Do Drug and Alcohol Rehab Centers Take HealthSmart Insurance?
If you seek drug and alcohol addiction treatment and have HealthSmart insurance, you may wonder, “Does HealthSmart cover rehab?” You may also have concerns about what is covered and what you can expect to pay out of pocket. Continue reading to learn more about HealthSmart insurance coverage and how to confirm your specific benefits.
Who is HealthSmart?
While HealthSmart does provide healthcare services, it is not an insurance company. HealthSmart is a third-party administrator that offers innovative administrative, cost management, and health improvement programs to self-funded employers and insurance carriers to assist in managing healthcare benefits for their employees and members.
HealthSmart was founded in 1996 and is headquartered in Irving, Texas. The company was created to provide healthcare solutions to employers and other stakeholders in the healthcare industry. Since its founding, HealthSmart has become one of the largest third-party administrators in the United States, serving clients in all 50 states.1
HealthSmart offers a range of healthcare solutions, including claims processing, network management, managed care, wellness programs, health savings accounts, and pharmacy benefits management. The company's services help employers and other stakeholders reduce healthcare costs while improving their employees' and members' health and well-being.
What is HealthSmart Addiction Recovery Insurance Coverage?
HealthSmart is not an insurance company and does not provide insurance coverage for addiction recovery or any other healthcare services. However, HealthSmart may work with insurance carriers or self-funded employers that offer addiction recovery coverage as part of their employee benefits package.2
The specific addiction recovery plans offered to you will depend on your employer, as HealthSmart is a plan administrator. Your company may provide flexible, cost-effective, personalized employee plans that include addiction recovery.3
Addiction recovery insurance coverage is the amount a health insurance policy will pay for services such as inpatient care and outpatient rehabilitation programs, detoxification, counseling, psychotherapy, and aftercare. The type of insurance policy, the particular rehabilitation treatments required, and other factors can impact the coverage level.
Does HealthSmart Insurance Cover Drug and Alcohol Addiction Recovery?
The coverage for drug and alcohol addiction recovery will depend on your specific policy and plan through HealthSmart. HealthSmart, though not an insurance company, generally manages claims for substance abuse and mental health treatment as part of its behavioral health services. These services may include inpatient and outpatient treatment programs, counseling, and medication-assisted treatment.
To determine your exact coverage for drug and alcohol addiction recovery, call us at 866-461-3339. We can review your specific plan documents with you or contact HealthSmart directly for more information.
Check Your HealthSmart Insurance for Addiction Treatment
Our admissions coordinators will interact directly with HealthSmart on your behalf, removing from your shoulders the burden of figuring out if your insurance will pay for your addiction treatment.
Does HealthSmart Insurance Cover Mental Health Rehab?
Healthsmart will likely cover rehabilitation in the same manner as substance abuse treatment. However, not every method of therapy or duration of treatment is covered. You can count on HealthSmart mental health coverage to pay some of the cost because the Affordable Care Act (ACA) designates mental health care and substance abuse treatment as essential health benefits.4
Mental health rehab can involve a range of services and therapies, such as inpatient or outpatient programs, individual or group therapy, medication management, and other forms of support.
Your coverage will depend on your specific health insurance plan and the services included in your policy. Call us at 866-461-3339 We can provide more detailed information about your HealthSmart rehab coverage.
Inpatient and Outpatient Addiction Recovery Centers That Take HealthSmart Insurance
Virtue Recovery Center has been saving individuals from substance abuse and rebuilding families for years with multiple treatment locations in several states. The Joint Commission accredits all our inpatient and outpatient recovery facilities that may be in-network with HealthSmart. We are also HIPAA compliant and National Association of Addiction Treatment Providers (NAATP) members.
Below you'll find links to all of Virtue Recovery Center’s treatment facilities:
Deciding what care you need is crucial because Healthsmart insurance may cover inpatient and outpatient care. Outpatient care is efficient and significantly less expensive. Although, it also implies that you’ll continue to be in the same setting where you may have been exposed to the triggers and enablers that contributed to your addiction. Mild to moderate addictions are the only ones for which outpatient therapy is advised.
