What Type Of Insurance Covers Alcohol Addiction Treatment In Massachussetts

What Type Of Insurance Covers Alcohol Addiction Treatment In Massachusetts

Published: 03/24/20

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If you or a loved one is suffering from alcohol addiction, then you know that this condition is a chronic disease – not a choice.

Just as someone with cancer wouldn’t be expected to pay for treatment on their own, there are options in place to help people with addictions to pay for treatment.

Most health insurance plans do include coverage for the treatment of addictions, such as alcoholism.

Massachusetts is no different in this sense. Whether you have a private plan or Massachusetts Medicaid (MassHealth), it is likely that your plan covers alcohol addiction treatment

Keep reading to learn more about the different kinds of health insurance offered in MA, and whether they cover alcohol treatment.

What Kinds of Insurance are Available in Massachusetts?

Health insurance in MA can be broken down into two categories: Medicaid plans and private plans.

Depending on your income, your job, your family situation, and your needs for care, you will choose an insurance plan that is right for you. 

Private Plans in Massachusetts

When it comes to private plans, there are several companies that offer insurance in MA.

Some people have this kind of insurance through their jobs. Others choose a private plan because it fits their needs the best.

Private health insurance companies are not as regulated as Medicaid plans. This means that it is your responsibility to look into whether a plan offers the kind of care you need before choosing it.

Only some people will qualify for Medicaid based on their income and other factors. If you don’t qualify, you may need to look into getting insurance directly from a company that offers it.

Medicaid Plans in Massachusetts

Medicaid plans in MA are called MassHealth plans. As part of the health care law, all MassHealth plans must cover substance abuse treatment.

Benefits specific to you, including what is covered, how much you have to pay, and where you can get treatment, will all depend on the MassHealth plans which you qualify for and choose.

There are many types of plans available via MassHealth. They each have different benefits and downsides.

Plans offered through MassHealth will all include behavioral health services through the Massachusetts Behavioral Health Partnership (MBHP).

The MBHP lists 767 care providers that provide alcohol treatment services! Your plan will not give you access to all of these providers, but this number gives you a good idea of the scope of coverage for addiction in MA.

How to Know if Your Insurance Plan Covers Alcohol Addiction Treatment

If you have a private insurance plan, you need to verify your insurance to see whether the plan will cover the treatment you want.

Thanks to the Affordable Care Act of 2014, it is likely that your plan will cover substance abuse treatment. In addition, most of these plans must also treat mental health services the same as physical health.

This means that your private plan is likely to be required to offer the same benefits for mental healthcare as they do for other types of care.

If this is the case with your plan, the same spending limits, copays, deductibles, etc. will apply to your substance abuse treatment coverage. This is called parity

When it comes to MassHealth plans, you can rest assured that they all include parity protections for substance abuse benefits.

Your deductibles, copayments, out-of-pocket limits, treatment, and care management will all be the same for alcohol addiction treatment as they are for any medical needs.

How to Find Out if Recovering Champions Takes Your Insurance

Although it is very likely that your insurance plan covers substance abuse treatment in MA, that does not mean you can walk into any rehab center in the state and get treatment covered by your plan.

Depending on your plan, certain treatment centers will be available to you, while others will not.

If we cannot accept your insurance, we will discuss cash pay options or help you find a treatment center that will work with your insurance.

There are many types of healthcare plans to choose from. They are all set up differently, which means that the process to get alcohol addiction treatment will look different depending on the type of plan you have.

Following are the most common types of healthcare plans in MA and how you can get addiction treatment through them:

  • ACO health plans: An ACO, or Accountable Care Organization, is a group of hospitals, doctors, and other providers who ‘team up’ to provide coordinated care to people with an ACO plan. You will still have a primary care doctor, but you will also have access to a network of resources and treatment options in your ACO. This will likely include options for addiction treatment.

  • PCC plans: PCC plans, also called Primary Care Clinician plans, are organized around your primary care doctor. Any services you get from anyone besides this doctor will need a referral from your primary care doctor. This type of plan is not recommended for people with chronic conditions like alcohol use disorder. 

  • Private plans: If you purchase a plan outside of MassHealth, it will likely operate similar to an ACO. Most health insurance companies work with a network of doctors, providers, and clinics. These are called ‘in-network’ providers. Your insurance benefits apply only to in-network providers. If you choose to get treatment from a provider outside of your insurance network, it might not be covered.

Get Help for Alcohol Addiction in Massachusetts

Are you struggling with alcohol abuse? Don’t let finances stand between you and the treatment you deserve. Call Recovering Champions today to find out whether our facility is included in your health insurance plan.

We can discuss your options with you and help you come up with a personalized plan to get you back on your feet. There is never a better time to start the recovery process than the present.

Sources

  1. Find a Behavioral Health Provider
  2. Health Insurance and Mental Health Services. (2019, March 22).
  3. MassHealth health plans. (n.d.).
  4. Mental health and substance abuse health coverage options. (n.d.).