Cocaine addiction is a serious medical problem that can threaten an individual’s physical and mental health, as well as his or her personal life. Cocaine is a stimulant that raises your heart rate and constricts blood vessels, which can lead to high blood pressure and even heart attacks and strokes. This powerful, dangerous drug can be compared with Russian roulette, as not only can it cause cardiac arrest leading to death, this can happen anytime, whether after the first use or after hundreds of uses.
If you are a member of an HMO, or health maintenance organization, you have a managed care plan that has agreements with specific medical facilities and providers. HMO cocaine treatment coverage varies widely because HMO plans are largely dependent on the group management the plan and the contracts it maintains.
The plans and coverage are generally restricted to in-network providers. This means you may not be able to go to the best rehab facility or see the medical professional you you would most like to treat you. To seek HMO cocaine treatment coverage, you will have to start with your assigned primary physician, who oversees all your care and would be the professional who would make a recommendation on your course of treatment. If your doctor recommended treatment at a facility, your HMO would have to accept the recommendation before you could enter the facility. If denied, you should be able to file an appeal.
Getting HMO cocaine treatment coverage is easier if the HMO contracts with a treatment center. Then, the treatment would be in network. If no rehab center is within your network, HMO cocaine treatment coverage becomes more complicated. The cost for out-of-network treatment would likely be higher for the HMO, which could make you absorb those costs through higher co-pays, or it could choose not to pay at all.
In the worst-case scenario, you would be stuck with the entire bill for a rehab center. You may be able to get a payment plan to cover your treatment, or you could work with your HMO and/or a rehab center to compromise with outpatient care or a combination or inpatient and outpatient care. Your HMO may also have a number of alternative treatment options that you may not have considered, so it’s best to speak to your primary care physician and your HMO representatives to explore options for HMO cocaine treatment coverage and find what works best. Be sure to be open and honest with your doctor to thoroughly communicate the degree to which cocaine addiction is affecting your life.