If relapse prevention is important to you or your addiction is severe, inpatient rehabilitation services may be more suitable.
How Much Is Rehab With HealthSmart Insurance?
The cost of addiction recovery with HealthSmart will depend on many factors, including your specific health insurance policy, your location, the type of treatment you need, and whether you receive treatment in-network or out-of-network. Virtue Recovery Center can address how much rehab is with HealthSmart insurance. Call 866-461-3339 today.
Unlike outpatient therapy, which allows you to remain at home while undergoing treatment, inpatient treatment necessitates a prolonged stay at a treatment facility and is typically more expensive. Depending on the previously mentioned factors, the typical monthly cost of inpatient rehab can range from $5,000 to $25,000 or more.5
How To Check My HealthSmart Insurance Coverage Levels for Addiction Recovery
The simplest approach to verify insurance information is to complete our free online form or call us at 866-461-3339. One of our admissions specialists can quickly review your insurance coverage levels while addressing any concerns or questions you may have regarding addiction recovery. Virtue Recovery Centers guarantees to keep any information shared or discussed entirely private.
How To Get HealthSmart To Pay For Addiction Recovery
Below are some general steps you can follow to get your insurance to cover your journey to recovery and sobriety:
- Confirm your coverage: First, you should confirm that your HealthSmart policy includes coverage for addiction recovery services. Virtue Recovery Center can complete this step for you. Call 866-461-3339 or fill out our no-obligation online insurance verification form.
- Choose an in-network provider: You’ll typically receive greater coverage for treatment from in-network providers. Therefore, choose an addiction recovery provider in-network with your plan. You can search for HealthSmart's provider networks via their website or by contacting Virtue Recovery Center at 866-461-3339.
- Get a referral or pre-authorization: Some addiction recovery services may require referrals or pre-authorization before being covered. To get pre-authorization, you must provide your health insurance carrier with a formal diagnosis or information about the treatment services you need and why they are medically necessary. Like Virtue Recovery Center, a treatment provider can assist you with this process.
- Pay any out-of-pocket costs: Depending on your plan provided through HealthSmart, you may be responsible for paying deductibles, copays, or coinsurance for addiction recovery services. Be sure to understand your out-of-pocket costs before treatment begins.
- Follow your treatment plan: It is important to follow your treatment plan and attend all appointments to ensure you receive the maximum benefit from your HealthSmart coverage. Otherwise, you risk a denial of your claims.
How Many Times Will HealthSmart Pay For Addiction Recovery?
HealthSmart will only pay for addiction recovery services that are considered medically necessary. The number of times HealthSmart will pay for addiction recovery services depends on your specific plan and policy. For example, some plans may have a specific limit on the number of covered treatments, while others may offer unlimited coverage.
In addition, while some insurance plans offer better coverage than others, most need a recommendation from your primary care doctor. Some plans are highly restrictive and only cover HealthSmart alcohol rehab and prescription pain medication addiction treatment.
To truly liberate yourself and start the new life you deserve, you must receive the necessary treatment. Don't be discouraged by other people's actions, as everyone’s journey is unique. Be sure to verify your coverage information by calling 866-461-3339 if you're unsure of the number of times that HealthSmart will pay for treatment.
Addiction Recovery Treatment and Insurance Statistics
- In 2020, 30% of persons 18 and older who reported having any mental illness (AMI) in the previous year and having a perceived need for services went without care because their health insurance did not cover any mental health services or did not pay enough for mental health services. This figure was comparable for people with severe mental illness (SMI).1
- Telehealth was used to access fewer than 1% of mental health and substance abuse services in 2019 compared to 40% from March through August 2020.2
- The percentage of patients who used telehealth for mental health and substance abuse treatments between March and August 2021 in rural regions was 55%, compared to 35% in metropolitan areas.3
- According to a US Government Accountability Office (GAO) investigation, from 2014 to 2019, 80% of states increased payment rates for at least one substance use disorder service.4
- The National Institutes of Health (NIH) estimates that the relapse rate for substance abuse is between 40 to 60%, comparable to treating other diseases with no known cure, such as asthma.5
- Over two million people worldwide are members of Alcoholics Anonymous (AA), which has support groups in approximately 180 countries.6
- Over 41 million Americans were thought to have a substance use disorder (SUD) in 2020. However, just 2.7 million people received care.
