Understanding Different Insurance Plans

Understanding Different Insurance Plans

Navigating the insurance plan and coverage standards is one of the last things you want to do when seeking out addiction treatment and detox. Different insurance plans offer different coverage for treatment programs, and each insurance provider has different standards to qualify programs for coverage. Sobriety Options prides itself on helping every person that calls with finding a detox and treatment program that takes their insurance plan. To make matters easier to understand, we’ve laid out the basics of the four main types of insurance policies: HMO, PPO, POS, and EPO.

Health Maintenance Organization (HMO)

A health maintenance organization or better known as an HMO covers healthcare services from a pre-approved network of providers. Typically, out of network care is only covered in the event of an emergency. HMOs also traditionally require the covered person to live and/or work in the HMOs service area to work. These types of insurance plans are less likely to be accepted by detox and rehab treatment centers that are not in your hometown. However, we suggest checking with your HMO provider to see if you can get out of state treatment approved under the umbrella of emergency detox.

Preferred Provider Organization (PPO)

A preferred provider or PPO insurance plan allows you to use out of network treatment providers, but at a higher cost than within the network. PPO plans are usually a bit more expensive than other insurance policies due to their flexibility, but that flexibility could save your life when it comes to being able to choose any detox and addiction treatment center you prefer.

Point of Service (POS)

A point of service, POS, plan combines different aspects of HMO and PPO insurance policies. You can choose your primary care provider and establish your network of providers, but you can also choose to get treatment out of that network without it being an emergency. With POS insurance plans, you usually have to receive a referral to an out of network provider to get the costs covered by your policy.

Exclusive Provider Organization (EPO)

With exclusive provider organization policies or EPOs, you are only covered when you see in-network providers. However, you do not need to establish a primary care provider and do not usually need a referral to see a specialist like detox and addiction programs. With EPO insurance plans, emergency care outside of the network is always covered regardless of whether or not it is in network.

Understand Your Coverage

The admissions team at Sobriety Options is available 24/7 to answer any questions you have pertaining to detox and addiction treatment and insurance plan coverage. Getting addiction help can be an overwhelming time, so we take the stress off your shoulders. We work directly with representatives from your insurance provider to ensure a clear line of communication. If you are looking for information on your insurance plan benefits, use our free benefit verification tool to see how much coverage your policy has for addiction treatment and detox. 

About Sobriety Options 

Sobriety Options is open 24/7 to provide support and care for those seeking substance abuse or mental health treatment. A branch of Solution Based Treatment, we serve as a central admissions office for seven different branches throughout Southern California. Our team is able to help you find the best sober living option for yourself or your loved one to help them get the care they need. For more information visit our website at sobrietyoptions.com or give us a call at (855) 485-0071.

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