What Kind of Coverage Does Coventry Insurance Offer for Eating Disorders?
Coventry Insurance (along with its subsidiaries) does offer a range of coverage options for eating disorders, including: authorized inpatient treatment (28-30, 60, 90 days or more), anorexia nervosa or bulimia nervosa rehab programs, executive or luxury treatment programs, eating disorder counseling, acute rehab, medication management, group therapy, day treatment programs and outpatient services.
Unless specifically covered in a Rider or Schedule of Benefits, Coventry Insurance plans do not cover feeding and eating disorders in infancy or early childhood.
How Much of the Cost of Rehab is Covered by Coventry Insurance?
The costs paid for through Coventry Insurance coverage for eating disorder rehab will vary depending on who is being covered, (Individual, Individual and Spouse and Family, Group, etc), what type of plan the person has (PPO, HMO, etc) and the facility in question.
You will likely pay less when receiving treatment at an in-network facility than you would at an out-of-network facility.
Can I Pay Above What My Insurance Will Provide to Receive Treatment?
As with other insurance plans, there are limitations on Coventry Insurance coverage amounts for eating disorder treatment; however, you can pay above what Coventry covers. In fact, if the costs of your chosen treatment or facility exceed the amount covered through insurance plan, you will have to pay above what Coventry covers. Even if your choice of treatment is not covered by Coventry, you are permitted to pursue it — but you will have to pay the costs.
Inpatient Addiction Treatment vs. Outpatient Therapy
"Unless specifically covered in a Rider or Schedule of Benefits, Coventry Insurance plans do not cover feeding and eating disorders in infancy or early childhood."
Inpatient and outpatient programs are the two main classifications of treatment available. Inpatient treatment involves 24-hour, on-site professional care where the patient resides in the facility through their recovery. Outpatient treatment programs involve regular visits to a facility or counseling professional. The patient is not required to live in the facility and receives treatment around their daily life schedule.
Inpatient rehab programs generally last between 28 and 90 days; further, these programs can be quite expensive. Inpatient facilities might charge as much as $20,000 - $30,000 a month for treatment services. The cost of these programs makes choosing the correct insurance provider all the more important.
On the other hand, outpatient services are less expensive because they do not charge room and board. However, these treatment facilities do not provide as in-depth, focused treatment as inpatient facilities as the patient is not under 24-hour supervision.
Should I Choose a Residential Rehab Center?
Residential rehab centers are treatment facilities that combine detoxification services, psychological counseling and after-care services. Whether or not a residential rehab center is the right choice for an eating disorder treatment depends on multiple factors:
- cost of the rehab center
- methodologies of the rehab center
- effectiveness of rehab center (this can be difficult, since not all rehab facility organizations track success rates)
- impact of living in residential rehab center on professional career / family life
If the costs and time-commitment of residential rehab centers are not prohibitive, they remain an excellent option for eating disorder treatment. However, according to the International Journal for Eating Disorders, average length of stay for a residential program is over 80 days at an average cost per day in the US of $956. All told, the average stay costs $79,348.
Will Coventry Insurance Pay for Local Rehab and Out-of-State Treatment?
Coventry Insurance and its subsidiaries offer coverage in all 50 states. However, this does not mean that all facilities are covered by Coventry. The amount of coverage may be different for local rehab options versus out-of-state treatment options. Check with your individual plan to see which treatment plan would be best for you.
Dependent out-of-area coverage is available for Coventry Insurance coverage for eating disorder treatment through PPO and HMO plans.
Does Coventry Insurance Pay for Private or Luxury Treatment?
Depending on your insurance Coventry Insurance plan, certain private or luxury treatment centers are covered. Luxury treatment — also called executive treatment — provides the patient with high-level service and amenities. Since it is more expensive and not always considered medically necessary, not all plans cover luxury treatment options. These services are available in both inpatient and outpatient clinics.
What Does Executive Treatment Offer Over Other Rehabs?
Executive treatment programs are designed with the executive professional in mind, and they provide amenities that you may not find at other facilities. Patients receiving care in an executive treatment center may be given private rooms, gourmet meals, swimming pools and spas, along with other services.
This treatment option is beneficial for executives and other professionals who need to fulfill certain work requirements while being treated. Executive treatment allows executives the chance to receive treatment without giving up their careers.
There are many different types of luxury treatment centers. For example, some patients seek non-spiritual care, while others seek help through spiritual and theological programs. If a 12-step program is an option that interests you or your loved one, for instance, make sure to identify a center that offers one.
What Treatment Lengths Will Coventry Insurance Pay For?
Coventry Insurance coverage for eating disorder treatment can last anywhere from 28 days to 90-plus days. The length of cover, though, often varies with treatment; there isn’t a “one-size-fit-all” treatment length option. Further, treatment options like outpatient therapy may not have set daily program lengths.
What if I Have No Insurance?
Recent health care reform has changed the way insurers interact with eating disorders.
Under the Patient Protection and Affordable Care Act, those with eating disorders have the option to enroll in individual health plans on the open market. Insurance coverage is required under the law, and providers may not issue exclusion periods or elimination riders. You will not face higher premiums on the basis of having an eating disorder.
Contact your state’s health insurance exchange and speak with an agent to find a plan that will get you coverage. Depending on your income and employment, you will have different options available to you. If your employer offers you significant benefits, for instance, you may not qualify for an individual plan on the insurance exchange.
The government provides tax credits to those who need payment assistance to cover health insurance premiums. You should also review possible Medicaid coverage through your state’s Department of Human Services.
Using Our Helpline to Determine Your Coventry Insurance Rehab Options
Each person has different struggles on the road to their recovery. We can help you or your loved one work through your insurance program to find the best option for you. Call us at 1-888-341-7785 if you need help making the transition to a happy lifestyle.
Questions and Answers
- Will Coventry Cover Multiple Rehab Stays?
Since benefits apply on an annual basis, Coventry will cover multiple rehab stays.
- Does Coventry Insurance Pay for Aftercare?
When aftercare is considered a medically necessary component of your treatment, Coventry should cover it.
- Could Rehab make my insurance premiums higher?
Rehab will not make your premiums higher. It is against the law the raise insurance premiums for using covered services.
- Has the Affordable Care Act (Obamacare) Affected Substance Abuse and Mental Health Insurance Coverage?
Obamacare has effectively expanded coverage for substance abuse and mental health disorders by providing options in the public marketplace for the uninsured and making sure insurance companies cover these disorders.
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