geha DRUG REHAB

While coverage for drug and alcohol treatment services varies depending on your specific GEHA insurance plan, many plans generally cover a range of treatment options to support members in their recovery journey.

It is essential to review your plan’s Summary of Benefits and Coverage (SBC) directly to get accurate information about your specific coverage. We can get that information for you through our insurance verification process.

Common treatment services that may be covered by GEHA insurance plans include:

Detoxification:

Medical detox helps individuals safely withdraw from drugs or alcohol under medical supervision.

Residential Treatment:

A residential treatment program offers a live-in, structured environment where individuals receive around-the-clock care; including medical supervision, therapy, and counseling.

Partial Hospitalization Programs (PHP):

A Partial Hospitalization Program provides intensive treatment services for several hours each day while allowing individuals to return home in the evenings.

Intensive Outpatient Programs (IOP):

Intensive Outpatient Programs offer treatment in an outpatient setting with a higher level of care than traditional outpatient programs, usually requiring several hours of treatment per day for multiple days per week.

Outpatient Programs:

Outpatient programs involve attending therapy and counseling sessions a few hours per week, allowing individuals to continue with their daily activities while receiving treatment.

Individual, Group, and Family Therapy:

Many GEHA plans cover different types of therapy sessions to address the psychological and emotional aspects of addiction.

Aftercare and Recovery Support Services:

GEHA may cover services like recovery coaching (navigation) which are programs that help you stay connected to a treatment center and remember what you’ve learned in treatment while you navigate the outside world. 

Remember, the specific services covered under your GEHA plan may vary, but we can help you figure out the ins and outs of your specific policy type.

GEHA offers two plans, both of which cover addiction and substance abuse treatment. If you meet the criteria for obtaining the treatment, you should address the specificity of the rehab required.

The GEHA insurance plan covers addictions that include:

· Alcohol
· Opioids
· Cocaine
· Meth
· Benzodiazepines

Cornerstone treats all of these, and more.

Dual-Diagnosis or Co-occurring Disorder Treatment Coverage Under GEHA

Along with addiction comes many mental health issues.

The two are interconnected so that declining mental health can lead to substance abuse for temporary happiness and highs or the prolonged use of substances changes the brain’s chemistry, resulting in mental health disorders.

Substance abuse disorder is also classified as a mental health disorder. Hence, GEHA offers multiple types of behavioral therapies that are covered under their health insurance.

Therefore, for an individual to require assistance from a mental health professional, they do not need to go to rehab to obtain it but can also get it out of rehab.

While GEHA covers many therapies, it is still important to explore whether the programs offered align with your needs, the treatment you require, and will play an essential role in healing your body and mind.

As a federal requirement for all insurance companies, GEHA must cover any essential service.

Therefore, even though the coverage might not be the same for all treatments, substance abuse and mental health services are considered vital services that will be paid for by the insurance provider. Luckily, GEHA does have a cap on deductibles that limit the amount to a certain level annually. 

The GEHA drug rehab coverage depends entirely on the expected treatment length and treatment the client is opting for.
For example, if the client is fulfilling the criteria of claiming insurance for a 30-day alcohol rehab program, GEHA will likely cover it.

GEHA generally covers up to six weeks of inpatient rehab and twelve weeks of intensive outpatient programs.

In addition, the company ensures the treatment is medically essential and might extend coverage if fatally required.

COVERING OUT-OF-POCKET EXPENSES

As discussed before, the type of insurance plan you buy significantly determines the amount you will have to pay out of pocket.

For example, if you are looking for top-quality healthcare with a luxury rehab resort, then there will probably be expenses that you will have to bear.

GEHA primarily determines all the essential services, medications, or treatments that can be covered under your insurance.

Therefore, on High Option or HDPD plans, you are less likely to pay any additional amount since the insurance will cover it.

However, on Standard plans, the deductible requirement can be pretty high.

While GEHA has a cap on deductibles, even paying a few thousand dollars a year is not something everyone can afford.

Deductibles are meant to be paid before insurance kicks in.

It’s essential to understand what is on your GEHA Insurance card and how to read the information it contains, as you’ll need this information to submit a GEHA insurance verification.

Member Name: The cardholder’s full name is displayed on the card. Ensure that it matches your name to avoid any confusion or issues when seeking medical treatment.

Member ID: This is a unique identifier assigned to each member. Your healthcare providers will need this number when you receive medical services or when they file claims on your behalf.

Group Number: This number indicates the specific insurance plan or group you belong to. It may also be referred to as the “Policy Number” or “Plan Number.”

Plan Type: This section will identify the type of plan you have, such as Fee-for-Service (FFS) with a preferred provider organization (PPO) or High Deductible Health Plan (HDHP).

Provider Network: The name of the preferred provider network affiliated with your GEHA plan may be listed on your card, which will help you identify in-network providers and facilities.

Co-payment Information: Co-payments are the fixed amounts you pay for specific services, like office visits or prescription medications. These amounts might be listed on your insurance card for easy reference.

Customer Service Phone Number: A dedicated phone number is usually provided on your card, allowing you to reach GEHA’s customer service representatives with any questions or concerns regarding your coverage.

Claims Address: This is the address to which healthcare providers will send claims for payment or reimbursement of services provided to you.