Will my insurance cover my treatment at a drug rehab in PA?

The law in Pennsylvania requires that insurance companies and HMOs that write group policies in the Commonwealth must provide for inpatient and outpatient care for drug and alcohol related illness. If you have a policy in this state, you have the right to appropriate treatment.

Before you enroll in any alcohol or drug treatment program in Pennsylvania, it is very important to know whether or not treatment is covered under your current health insurance plan.  You would not want to prepare for treatment at a certain facility only to find that you are on the hook for the entire cost of services.

PA drug rehab centers accept most major insurance policies, although they get better coverage from the PPO type plans. They can tell you quite accurately and quickly what to expect from your insurance company in the way of behavioral health benefits.

What PA drug rehab services are covered?

Many insurance carriers now contract with managed-care organizations. These companies assess the information given them by doctors and other healthcare providers and then tell us what they think is the appropriate level and type of care a patient should get.

Drug rehab centers in Pennsylvania cannot always decide what kind of care, or how much care, an insurance company will pay for. This decision is often made by the managed-care company used by your insurance carrier .

Often they are in agreement with a PA drug rehab center’s assessment of a patient, sometimes not. Most drug rehab centers in Pennsylvania can appeal their decision, and fight for what they think you need, but the final say regarding payment is up to them.

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Health Insurance for Individual, Family and the Self Employed

As a resident of Pennsylvania, you have plenty of Pennsylvania health insurance options to choose from. There are multiple insurance companies in Pennsylvania that provide a range of plans for a variety of health needs. Here you’ll be able to get free Pennsylvania health insurance quotes and helpful information for finding PA health insurance plans.

Pennsylvania Health Insurance Statistics

Consider the following statistics about health care coverage in Pennsylvania:

Total Pennsylvania Residents – 12,234,267
Pennsylvania uninsured residents – 9.75%
Avg annual employee premium in PA employer-sponsored plan (after employer contribution): $852
Avg PA hospital cost per inpatient day (before insurance) – $1,626

Pennsylvania Drug Rehab Cost

The price of a month at a Pennsylvania drug rehab is rarely cheap. The average cost for inpatient rehab programs is about $7,000 per month. Drug and even alcohol abuse is very expensive.

Prices range from a few thousand dollars a month for a basic Pennsylvania drug rehabilitation treatment center to $10,000 – $40,000 per month for a private and comfortable facility, and the costs can continue upwards from there.

We’ve done a lot of research on different treatment methods and specific Pennsylvania drug rehab centers to see what works and how much these programs cost. We can help find you something that will work for a reasonable price relative to overall costs of Pennsylvania drug rehabilitation centers.

What determines the cost of a drug rehab in PA?

When determining the cost of a drug rehab in PA, you need to evaluate these things:

1. Does the cost include all treatments, accommodations and medical expenses?
Ask if there are any optional add-ons that may increase the bill at the end of the month.

2. What percentage of the care as offered is covered under private insurance packages?

To reduce the total costs of the experience look for a PA drug rehab facility that allows for the highest proportion of insurance coverage.

When evaluating a Pennsylvania drug rehab, look at more than the bottom line, and a program should never be selected on price alone. The price as offered may or may not reflect quality of care and service, and you need to evaluate the credentials of the facility, the standards of the accommodation, the treatment intensity with professionals as offered, and the success rate of the facility. The price also needs to be factored into the decision, but by choosing a rehab on price alone you may not be getting your money’s worth.

Will My Insurance Pay for Drug Rehab in PA?

Will insurance cover my treatment in a PA drug rehab? The short answer is maybe. Insurance is a big racket. Don’t assume that because you have insurance, it’s going to pay.

Usually insurance companies will pay for as little as they can – that’s their business. In-network 30 day programs are usually it. Out-of-network benefits are at a lower percentage and therefore cover less theoretically.
In addition, any benefits paid usually are reimbursements to the insured rather than payments to the rehab center, so you’re still looking at money out of pocket up front in many cases, if not for the whole cost then at least a down payment to get started.

You need to be prepared to spend a significant amount of money to get a quality and effective treatment program. Ideally, a larger proportion of the costs are offset by your insurance provider, but even if the total costs of the program need to be met by the individual, the necessity of recovery demands that the costs of a program not discourage families from needed care.

If you’re going to pay money, be sure it presents the best possibility for that person to become drug-free, otherwise you’ll have to do it again soon.

Pennsylvania Drug Treatment Is Covered by Insurance

Insurance companies must cover Pennsylvania drug treatment and alcohol rehab costs for HMO and group health insurance policy holders as long as a doctor prescribed the alcohol or drug rehab program.

This decision by the Pennsylvania Commonwealth Court should help thousands Pennsylvania residents with private health insurance coverage, who need help through alcohol rehab and Pennsylvania drug treatment each year. The insurance industry’s reviews of alcohol and drug rehab referrals would be conducted by physicians and psychologists.

Slowing down the availability of alcohol and drug rehab through a complicated approvals process places addicts at risk.  The Pennsylvania law may finally have the chance to accomplish its intentions – to get people suffering from substance abuse and addictions into an alcohol or drug rehab program as quickly as possible.

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