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Does WellPoint Cover Treatment for Cocaine Addiction?

cocaine07Yes, they do. Thanks to the Affordable Care Act, all insurance companies are required to conform to certain standards of substance abuse coverage. While WellPoint offers benefits for cocaine addiction treatment, they also have some limitations. The specific policy you choose will determine how much you'll pay out of your own pocket when you receive treatment.

What Kind of Coverage Does WellPoint Offer for Cocaine Addiction?

Different types of rehab are offered through WellPoint Insurance for cocaine addiction rehab and treatment.
WellPoint will pay benefits for several types of rehab, including:

  • Inpatient rehab
  • Outpatient rehab
  • Therapy
  • Aftercare programs

Unfortunately, WellPoint does not cover wilderness programs.

How Much of the Cost of Rehab Does WellPoint Cover?

The Affordable Care Act requires insurance companies, including WellPoint, to cover substance abuse rehabilitation just like they would any other medical event. So, if your policy requires you to pay a $1,500 deductible and 80 percent of the remaining cost of a hospital stay, you can expect it to pay similarly for substance abuse rehabilitation. When considering a health insurance plan to cover rehabilitation, it's important to pay close attention to the general benefits in the policy.

Can I Pay Above What My Insurance Will Provide to Receive Treatment?

Your WellPoint policy won't limit your treatment to a certain dollar amount. However, once you decide to receive treatment, based on the treatment plan your doctor and WellPoint decide on, your treatment coverage may be limited to a certain number of days. If you need treatment for long than the number of days allowed, you are welcome to pay out of your own pocket, so your treatment can continue.

Inpatient Addiction Treatment vs. Outpatient Addiction Treatment

Inpatient and outpatient addiction treatment are both effective treatments. Here's a little more about how each type of treatment works.

  • Inpatient Addiction Treatment - Inpatient treatment generally requires that the recovering addict spend 24 hours a day at the facility, in the treatment program. The recovering addict spends their time working on recovering from their addiction, in the presence of staff members and certified addiction counselors.
  • Outpatient Addiction Treatment - Outpatient treatment isn't quite as rigorous as inpatient, but it can still be very effective. In this type of treatment, the recovering addict sleeps off site (at home or elsewhere) and goes to the treatment facility in regular intervals. During the time they are in treatment, they may participate in work groups, one-on-one therapy, group therapy and other recovery exercises.

Should I Choose a Residential Rehab Center?

"While WellPoint offers benefits for cocaine addiction treatment, they also have some limitations."
Whether or not to use a residential or outpatient rehab program is something you should discuss with your therapist or doctor. Whichever medical professional you chose to work with, should have experience diagnosing addiction and recommending the appropriate treatment.
Residential programs aren't always the best fit. They remove a recovering addict from the environment they are used to living in. This can backfire once the recovering addict returns to their daily life. Outpatient rehab allows the recovering addict to recover in their daily setting. This can either be advantageous or disadvantageous. Having a medical professional weigh the treatment options, while considering your specific situation, can help ensure a successful outcome.

Will WellPoint Pay for Local Rehab, Out-of-State Treatment or Both?

It depends on whether or not you have out-of-network coverage or access to a national network. Depending on where you live, you may be able to choose between different networks.
If you chose an EMO or HMO network, your policy will probably only pay benefits for services you receive in-network. However, if your policy offers a PPO network and offers national coverage, you may be able to receive in-network benefits for using an out-of-state treatment center.

Does WellPoint Pay Benefits for Private or Luxury Treatment?

WellPoint is unlikely to pay for private or luxury cocaine addiction treatment. Most insurance companies decide whether a service is medically necessary before they provide benefits. Private and Luxury rehab are seldom deemed medically necessary, because they are not required for an addict to recover.

What Does Executive Treatment Offer Over Other Rehabs?

Executive treatment centers are a type of hybrid between inpatient and outpatient rehab centers. Although the recovering addict lives at the facility and spends their whole day there, they are able to communicate with people outside of the facility and/or run a business while they recover. Often times, executive professionals and celebrities opt for executive treatment centers. WellPoint Insurance for Cocaine Addiction Rehab rarely includes executive treatment.

What Treatment Lengths Will WellPoint Pay For?

DrugAbuse.gov states that "…for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes."
Some insurance companies put limits on the length of treatment they'll pay benefits for. The most common lengths of treatment are:

  • 28-30 days
  • 60 days
  • 90 days
  • 180 days (long term residential treatment)
  • 365 days (long term residential treatment)

WellPoint does things a little differently. Rather than limiting treatment to a specific number of days, your doctor or therapist must recommend a treatment program and have it pre-certified through WellPoint. Once the pre-certification is requested, WellPoint has the option to approve or deny the proposed treatment plan.

What If I Don't Have Insurance?

It's ideal to have insurance if you need cocaine addiction treatment. However, if you find yourself without insurance and need treatment, here are some options you can look into:

  • Cocaine Anonymous
  • Using credit to pay for treatment (in-house or other credit)
  • Treatment programs offered by your local city or state

Thanks to the Affordable Care Act, each year there is an annual open enrollment period that allows you to apply for a health insurance plan with cocaine addiction treatment benefits. In addition, you might qualify to sign up for insurance mid-year because of a life event such as; divorce, marriage, loss of coverage or another event.

Call Our Helpline to Determine Your WellPoint Rehab Options

If you are experiencing problems with cocaine addiction, and you are ready to get help, call our helpline and let us help you determine your options. Call us now at 1-888-366-2645.

Frequently Asked Questions

  • Will WellPoint Cover More than One Treatment?
  • rehab centerLike most insurance companies, WellPoint will only cover one drug rehab treatment per year. You benefits reset each year, meaning that if you have treatment this year and need treatment next year, both treatments will likely be covered. It's always a good idea to have your doctor or therapist pre-certify your treatment before you start.

  • Does WellPoint Pay for Aftercare?
  • As long as it's pre-certified and approved by WellPoint, they will provide benefits for aftercare.

  • Could Using my Rehab Benefit Increase my Premiums?
  • No, it can't. In the past, your claims history and health history could be taken into consideration when setting your premiums. However, since the passing of the Affordable Care Act, insurance companies are only allowed to use your age, your area of residence and your tobacco status to set your premium.

  • Has the Passing of the Affordable Care Act Improved Substance Abuse Insurance Coverage?
  • Yes, it has. Before the law went into effect, some insurance companies covered substance abuse, and some didn't. In most cases, even if they did cover it, the coverage was sub-par to other benefits in the policy. The Affordable Care Act sets the bar for mental health and substance abuse coverage to match other medical benefits.
    Note: The information above is not a guarantee of benefits. If you have specific questions about WellPoint Insurance for Cocaine Addiction Treatment, call us at 1-888-366-2645.

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