What is In-Network Insurance and How to Use it for Addiction Treatment in Massachusetts?

Did you know that private residential drug and alcohol rehab centers can cost $17,000 per month? On the other end, outpatient programs can cost as little as a couple of thousand. 

Partial hospitalization and intensive outpatient programs can fall somewhere in the middle. Without in-network insurance, you could assume a large portion of those costs. 

Are you interested in learning more about in-network versus out-of-network coverage for rehab? We have the ultimate guide for you. In our article, we will break down the differences in coverage and how you can find a cost-friendly substance use disorder recovery center. 

What is In-Network Insurance and How to Use it for Addiction Treatment in Massachusetts?

In-Network Insurance vs. Out-of-Network Insurance

In-network facilities and providers essentially mean receiving a discounted insurance rate on your final costs. These are contracted doctors or facilities that have an agreement with an insurance company. They may have to meet certain credentials or criteria. 

Ultimately, seeing a physician or attending a facility specializing in addiction treatment in MA in-network could save you thousands. Out-of-network providers and facilities are not contracted with your insurance company. They can charge full price for their services. 

Since rates are higher, you are responsible for paying the difference between what your plan is willing to pay. For example, if your insurance company has an agreement to only pay a specific amount for a service, you may not accrue any costs. On the other hand, if your plan will still only cover a specific amount but does not have an agreement with an out-of-network provider, you are responsible for the difference. 

Does Insurance Cover Addiction Treatment?

The answer is more complex than a simple yes or no. It primarily depends on your insurance provider and how much of your deductible you have met. Also, you will want to check with the rehab facility on which insurance providers they have a contract with. 

Medicare is often the gold-standard insurance provider that many private insurances follow. Medicare will cover substance use treatment with the following criteria:

  • Your physician has deemed it medically necessary
  • If the center is Medicare-approved

Additionally, private insurances might have different contracts with facilities. It is essential you speak to an admissions specialist about your insurance beforehand. 

So, how much can you expect Medicare to pay?

Inpatient rehab falls under different criteria than outpatient. If you require a residential stay, it is usually covered by your hospital portion. Medicare Part B or other insurances focusing on outpatient treatment will cover additional stays, such as an intensive outpatient program. 

You will have to meet your deductible and coinsurance. For Medicare Part A, this could total $1,408 for a deductible. Yet, each insurance may have different deductibles dependent on traditional or high deductible plans. 

Northstar Recovery Center Insurance Coverage

Some in-network providers that Northstar Recovery has teamed up with are Cigna and Tufts. Tufts Health Plan is fairly comprehensive, offering coverage for:

  • Preventive care
  • Wellness
  • Mental health services

This new partnership offers full coverage if enrolled in Northstar Recovery Center’s rehab programs. Cigna is a global health provider with extensive outreach in the United States.

Its headquarters are in Connecticut, and they offer several medical, dental, and vision benefits. Cigna offers self-insured or private plans and employer-sponsored plans.

Additional benefits of Cigna are their Medicare Advantage plans, which could offer more comprehensive coverage than traditional Medicare. Many patients with Cigna can now benefit from in-network contracts with Northstar Recovery.

If you do not see your insurance explicitly listed on the site, there are a couple of ways you can verify. First, you could contact your insurance provider directly. Usually, one of the easiest and most user-friendly options is filling out an insurance verification form on Northstar Recovery Center’s site. 

What is In-Network Insurance and How to Use it for Addiction Treatment in Massachusetts?

Rehab Program Options

There are several programs you can choose from at Northstar Recovery Center. Some of the more popular ones include:

  • Partial hospitalization program (PHP)
  • Intensive outpatient program (IOP)

There are two primary reasons you may enroll in a PHP or IOP. First, you could be transitioning from detox or a residential program. It is often recommended to continue intensive therapy when moving from 24/7 facilities back home. 

Next, you may have a mild substance use disorder. In these situations, you might not pose a threat to yourself or others and/or not require a medical detox. How can you decide between them?

PHP is more time-intensive, requiring upward of six hours daily for five days. In an IOP, this is largely cut in half. You can plan on around two to four hours daily for up to three days a week. 

Both programs do not require overnight stays. The benefit of these programs is it provides a safe environment for you to continue working on skill development and coping mechanisms. You can participate in individual-specific therapies and group therapy. 

You will also have access to highly skilled professionals with vast experience. They will help you develop a plan of care that works for your lifestyle and facilitate improved health and wellness. 

Find Coverage for Your Rehab

In-network insurance providers can cut your costs substantially when you enroll in rehab. Many people with substance use disorders are worried about the costs and inability to work. And rightfully so!

Rehab can be expensive, but it can also save your life. Enrolling in a program that has a contract with your insurance provider, such as Northstar Recovery Center, provides you with access to a skilled addiction treatment center at a fraction of the cost of others. 

Are you ready to get started? Contact us today and find out how you can enroll!

WHO WE ARE
Northstar Recovery Center in Southborough, MA is made up of a team of experienced, dedicated, and compassionate addiction treatment professionals. We want to see our community heal from the effects of the opioid epidemic, alcohol addiction, and other substance use disorders.

Partial Hospitalization Program in Southborough, MA

Our partial hospitalization program in Southborough, Massachusetts is the highest level of care we offer. This addiction treatment option includes clinical care and behavioral therapies. During the early days of recovery from addiction, it’s essential to have support for both the physical and emotional challenges you might face. Our team at Northstar Recovery Center in Massachusetts will help you build a strong foundation for lifelong recovery from addiction to drugs and alcohol. Typically, clients come to our addiction treatment center each weekday for several hours of counseling sessions and other interventions as needed.

Intensive Outpatient Program in Southborough, MA

An intensive outpatient program (IOP) in Southborough, MA does not require 24/7 residency at a facility, but it demands more of your time than a regular outpatient program. It is ideal for those who need a higher level of care but are okay being at home. This way the individual can still live their life while getting counseling and support that is still needed in early recovery from substance use disorder.

Individual, Group, and Family Counseling in Massachusetts

Addiction thrives in isolation, which is why group counseling sessions are a foundational part of our addiction treatment plans. In group sessions, you’ll gain perspective on your struggles with substance abuse and can connect with others who understand your experiences. Family counseling can help your loved ones understand the disease of addiction, navigate conflict, and build healthier relationships. In individual counseling sessions, you’ll be able to work through personal issues like past trauma with the help of an experienced therapist.

Contact Northstar Recovery Center

Let us guide you on your journey to recovery from addiction. Connect with our team today.
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