If you are struggling with sex addiction, obtaining medical treatment is your best chance for recovering from the condition and living a healthier life. Unfortunately, medical treatment can be costly. For this reason, some people dealing with sex addiction are hesitant to seek the treatment they need.
Although there are always costs associated with addiction treatment, having the right insurance coverage can reduce your expenses and make treatment more affordable. If your employer provides self-funded insurance through HealthSmart, consult the information below to determine whether you qualify for HealthSmart Sex Addiction Coverage.
What is HealthSmart?
HealthSmart is not a traditional insurer. Instead, it is a company that provides a variety of solutions for employers who have opted for self-funded insurance policies, such as claims management, information systems solutions and more. A self-funded insurance plan is a program that allows the employer to design a group policy, administer it and pay all claims from the company’s funds. Employers typically choose this option to save money and/or retain more control over health insurance.
Understanding Your HealthSmart Sex Addiction Coverage
Employers who implement self-funded insurance policies through HealthSmart can decide what services will be covered. However, because these plans must typically comply with the requirements of the Affordable Care Act, coverage for sex addiction treatment will typically be included in a self-funded policy. The specifics of your Healthsmart Sex Addiction Coverage will depend on the options selected by your employer.
Factors that may affect your Healthsmart Sex Addiction Coverage include:
- Network Requirements – Your employer may have designed your plan with a preferred provider network or health maintenance organization. If so, you must choose providers from within the PPO or HMO in order to maximize the coverage you receive. In some cases, out-of-network treatment may not be covered at all.
- Cost-Sharing Requirements – Many self-funded insurance policies include cost-sharing requirements, such as a deductible, copayments or coinsurance. The cost-sharing requirements of your policy will determine how much you must contribute toward your sex addiction treatment expenses.
- Precertification and Referral Requirements – Depending on the specifics of your plan, you may need to obtain a referral from your primary care physician and/or precertification from your plan before beginning certain types of treatment.
Self-funded plans through HealthSmart vary considerably. To learn more about your coverage or for answers to specific questions, consult the plan documents provided by your employer or contact HealthSmart directly.