About HMO Plans

A health maintenance organization, or HMO, plan is a type of insurance policy in which all of your care must come from a specific network of doctors and facilities. If you have an HMO, you will also be required to choose a primary care physician, or PCP, who will coordinate all of your care.

Estimating Your Benefits

If you plan to seek treatment for an addiction, the benefits you receive from your HMO plan will depend on a number of different factors. For example, before you can visit any specialists or obtain treatment, you must first get permission from your PCP. If you don't, the HMO won't cover any of your expenses. In addition, you must choose an HMO Drug Rehab Treatment Center in order to qualify for benefits. If you choose a center outside of the HMO network, none of your expenses will be covered.

Other Considerations

Before you check in to the HMO Drug Rehab Treatment Center, remember to consider these other factors as well.

  • Deductible. Before your treatment at an HMO Drug Rehab Treatment Center will be covered by your plan, you must first meet your plan's deductible for the year.
  • Coinsurance. After you have met your deductible, you may still be required to pay a certain percentage of the remaining expenses. This is known as "coinsurance."
  • Out-of-pocket maximum. The out-of-pocket maximum is the maximum amount you can expect to pay for medical expenses during any calendar year. Once you have reached this limit, you will no longer be required to pay coinsurance.
  • Precertification. Some services may require approval from the HMO in advance in order to be covered.

HMO insurance plans may vary. If you have specific questions about the amount your plan will pay for drug addiction treatment, be sure to read your plan documents or contact the insurer directly for more information about your benefits. 


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