PPO, or Preferred Provider Organization, consists of a large or small network of physicians, doctors and medical experts. Unlike insurance companies that require a referral when visiting a doctor other than your primary physician, a PPO lets you visit any doctor within that network.
"PPO, or Preferred Provider Organization, consists of a large or small network of physicians, doctors and medical experts."
PPO plans typically charge a deductible every time you visit a doctor, and the PPO might make you pay a specific amount before it begins coverage. Detox isn't covered by all PPO plans, and if your policy does cover detox, you'll likely need to pay a deductible first. Call 1-888-341-7785 to talk to one of our advisers about detox services.
Does PPO Cover Rehab?
Detox is only one step to recovery; the next step involves getting help from an inpatient or outpatient program. The Mental Health Parity and Addiction Equity Act of 2008 made substance abuse coverage a federal law. While your PPO doesn't have to cover your rehab stay, if it offers coverage for substance abuse, it cannot impose any limits that it would unless it has those same limits on other insurance coverage.
Addiction Treatment Length PPO Will Cover
According to the Substance Abuse and Mental Health Services Administration, the average length of time that a person stays in an inpatient treatment center is 30 to 105 days. In comparison, those who successfully complete an outpatient program might spend more than 120 days on it. Inpatient programs are a little more discreet and confidential than outpatient ones because no one outside the private facility knows that you're there. Your PPO might limit your stay based on your policy.
Specialty Alcohol and Drug Treatment Through PPO
You don't always get a choice when it comes to your insurance because your employer might pick a PPO without asking for recommendations from employees. The top executive in your company has access to the same plan as you, which means that you have access to some luxury treatment facilities. Exclusive rehabs are more expensive than other types of treatment because of the amenities that those centers offer. Tennis courts, horseback riding, aromatherapy and swimming pools are just a few of the features available. Look at what your PPO expects you to pay before you choose a luxury treatment facility.
Insurance for Inpatient Addiction Treatment vs. Outpatient
Outpatient and inpatient substance abuse treatments are like two sides of the same coin. Both methods teach substance abusers skills that they can use in the center and beyond, but the programs are significantly different. Before you get your heart set on a residential program, you'll want to double check that your insurance covers the program. Outpatient programs are usually not as expensive as inpatient ones because the user doesn't live in the center or eat meals there, but your provider can tell you more about what is and isn't covered by your policy before you schedule a check-in date.
How to Cover What Insurance Won't
Paying for the costs of drug rehab should be the last thing on your mind. Centers now offer patients different ways to pay, making it easy to cover your costs when your insurance won't step up to the plate. Work out an installment plan that divides the total cost into affordable monthly payments, or request another type of payment plan. You can also talk to the staff about your other available options when you can't rely on insurance for your stay.
Verifying Coverage and Finding the Best Treatment
"Once we know more about your PPO, we can narrow down your treatment options and help you find the right one."
If your house was on fire, you wouldn't hesitate to call 911, but when someone you care about suffers from substance abuse, you might feel tempted to wait and see what happens. If you have insurance benefits through a PPO that covers your spouse and children and one of those loved ones has an addiction, now is the time to get that person some help. We have a toll-free number available at 1-888-341-7785 that will let you talk to a knowledgeable adviser within seconds of dialing the number. Once we know more about your PPO, we can narrow down your treatment options and help you find the right one.