AmeriHealth is a New Jersey-based insurance company that offers consumers in the healthcare market a selection of individual, family, and employer plans. The state of New Jersey faces over 69,477hospital stays due to substance abuse alone, so it is no wonder why adequate treatment coverage is necessary. At Seacrest Recovery Center here in Boynton Beach, Florida, we are dedicated to helping clients find what their policy initially covers, and how to achieve the lowest amount of co-pays and deductibles.

Verifying That a Policy Covers Both Detox and Rehab

Most AmeriHealth plans offer coverage for detox programs in which professional medical staff overlook and treat the medical symptoms of withdrawal. These detox programs typically only cover inpatient stays in 3 day, 5 day, and 7 day increments. It is paramount for many recovering addicts and alcoholics to be placed in an actual rehabilitation program following their completion of a detox stay.

Long-term rehabilitation programs are much different compared to detox programs due to them treating the underlying causes that often cause addictive behavior to manifest. Detox only focuses on the physical aspects of recovery when the core issues reside in a much deeper place. Verifying that your policy doesn’t just cover detox, but inpatient rehabilitation programs as well, is important when seeking out the most effective treatment approach.

Obtain an In-Network Physician Referral

AmeriHealth plans that include inpatient rehabilitation always require an initial referral from a primary care physician. This referral is the key component in deeming your treatment as a medically necessary form of medical care. Without a verifiable referral, AmeriHealth does not have to deem the treatment as medically necessary, which could cause issues in both billing and the amount of future coverage. Future patients should make an appointment with their primary care physician in order to request a referral to our treatment center. Be sure that the physician you book the appointment with is in your policy’s network, as well as listed as your primary care provider within your individual plan. If you notice that the doctor listed on your insurance card does not match the physician that you typically see, you may need to change it with AmeriHealth directly. This is to make sure that the provider who places the referral is parallel to who AmeriHealth has listed as your PCP.

Request Coverage for Inpatient Care

Many plans within the AmeriHealth network only cover outpatient treatment for mild and moderate levels of addiction. The most common form of coverage is 20-30 outpatient visits within a singular calendar year. This is not ideal when it comes to a successful recovery long-term, so a revision in the patient’s current policy may be needed. Outpatient services are often not as effective as inpatient stays due to them not having the appropriate intensity when it comes to dealing with dual diagnoses and other common patterns seen in active addiction. If your plan does not currently cover inpatient stays, see if it is possible to find a new policy with AmeriHealth that better suits your recovery needs.

Determining Your Co-Pays and Deductibles

The majority of insurance plans with AmeriHealth do come with co-pays and deductibles that factor into the cost of treatment during the recovery process. A co-pay is a payment that the policy holder or beneficiary makes along with the payments that the insurance company will put forth. A deductible, on the other hand, is a specific amount of money that the beneficiary must pay in order for their policy to start covering the cost of treatment. It is best to become well-versed in your plan’s co-pay and deductible fees to prepare yourself for any payments that you may owe before or during treatment. Our staff at Seacrest Recovery Center in Boynton Beach will be able to help you figure out this information through verification forms. This verification process will provide you with extensive information surrounding possible co-pays and deductibles you will need to pay upfront before treatment.

Taking the initiative to contact a medical professional for help in regards to your recovery can be intimidating, but our staff at Seacrest Recovery Center are welcoming, knowledgeable, and accommodating to your recovery needs. Even if your AmeriHealth plan does not include significant coverage, there may be flexibility in terms of potential treatment options. Contacting our facility directly at (800) 411-8019 will give you the opportunity to speak with an educated, compassionate professional about where to begin.