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SelectHealth Health Insurance and Substance Abuse Treatment: What You Should Know

Under the Affordable Care Act (ACA), drug rehab and related mental health treatment options are now considered essential health benefits. With the ACA in effect, the vast majority of those with private insurance are entitled to coverage for drug detox or drug rehab programs. This means that private health insurance policies must cover the majority of the health benefits associated with addiction treatment. This is good news for you.

More specifically, for drug and substance rehab, these essential health benefits for mental and behavioral health services include three types of services according to the ACA website: behavioral health treatment (including psychotherapy and counseling), mental health inpatient services, and substance abuse disorder treatment.

Selecthealth Insurance for Rehab

The good news: SelectHealth is now in-network with Ashwood Recovery, our high-quality drug rehab facility.

While the amount of coverage you get from your SelectHealth insurance plan varies depending on the individual policy that you have, you should be able to obtain financial coverage for at least most of the drug rehab services received at Ashwood Recovery. Being in-network with our facility means that we can better help you get the drug rehab benefits that you need through SelectHealth Idaho.

Many people think of drug rehab as being prohibitively expensive. Fortunately, if you have SelectHealth Idaho as your health insurance provider, getting the drug rehab and addiction treatment services you need to help you along your recovery can be much more affordable. You can learn more about what it means for SelectHealth to be in-network with our facility in Idaho here.

What Are the Major Differences Between In-Network and Out-of-Network Insurance Companies in Idaho?

In simple terms, in-network insurance essentially means that you will receive your health care benefits at lower prices. Having in-network insurance coverage for drug rehab means that it is usually much easier to realize the drug rehab benefits available to you, and usually at a lower price. In contrast, an out-of-network provider means that the facility is not directly contracted with the health insurance provider. Now that Ashwood Recovery is in-network with SelectHealth, we are happy to continue to offer our high-quality addiction treatment services at a lower cost to those who need them.

The most important implication of SelectHealth being in-network with Ashwood Recovery is that coverage for drug rehab and addiction treatment services is much more likely to be approved. The best way for you to realize your SelectHealth benefits is to first get an assessment either with our facility or any facility you choose. This assessment will cover your drug treatment options and determine whether the treatment is medically necessarily.

Of course, we cannot answer exactly what will and will not be covered by SelectHealth - that is determined by the plan that you have with the health insurance provider. To get started on the process of determining coverage, you can fill out the insurance verification form, provided below. You can also find a list of general limitations and exclusions for most health insurance plans with SelectHealth to get a better idea of how drug rehab is covered. According to the SelectHealth website, these exclusions include:

  • Attention-Deficit and Hyperactivity Disorder (ADHD) treatment
  • Certain behavioral health/chemical dependency services
  • Claims after one year
  • Administrative services/charges, for nonmedical purposes
  • Methadone therapy
  • Selected types of prescription drugs, injectable drugs, and specialty medications

How Do You Get the Drug Rehab Services in Idaho You Need at SelectHealth?

The easiest answer is to let someone help you who is skilled in working with those who are battling alcoholism or substance abuse. Ashwood Recovery is a great ally for you in the process.

We are committed to working with SelectHealth to inquire about your benefits regarding drug rehab and the addiction treatment that you have. SelectHealth is pretty specific about their benefits on their health insurance policies. In fact, they state, "To receive benefits, covered services must be medically necessary. SelectHealth's medical director or a doctor chosen by us defines what is necessary." This means that your SelectHealth primary care physician must specifically state that you are in need of drug detox, drug rehab, or other forms of addiction treatment at either an inpatient or an outpatient facility in Idaho. More specifically, these can include one or more of the following elements of addiction treatment:

  • Drug rehab for cocaine, crystal meth, heroin, opiates, or prescription drugs
  • Drug detox for any substance
  • Either long-term or short-term treatment for drug dependency and addiction
  • Treatment in an inpatient or an outpatient facility
  • Therapy for drug addiction (either in a group, individual or family setting)

Once it drug rehab is determined to be medically necessary, the drug addiction treatment options that SelectHealth covers generally include:

  • Alcoholism treatment
  • Prescription drug rehab
  • Heroin rehab
  • Cocaine rehab
  • Crystal meth rehab
  • Marijuana treatment and rehab

Considering getting the help you need to overcome your addiction, through drug rehab, is perhaps the most important step you take toward recovery. The next elemental step is to call SelectHealth Idaho directly to discuss your health benefits in relation to drug rehab more specifically. It is not enough to simply enter rehab and hope that all the financial aspects will work out later. You can take a more proactive approach, and we are here to help. 

Next Steps for Understanding Drug Rehab & Insurance in Idaho

Many insurance companies in Idaho, including SelectHealth, require a preauthorization process for addiction treatment services. This process makes sense, since it is important to ensure that you are on the same page with both the treatment facility and the insurance company. Even though SelectHealth is now in-network with our facility, it still requires preauthorization for services related to addiction treatment. The SelectHealth website states in its FAQs that "Preauthorization is required for... all admissions to facilities, including rehabilitation and all hospitalizations that are not for urgent or emergency conditions."”" With this in mind, it is crucial that you first reach out to SelectHealth for this preauthorization - the insurance provider states that benefits may be reduced by 50 percent and will not be applied to your out-of-pocket maximum.

It doesn't mean you should give up and figure that you won't be going to drug rehab in Idaho. It means you have to keep reading the fine details. For example, treatment of emotional conditions or chemical dependency when it's listed as a mental disorder in the official Psychologist's book called ant DSM (Diagnostic and Statistical Manual), which requires professional intervention is paid for.

If you want to go to drug rehab in Idaho or drug detox or other addiction treatment, you've progressed a lot just to come to that realization. The next thing to do is to call Select Health, and / or get a doctor's appointment, which can be the next qualifying step. Don't simply enter the drug detox or drug rehab addiction treatment and figure that it will all work out in the end. Most insurance companies, including Select Health want to take you through a process of pre-authorization for these type of addiction treatment services. And it makes a lot of sense. When you are reading to contact a representative at SelectHealth, be ready with answers to the following questions:

  • Which facility do you want to attend for addiction treatment in Idaho?
  • Has your primary care physician already approved addiction treatment as medically necessary?
  • Do you have any other mental conditions or disorders?
  • What type of substance will you be getting treatment for?
  • How long is the addiction treatment program that you wish to attend?
  • Do you want to attend inpatient or outpatient treatment?
  • Have you ever attended an addiction treatment program or drug rehab in the past?

You can also get help from Ashwood Recovery directly - in order to get more specific insight about how SelectHealth will cover drug rehab and addiction treatment at our facility, you should complete our insurance verification form. The information gathered in this form allows our facility to determine what SelectHealth will cover in addiction treatment.

If you still have questions about how health insurance works in conjunction with drug rehab, don't hesitate to give us a call today. We can take the guesswork out of the process for you, helping you not only get the professional help that you need for recovery but also how to make it more financially feasible.


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