February 1, 2024

Banner Employee Health Insurance Substance Abuse Coverage

This guide helps you understand your Banner Employee Health Insurance Substance Abuse Coverage for better decision-making about your recovery.

Banner Employee Health Insurance Substance Abuse Coverage

Table of Contents

Table of Contents

Contributors & Editors

Julie Miller

Addiction & Mental Health Writer

Last Update on February 1, 2024

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As a Banner Health employee, you have access to important information about your substance abuse treatment coverage through various employer health plans, including VALUE, PREMIER, and CHOICE PLUS.

This article aims to equip you with the knowledge you need about your Banner Employee Health Insurance Substance Abuse Coverage, ensuring you can make the best decisions for your recovery and well-being.

Please note that the information provided is current as of this writing and may change at any point in the future.

Key takeaways

Is substance abuse treatment covered for Banner Health employees? Yes, Banner Health provides coverage for substance abuse treatment to its employees, with specific details depending on the chosen health plan, including VALUE, PREMIER, and CHOICE PLUS.

Banner Employee Health Insurance Substance Abuse Coverage

Detailed Comparison of Banner Health Insurance Plans

Banner Health offers three main health insurance plans, tailored to meet the diverse needs of its employees, including specific provisions for Banner health drug rehab and substance abuse treatment.1

These plans are VALUE, PREMIER, and CHOICE PLUS.

Below is an overview of each plan:


• The VALUE plan is tailored for those seeking essential coverage at a more affordable cost.

• It typically offers lower premiums but comes with higher deductibles and

• This plan suits employees who do not anticipate frequent medical services but want protection against high-cost medical events.

• The VALUE plan might cover basic services for substance abuse treatment but with higher co-payments or coinsurance rates.


• The PREMIER plan is designed for employees seeking a balance between cost and coverage.

• It generally offers moderate premiums with lower deductibles than the VALUE plan.

• This plan might be ideal for employees who expect moderate healthcare needs and desire broader coverage, including more comprehensive substance abuse treatment options.

• The PREMIER plan often includes better coverage for specialized substance abuse services, such as intensive outpatient programs or advanced therapy sessions.


• The CHOICE PLUS plan is the most comprehensive option, offering the broadest range of coverage with higher premiums and the lowest deductibles.

• It is well-suited for employees anticipating frequent medical care or requiring extensive healthcare services.

• This plan often provides the most extensive coverage for substance abuse treatments, including inpatient rehabilitation, outpatient services, and extended therapy options.

• Employees under the CHOICE PLUS plan may benefit from lower out-of-pocket costs for substance abuse treatments and greater flexibility in choosing providers.


Does Banner Health impose any deductibles for its health plans? Yes, Banner Health’s health plans, including VALUE, PREMIER, and CHOICE PLUS, each come with specific deductible amounts that vary based on the chosen plan.

Plan Highlights and Deductibles

Understanding the highlights and deductibles of each Banner Health insurance plan is essential for making informed decisions about your healthcare, especially when considering substance abuse treatment.

Here’s a concise snapshot of the VALUE, PREMIER, and CHOICE PLUS plans:


Key Features: Designed for cost-saving, this plan offers essential coverage at more affordable premiums. It’s ideal for employees expecting minimal medical care.


• Individual: Higher individual deductible, suitable for those with fewer healthcare needs.

• Family: Family deductible aligns with the plan’s focus on affordability but may be higher than other plans.


Key Features: A middle-ground option, the PREMIER plan balances cost with coverage. It offers more comprehensive coverage than the VALUE plan with moderately priced premiums.


Individual: Moderate individual deductible, reflecting the plan’s balance between cost and coverage.

Family: Family deductible is lower than VALUE but higher than CHOICE PLUS, catering to families with moderate healthcare needs.


Key Features: This is the most comprehensive plan, offering extensive coverage with the highest premiums and lowest deductibles. It’s tailored for those with significant healthcare needs or who desire the broadest coverage.


Individual: Lowest individual deductible among the three plans, catering to those requiring frequent healthcare services.

Family: Family deductible is significantly lower, reflecting the plan’s emphasis on comprehensive coverage.


What are the out-of-pocket costs for Banner Health’s insurance plans? Out-of-pocket costs under Banner Health’s insurance plans, such as VALUE, PREMIER, and CHOICE PLUS, vary, including deductibles, co-pays, and maximums, depending on the specific plan selected.2

Out-of-Pocket Costs and Care Specifics

For Banner Health employees considering substance abuse treatment, understanding the out-of-pocket costs and specifics of care under each health plan is crucial.

