HMO Opiates Rehab and Opioid Detox Coverage

Being addicted to opiates can affect your life in many different ways. You may experience problems in both your personal and professional life, and you may even develop serious health conditions. In the worst cases, an addiction to opiates can be fatal. To avoid these consequences, seeking professional treatment is highly recommended. However, before you can participate in a treatment program, you must first undergo detoxification in order to eliminate the drugs from your system.

Detoxification can be expensive. However, if you have insurance coverage under an HMO plan, you may not be responsible for paying all of your treatment expenses.

About HMO Plans

A health maintenance organization, or HMO, is a type of managed-care insurance plan. Under this type of plan, you will typically be required to choose a primary care physician, or PCP, who will be responsible for managing your care. Before you will be able to see a specialist or receive any treatment services, you will need approval from your PCP. HMO plans also require you to receive all of your care from providers within the HMO network in order to qualify for coverage. 

Estimating HMO Opioid Detox Coverage

Many different factors can affect HMO Opioid Detox Coverage. Some of the issues to consider include:

  • PCP Referrals - Before you can begin detoxification, you will need to obtain approval from your PCP. In some cases, you may also need an approval from the HMO itself.
  • Choice of Provider - To ensure that you qualify for HMO Opioid Detox Coverage, you must select a provider from within the HMO network. Any treatment that you receive from outside of the network will not qualify for coverage, so you will be responsible for all of the associated expenses.
  • Terms of Plan - Like most other insurance policies, HMO plans have deductibles, copays and coinsurance requirements. The deductible is the amount you must pay toward medical expenses for the year before your HMO Opioid Detox Coverage will begin, while a copay is a flat fee you must pay when you receive certain services. Coinsurance is the percentage of treatment expenses you must pay after your deductible has been met. All of these factors will affect how much you can expect to pay for opioid detox.

Before you begin treatment, it is wise to get an accurate estimate of your expenses. For specific information about your policy, consult your plan documents.



HMO Opiod Detox Coverage

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