At The Refuge, we understand that seeking treatment, understanding the financial options, and ultimately beginning the admission process can be intimidating. Let us guide you along every step of the process.
About Out-of-State Insurance Coverage
If you or someone in your family has been struggling with substance abuse and chemical dependency, there are many excellent reasons to consider treatment programs that are not in your community or even in your state.
Unfortunately, many people limit their search to the immediate geographical area due to fears that their insurance will not cover treatment in an out-of-state program.
Yes, the vast majority of insurance policies do have limitations on what types of care are covered and where you can receive that care. But you should not dismiss the possibility of entering an out-of-state program until you have researched the matter and confirmed the extent of your insurance coverage.
The answers you get may be pleasantly surprising, and may significantly expand your ability to find the treatment program that is best suited to your specific situation.
In-Network vs. Out-of-Network
Two terms that will immediately come to the forefront when researching limits to your insurance coverage are in-network and out-of-network.
In order to best manage costs, insurance providers will negotiate prices with certain providers, which are then identified as in-network providers. This situation can benefit both the insurer and the healthcare provider. The insurer gets a lower rate than would otherwise be charged, and the provider has the opportunity to serve the large pool of people who are covered by that insurer.
Since most people will receive healthcare services near where they live, most in-network providers will be within a limited geographical area.
However, this does not mean that it is impossible to receive care, and have that care covered by your insurance company, at an out-of-state or otherwise out-of-network program. Some insurance plans only cover care that is received at in-network programs. Others provide limited coverage for out-of-network services, and some offer full coverage if the out-of-network care meets certain conditions.
Getting coverage for an out-of-network program typically requires advance authorization from your insurer, as well as proof that other criteria have been met, such as that the care that you need is not available within your community or in the insurer’s existing network.
Navigating the Insurance Maze
It’s no secret that insurance can be extremely confusing. In-network and out-of-network requirements can be just the tip of the proverbial iceberg when it comes to identifying, verifying, and accessing all of the benefits to which you are entitled.
The good news is that you don’t need to fight this battle on your own.
One of the many benefits of receiving care at a reputable and effective addiction treatment center is that you will have professionals on your side who have specific expertise in working with insurance providers. This professional will be able to review your policy, determine the extent of the coverage for which you may be eligible, and provide your insurer with the necessary documentation to get authorization for that coverage.
This process provides you with three immediate benefits:
- You will be working with dedicated professionals who are experienced at working with insurance providers to confirm coverage.
- You will know the extent of your coverage and the total cost of care before treatment begins, thus removing any fear unknown costs.
- You can focus on the most important matter: your health, or the health of your family member.
Beyond these three immediate benefits, taking the time to contact programs beyond your immediate geographical area and confirming your insurance benefits will ensure that you are aware of all options that are available to you, and that you will have the opportunity to choose the treatment program that best meets your unique needs or the needs of your loved one.
Don’t limit yourself to choosing an addiction treatment program based on geography alone. Get the information that you need in order to make the choice that will best prepare you or your loved one for to achieve successful long-term recovery.
Learn More Today
The answers to your insurance questions are a phone call away. A friendly and knowledgeable member of our team is available to speak with you 24 hours a day, seven days a week. Call us at your convenience and get the information that you need.