This includes knowledge about out-of-pocket maximums, Health Savings Account (HSA) contributions, and costs associated with various types of care.

Here’s an overview for the VALUE, PREMIER, and CHOICE PLUS plans:


• Out-of-Pocket Maximums: Typically the highest among the three plans, providing a cap on the maximum amount you’ll pay in a year.

• HSA Contributions: Eligibility for HSA contributions, which can be used to offset higher out-of-pocket costs.

Costs for Various Types of Care:

• Preventive Care: Generally covered at low or no cost.

• Primary Care: Higher co-pay or coinsurance compared to other plans.

• Specialist Visits: Higher costs for specialist care, including substance abuse specialists.

• Surgery and Emergency Room Visits: Higher out-of-pocket costs, reflecting the plan’s higher deductibles and maximums.


• Out-of-Pocket Maximums: Moderately set to balance between coverage and cost.

• HSA Contributions: May offer HSA options but with less emphasis compared to the VALUE plan.

Costs for Various Types of Care:

• Preventive Care: Usually covered at no extra cost.

• Primary Care: Moderate co-pay or coinsurance.

• Specialist Visits: More affordable than VALUE for specialty care, including substance abuse treatment.

• Surgery and Emergency Room Visits: More reasonable costs compared to VALUE, reflecting the plan’s balance.


• Out-of-Pocket Maximums: The lowest among the plans, minimizing your yearly

• HSA Contributions: While offering comprehensive coverage, HSA options might be limited due to lower out-of-pocket expenses.

Costs for Various Types of Care:

• Preventive Care: Usually covered fully.

• Primary Care: Lower co-pay or coinsurance.

• Specialist Visits: Lower costs for specialists, ideal for regular substance abuse treatment sessions.

• Surgery and Emergency Room Visits: Significantly lower costs compared to the other plans.


How do I know if my substance abuse treatment requires pre-authorization under my Banner Health plan? It’s advisable to consult your plan’s documentation or contact the insurance provider directly to determine if your specific substance abuse treatment requires pre-authorization.

Eligibility for Substance Abuse Treatment Coverage

Understanding the eligibility criteria and pre-authorization requirements for substance abuse treatment is a critical aspect for Banner Health employees when evaluating their healthcare plans.

While specific details can vary, here’s a general overview for the VALUE, PREMIER, and CHOICE PLUS plans:


• Eligibility Criteria: Coverage for substance abuse treatment under the VALUE plan may be more restrictive compared to other plans. Employees might need to demonstrate medical necessity through clinical evaluation.

• Pre-Authorization Requirements: This plan likely requires pre-authorization for most, if not all, types of substance abuse treatments. This means obtaining approval from the insurance provider before commencing treatment, ensuring that the services are covered.


• Eligibility Criteria: The PREMIER plan typically offers broader eligibility for substance abuse treatments. Employees might still need a clinical assessment but may have more flexibility in qualifying for coverage.3

• Pre-Authorization Requirements: Pre-authorization is often required, especially for specialized treatments or inpatient care. However, the process may be more streamlined compared to the VALUE plan, reflecting the plan’s balance between accessibility and cost.


• Eligibility Criteria: As the most comprehensive plan, CHOICE PLUS generally has the most lenient eligibility criteria for substance abuse treatment. It may cover a wider range of treatment options and potentially include services that are not covered under other plans.

• Pre-Authorization Requirements: While pre-authorization might still be necessary, particularly for expensive or extensive treatments, the process is often more flexible. This plan may also allow for quicker approvals given its emphasis on comprehensive coverage.

Limits and Restrictions

When it comes to substance abuse treatment coverage under Banner Health insurance plans, it’s important to be aware of the various limits and restrictions that may apply.

These can include caps on the number of sessions, limitations on treatment duration, and exclusions on certain types of treatments.

Here’s how these aspects generally play out across the VALUE, PREMIER, and CHOICE PLUS plans:


• Session Caps: This plan may have the most stringent caps on the number of covered therapy or counseling sessions.

• Duration Limits: Inpatient treatment coverage might be limited to a shorter duration compared to other plans, with strict guidelines on extensions.

• Treatment Type Exclusions: Certain types of treatments, especially those considered experimental or less traditional, might not be covered.


• Session Caps: There may still be caps on therapy sessions, but they are likely to be more generous than the VALUE plan.

