Insurance plans vary greatly—some cover only in-network providers, while others allow you to seek care wherever you choose. Navigating the process of finding a detox and rehab program that works with your insurance doesn’t have to be stressful. The admissions team at Sobriety Options is here to guide you in finding a program approved by your insurance. Here’s an overview of the four primary types of insurance coverage: HMO, PPO, POS, and EPO.
Preferred Provider Organization (PPO)
PPO plans offer flexibility by covering out-of-network providers, though at a higher cost compared to in-network care. While these plans are typically more expensive than other options, they give you the freedom to choose any detox or addiction treatment center across the country. This flexibility could be crucial in finding the right care for your recovery journey.
Health Maintenance Organization (HMO)
HMO plans provide coverage for healthcare services within a designated network of providers. Out-of-network care is only covered in emergencies, such as an ER visit. Generally, HMO plans require you to live or work within their service area to qualify for coverage.
Because of their network restrictions, HMO plans may limit your options for detox and rehab facilities outside your local area. However, it’s worth consulting with your HMO provider to explore whether emergency detox due to overdose or severe relapse risks could qualify for out-of-state treatment.
Point of Service (POS)
POS plans combine features of both HMO and PPO policies. With a POS plan, you can select a primary care provider and establish a network while also retaining the option to seek out-of-network care without requiring an emergency. If you want to visit an out-of-network provider, you may need a referral from your primary care physician to have the costs partially or fully covered by your insurance.
Exclusive Provider Organization (EPO)
EPO plans cover care only from in-network providers but do not require you to choose a primary care provider. Additionally, you typically don’t need a referral to see specialists, such as those at detox and rehab centers. This can simplify the approval process for treatment. Emergency care outside the network is always covered under EPO policies.
Get Clarity on Your Coverage
At Sobriety Options, our admissions team is available around the clock to help you understand your insurance coverage for detox and addiction treatment. We collaborate directly with your insurance provider to streamline communication and ensure you get the answers you need.
If you have questions about your insurance benefits, check out our comprehensive FAQ page or contact us anytime for a one-on-one conversation. You don’t have to face this journey alone—we’re here to support you every step of the way.
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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