What Kind of Coverage Does Coventry Insurance Offer for Sex Addictions?
Coventry Insurance coverage options — as well as the coverage available through Coventry’s subsidiaries — include authorized inpatient treatments of varying lengths (28-30, 60, 90 days or more) and varying amenities (such as executive and luxury programs), and authorized outpatient coverage such as sex addiction counseling, group therapy, day treatment programs. Coventry also covers certain medication management strategies.
The primary behavioral health product available through Coventry Insurance is known as The Total Behavioral Solution, which includes “care coordination, preventative health programs and disease management.”
Preauthorization is required for all coverage.
How Much of the Cost of Rehab is Covered by Coventry Insurance?
The standard coverage provided by Coventry Insurance plans allows for mental/behavioral health outpatient services with a $20 co-pay per visit for participating providers only. Mental/behavioral health inpatient services have a $250 co-pay per admission for participating providers only.
Non-participating providers are not covered for either inpatient or outpatient services.
That said, the costs paid for through Coventry Insurance coverage for sex addiction rehab may vary depending on who the coverage is for (Individual, Individual and Spouse and Family, Group, etc), the Plan Type (PPO, HMO, etc).
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 sex addiction rehab treatment. While preauthorization is required for coverage, non-covered providers are an option for those with the financial resources to pay for them.
You are not prohibited from pursuing a treatment option if it is not partially or fully covered through your Coventry Insurance health plan.
The Total Behavioral Solution offers up to three 50-minute “life coaching” sessions, including Stress Management and Balance, Motivation and Time Management, and Spirituality and Personal Growth. These services are provided at no additional cost.
Inpatient Addiction Treatment vs. Outpatient Therapy
"As with other insurance plans, there are limitations on Coventry Insurance coverage amounts for sex addiction treatment. "
All forms of addiction treatment and rehabilitation programs can be classified into two broad categories: inpatient and outpatient.
Inpatient treatment is the name for 24-hour, on-site professional care. The patient lives in a separate facility through the course of their recovery and has access to professional care 24/7. Standard inpatient treatment can be substantially more expensive than outpatient treatment; some rehab facilities charge $20,000 - 30,000 per month or more.
There are many types of outpatient rehabilitation, but usually involve regular visits to a facility or counseling professional. The patient does not stay on-site full time during outpatient therapy.
Since outpatient services do not charge room and board, they are subsequently less expensive on average. The downside to outpatient therapy is that the patient is not near to, or monitored by, professionals at all times and is not necessarily removed from temptations or other stressors.
Should I Choose a Residential Rehab Center?
Residential rehab centers are treatment facilities that combine detoxification services, psychological counseling and after-care services. They are designed to separate the patient from stressors, distractions and unhealthy routines.
Whether or not a residential rehab center is the right choice for you or your loved on depends on many factors, including:
- cost and coverage of the rehab center
- treatment methodologies of the rehab center
- effectiveness of rehab center (this can be difficult, since not all rehab facility organizations publish success rates)
- professional career / family impact of living in residential rehab center
Like any addiction, compulsive sexual behavior can be difficult to diagnose. It is critical that you or your loved one has a confirmed, diagnosed sexual disorder prior to entering into a residential rehab center. The treatments and the costs associated with these facilities are designed for a specific condition and may not be effective for others.
Will Coventry Insurance Pay for Local Rehab and Out-of-State Treatment?
Coventry Insurance (along with its subsidiaries) has a presence in all 50 states. There are also rehabilitation centers in every state. However, not all facilities are participating providers that are covered by Coventry; the amount of coverage may be different for your local rehab options.
Dependent out-of-area coverage is available for Coventry Insurance coverage for sex addiction treatment through PPO and HMO plans.
Does Coventry Insurance Pay for Private or Luxury Treatment?
Only participating providers of behavioral health services are covered by Coventry Insurance. Private and luxury treatment rehabilitation centers may be covered through your Coventry health plan so long as they are a participating provider.
High-end treatment services come in both inpatient and outpatient clinics. If you find a treatment service that you or your loved one would prefer to use that is not covered by your health plan, you can speak to the clinic staff and request that they negotiate coverage terms with Coventry. It is important to know that Coventry Insurance is under no contractual obligation to agree to or accept negotiated terms.
What Does Executive Treatment Offer Over Other Rehabs?
Executive treatment programs are designed to provide upscale, high-level services and amenities that you may not find at more traditional facilities.
Some services include private rooms, gourmet meals, swimming pools and spas, conference rooms, horseback riding, or other accommodations.
Professionals who need to stay in a single facility for an extended period of time should consider executive treatment centers. These centers offer the ability to meet with business associates and maintain a comfortable working lifestyle while receiving help.
You should also consider the style of treatment center that is most effective for you or your loved one’s needs. Many sufferers can benefit from non-spiritual care; others seek strength in holistic or religious programs. If you or your loved one is interested in a 12-step program, for instance, make sure to identify a center that offers one.
What Treatment Lengths Will Coventry Insurance Pay For?
Coventry Insurance coverage for sex addiction treatment ranges from 28 days to 90-plus days. Many facilities will offer different treatment lengths, but not all facilities are covered through your health plan. It is important to identify if a center is considered a participating provider for Coventry Insurance coverage.
Some forms of treatment, such as forms of outpatient therapy, may not have set daily program lengths. In these instances, coverage varies based on the type of treatment and provider status.
What if I Have No Insurance?
Even if you have no insurance coverage for sex addiction treatment — or if your preferred rehab service is not one of Coventry Insurance’s participating providers — there are other options available to those with compulsive sexual behavior.
Many treatment facilities understand that rehab programs are expense and offer flexible payment plans or alternative forms of financing. If there is a rehab program that you are interested in, try to negotiate a financing strategy that works for you.
You can also speak with our specialists to identify your coverage options and potential treatment programs.
Using Our Helpline to Determine Your Coventry Insurance Rehab Options
The road to successful recovery is different for each person. You or your loved one should identify the right rehab program, and we can help you do just that. If you are looking to make the transition to a healthy lifestyle, call 1-888-341-7785.
Questions and Answers
- Will Coventry Cover Multiple Rehab Stays?
The benefits for Coventry renew each year, so the company does cover multiple rehab stays.
- Does Insurance Pay for Aftercare?
Since aftercare has a significant effect on the effectiveness of your treatment, most Coventry plans cover it.
- Could Rehab Make My Insurance Premiums Higher?
No — using your insurance coverage benefits will not cause your premiums to raise, as mandated by the Mental Health Parity Act.
- Has the Affordable Care Act Affected Substance Abuse and Mental Health Insurance Coverage?
The ACA, or Obamacare, has positively impacted substance abuse and mental health insurance coverage. If you bought your policy in 2014, Coventry is legally compelled to cover at least 60 percent of your treatment.