• Duration Limits: The duration of covered inpatient treatment could be longer than VALUE but may still have certain restrictions.

• Treatment Type Exclusions: While offering broader coverage, some specialized treatments might not be included, or may require additional justification for coverage.


• Session Caps: This plan typically offers the highest number of covered sessions for therapy and counseling, reflecting its comprehensive coverage.

• Duration Limits: Inpatient treatment durations are generally more flexible, with potential for extensions based on medical necessity.

• Treatment Type Exclusions: CHOICE PLUS is likely to cover a wider array of treatment modalities, including some newer or specialized treatments, though some exclusions may still apply.


Is family counseling covered as part of substance abuse treatment in Banner Health insurance plans? Family counseling is often covered as part of substance abuse treatment, especially under the PREMIER and CHOICE PLUS plans, but the extent of coverage can vary, so it’s important to check your specific plan details.

Types of Substance Abuse Treatments Covered

Under Banner health employee substance abuse benefits, the insurance plans typically cover a range of treatments, including inpatient services, outpatient services, counseling, and therapy.

The extent and nature of this coverage can vary significantly between the VALUE, PREMIER, and CHOICE PLUS plans.

Here’s an in-depth look at how each plan typically handles these treatment types:


• Inpatient Services: Coverage may be more limited compared to other plans. It might cover a basic level of inpatient care, but with higher co-payments or coinsurance and possibly a shorter duration of stay.

• Outpatient Services: Outpatient care, such as regular counseling or therapy sessions, is typically covered. However, there may be limits on the number of sessions or types of therapies covered.

• Counseling and Therapy: Coverage for counseling and therapy is usually included but might be subject to more stringent caps on the number of sessions or types of counseling techniques.


• Inpatient Services: Offers broader coverage for inpatient treatments compared to the VALUE plan. This might include a wider range of facilities or longer treatment durations with more manageable out-of-pocket costs.

• Outpatient Services: Provides good coverage for outpatient care, including regular counseling sessions and various forms of therapy, with more flexibility in terms of the number of sessions and types of therapy.

• Counseling and Therapy: Generally includes comprehensive coverage for different counseling and therapy modalities, supporting a broader range of substance abuse treatment approaches.


• Inpatient Services: This plan usually offers the most extensive coverage for inpatient services, including stays at specialized facilities, with the lowest co-payments and longest permissible treatment durations.

• Outpatient Services: Highly flexible and extensive coverage for outpatient care, including a wide range of therapy options and more frequent counseling sessions.

• Counseling and Therapy: Typically covers the widest array of counseling and therapy options, including emerging and specialized treatment modalities, with the least restrictions on frequency and duration.

Navigating Your Path to Wellness with Banner Health Benefits

Understanding your Banner Health insurance plan is vital when considering substance abuse treatment.

It enables you to make informed decisions about your healthcare, effectively navigate the various drug rehab options available through Banner Health, and thoroughly assess your substance abuse treatment coverage.

Additionally, being well-informed about your plan allows you to maximize the use of employee benefits related to substance abuse.

With this knowledge, you are better equipped to embark on a path toward recovery and wellness, confidently utilizing the resources and support available to you through your Banner Health benefits.

Additional Resources

For more details on your specific Banner Employee Health Insurance Substance Abuse Coverage, please explore the resources available through the following links:

Banner Health Insurance Benefits | For Employees

2024 Banner | New Hire Benefits

Banner Health Insurance is Welcomed at Cornerstone Healing Center in Arizona!

To better understand how your Banner Health benefits apply to your situation and receive personalized assistance, you can contact us at Cornerstone Healing Center.

Our dedicated team can verify your Banner Health benefits and offer a free treatment consultation, helping you find the right path to recovery and wellness.

For additional info, please explore our Health Insurance section, where you can discover the various other insurance types we accept and more!

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Author & Reviewers

julie miller recovery writer and author
Julie is a recovery advocate, with over two years sober. She is a recovery speaker who believes people can change for the better. Her mission is to write factual, helpful information about addiction, treatment, and recovery. She believes that no one should be left in the dark about the process at any stage of their recovery.
lionel estrada lisac clinical director

Lionel is the Clinical Director of Cornerstone’s treatment facilities in Arizona. He has had over 4 years at Cornerstone. He is personally in recovery and passionate about helping others overcome substance abuse and mental health challenges, he is trained as an EMDR, adopting a trauma-informed approach to treat the underlying issues of conditions.

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