PPO Rehab and Heroin Detox Coverage

Heroin is one of the most addictive drugs available. Because this drug's addictive properties, people are often unable to stop using without professional inpatient and/or outpatient treatment. Before you can begin heroin addiction treatment, however, you must undergo detoxification to remove any remaining heroin from your body.

Because of the expenses associated with medically-supervised heroin detox, many people are hesitant to seek the treatment they need even when they want to recover from the addiction. Fortunately, if you qualify for PPO Heroin Detox Coverage under your insurance policy, your expenses during detox may not be as high as you think.

What is a PPO?

A preferred provider organization, or PPO, is a common policy structure that is offered by insurers in all states. Under this arrangement, you can use the providers of your choice whenever you receive medical care, and you can always visit a specialist without a referral from your primary care physician. However, in order to maximize your coverage, you must select providers from within the policy's network of doctors and hospitals. If you select providers from outside of this network, you will still receive some coverage, but you will be responsible for a greater amount of the associated expenses.

About PPO Heroin Detox Coverage

If you have a PPO policy, you can use the detox facility of your choice without a referral from your primary doctor. However, the facility you choose will affect your PPO Heroin Detox Coverage. If you choose an in-network facility, you will receive the maximum possible benefit under your policy. If you choose an out-of-network facility, however, you will be required to pay more for care.

Other factors that may affect your PPO Heroin Detox Coverage include:

  • Specifics of Coverage - Because of the requirements of the Affordable Care Act, most PPO plans will cover detox. However, your plan may cover only specific types of detoxification. Consult your plan documents to learn more.
  • Precertification Requirements - Some policies may require you to obtain precertification before entering detox. This means that you must request permission from the insurance company before treatment begins.
  • Cost-Sharing Requirements - Even with coverage from your PPO plan, you will still be required to pay some of the expenses you incur during treatment. For example, you may be required to meet a deductible and/or pay a certain amount of coinsurance after meeting the deductible.
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