The National Institute on Drug Abuse reports that approximately 8.76 million people in the United State were abusing prescription drugs, including opiates, in 2010. Addiction to opiates can lead to a number of serious consequences, including legal problems, health complications and even death. For this reason, getting the proper treatment is essential.
Many people are hesitant to seek treatment for opioid addiction because of the associated expenses. However, if you have coverage from Great West Insurance, a portion of your addiction treatment may be covered.
About Great West Insurance Plans
Great West Healthcare became part of the CIGNA network in 2008. However, CIGNA continues to maintain a separate network for Great West Insurance customers known as GWH-CIGNA. This network includes different precertification procedures, claim submission processes and preferred providers.
Plan Provisions
All of Great West Insurance/CIGNA plans cover substance abuse treatment, including treatment for opiates. However, the exact amount your plan will pay toward your treatment expenses depends on several different factors. Some of the issues to consider as you estimate your Great West Insurance Opioid Detox Coverage include:
- Medical Necessity– Great West Insurance won’t cover certain health services unless they are deemed “medically necessary.” In order to show medical necessity for a certain treatment, you may need to undergo testing or other, less aggressive services first. For example, Great West Insurance may not cover inpatient detoxification unless your provider evaluates you face-to-face and determines that outpatient detox isn’t safe.
- Deductible – All Great West health plans have a deductible, which is the amount you must pay before the insurance company will begin paying their portion of your expenses. You must meet this deductible before substance abuse treatment will be covered.
- Copays – Certain opiate addiction treatment services, such as office visits, may not be subject to the deductible. In this case, you may pay a flat fee, or “copay,” instead.
- Coinsurance – After you have met your deductible, you will most likely be required to pay coinsurance for the services you receive. For example, your Great West Insurance Opioid Detox Coverage may be 60 percent, and you will be responsible for the remaining 40 percent of the charges.
- In-network versus out-of-network – GWH-CIGNA maintains a network of preferred providers. If you choose a provider from within this network, your Great West Insurance Opioid Detox Coverage will be higher than it would have been if you had chosen an out-of-network provider.