- Less than 8% of the 15 million people with alcohol use disorder (AUD) obtain treatment.7
- 7% of adolescents with a major depressive episode and a substance use disorder, or dual diagnosis, received either mental health treatments or substance abuse treatment at a specialized institution.
Check Your HealthSmart Insurance Coverage With Virtue Recovery Center
If you’re committed to recovery, submit a request to one of our professional admission coordinators today using the form below. Before discussing the next steps, a coordinator will address any inquiries regarding our programs, including interacting directly with HealthSmart on your behalf to check your insurance coverage levels for drug or alcohol addiction rehab.
Using your Health Insurance Card, fill out all of the fields on the confidential form.
A member of our staff will contact your insurer to verify if your policy will cover your treatment
We will contact you promptly with the results of the verification and discuss the next steps
*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note that this is only a quote of benefits and/or authorization. We cannot guarantee that payment or verification eligibility will be accurate and complete as conveyed by your health insurance provider. Payment of benefits is subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. Your health insurance company will only pay for services it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. Suppose your health insurance company determines that a particular service is not reasonable and necessary or that a specific service is not covered under your plan. In that case, your insurer will deny payment for that service, and it will become your responsibility.
*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.
- “About HealthSmart.” HealthSmart, 2023, www.healthsmart.com/Who-We-Are/About-HealthSmart.
- “HealthSmart Provider Manual.” HealthSmart, www.healthsmart.com/HealthSmart/media/Provider-Manual-Files/HealthSmart-Provider-Manual-2021.pdf. Accessed 19 Apr. 2023.
- “Plan Administration.” HealthSmart, 2023, healthsmart.com/How-We-Help/Benefit-Solutions/Plan-Administration.
- U.S. Centers for Medicare & Medicaid Services. “Find Out What Marketplace Health Insurance Plans Cover.” HealthCare.gov, www.healthcare.gov/coverage/what-marketplace-plans-cover. Accessed 19 Apr. 2023.
- Stilkind, Joseph. “Average Cost of Drug Rehab : By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab
- U.S. Department of Health & Human Services. “Welcome to the Center for Behavioral Health Statistics and Quality (CBHSQ).” Substance Abuse and Mental Health Services Administration, 2021, www.samhsa.gov/data.
- Modi, Hemangi, et al. “Exploring Barriers to Mental Health Care in the U.S.” Association of American Medical Colleges, www.aamc.org/advocacy-policy/aamc-research-and-action-institute/barriers-mental-health-care. Accessed 19 Apr. 2023. Lo, Justin, et al. “Telehealth Has Played an Outsized Role Meeting Mental Health Needs During the COVID-19 Pandemic.” Kaiser Family Foundation, 15 Mar. 2022, www.kff.org/coronavirus-covid-19/issue-brief/telehealth-has-played-an-outsized-role-meeting-mental-health-needs-during-the-covid-19-pandemic.
- “Medicaid: States’ Changes to Payment Rates for Substance Use Disorder Services.” U.S. GAO, 30 Jan. 2020, www.gao.gov/products/gao-20-260#summary.
- “Treatment and Recovery | National Institute on Drug Abuse.” National Institute on Drug Abuse, 9 Mar. 2023, nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery.
- Alcoholics Anonymous World Services, Inc. “A.A. Around The World.” Alcoholics Anonymous, www.aa.org/aa-around-the-world. Accessed 19 Apr. 2023.
- Bustamante, Jaleesa. “NCDAS: Substance Abuse and Addiction Statistics .” NCDAS, 1 Jan. 2023, drugabusestatistics.org.
START YOUR RECOVERY TODAY!
Contact Virtue Recovery Center 24/7 for inpatient treatment near you