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Do You Have An HMO or a PPO Health Insurance Policy?

Health insurance policies can vary according to many different factors, but one of the biggest ones is the difference between having coverage that falls under the definition of an HMO or PPO. Although these acronyms are confusing, it is fairly simple to figure out what type of coverage you have by grabbing your insurance card and policy information. With those in hand, you can use this guide to start figuring out how your insurance influences the decisions you make regarding your choice of a treatment center that puts you on the right path for recovery.

What is an HMO?

HMO simply stands for Health Maintenance Organization. This type of coverage restricts you to a specific network of care providers that is created by the insurance company. Typically, a network is set up with specific care providers who all agree to charge the insurance company discounted rates for services they perform. You might have heard this referred to as choosing an in-network provider. While this is a cost-effective way to manage your care, you may not always be covered under your insurance if you choose to go to a treatment center that is not considered to be part of your insurance company’s network of providers.

How is a PPO Different?

A PPO, or Preferred Provider Organization, allows you to choose to go to any treatment center that accepts your insurance. While this does give you more freedom of choice, you may find that some treatment programs fall into the out-of-network category. In this case, you would possibly pay more for your treatment, but this could still be preferable if it helps you reduce the costs overall so that you can go to the facility of your choice. Your insurance company will have a list of providers that fall both in and out-of network. However, these tend to change often so always make sure that you are working with an up-to-date list.

How Do I Find Out What I Have?

Many of the major insurance companies list the type of policy you have right on your identification card. However, you can also find this information in the paperwork your insurance gave you that details your policy along with the different types of coverage that are available. This paperwork may also explain how much of inpatient and outpatient stays at drug rehab are covered. Naturally, reading through the complicated wording in these policies can get challenging, which means that it may be necessary to reach out to one of our treatment specialists to get help understanding how your insurance can help cover your stay.

Will This Affect My Options for Treatment?

The differences between an HMO and PPO plan can affect your options for treatment but it does not always have to when you consider the full financial impact of each option that you have for battling your addiction. With an HMO policy, you will be required to visit your primary care physician first to receive a referral for a treatment program that is in-network. In most cases, it is not hard to get a referral for drug and alcohol treatment since the medical community tends to view sobriety as being important for protecting your overall health. If you are unable to find a suitable treatment program that is in-network, then you still have the option of choosing to self-pay for your stay at a recovery facility. A PPO policy allows you to choose to go to treatment without having to seek a referral first, which often speeds up the process of getting help for your addiction.

How Can I Get More Help Understanding My Insurance?

When it comes to paying for your treatment program, you want to get it right. Avoid getting confused and giving up by being willing to reach out to someone who can help. The verification process for our intensive outpatient program allows you to find out exactly what your insurance policy covers so that you can relax and focus solely on getting sober during your stay.

Finding a treatment program that works with your insurance company is important for ensuring that you leave rehab on strong financial footing that helps you stay stable. Be sure to check out our financial options so that you can take advantage of every benefit that you have for gaining another step toward recovery.

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Our Locations

Columbus OH

Unlike many other rehab programs in Columbus, Ohio that offer a one-size-fits-all approach, we create personalized treatment plans tailored to each client's unique needs and specific circumstances. Our dedicated team ensures that every aspect of your treatment is designed to support your individual journey towards recovery.

Eatontown NJ

Our addiction treatment center in Eatontown, New Jersey, provides comprehensive and compassionate care for individuals seeking recovery from substance abuse. With personalized treatment plans and a dedicated team of professionals, we are committed to guiding you on your path to lasting sobriety.

Willard OH

Willard Ohio Detox by Seacrest Recovery Center provides specialized care for individuals recovering from alcoholism and addiction. With 24/7 medical supervision and individualized treatment plans, we ensure a safe and comfortable detox process to help you on your path to recovery as comfortably and safely as possible.

Cincinnati OH

We proudly serve the Cincinnati, Ohio area with comprehensive drug and alcohol treatment services, offering personalized care to support individuals on their recovery journey. Our dedicated team of professionals is committed to providing compassionate and effective treatment to help you achieve lasting sobriety.

Most Major Insurance Accepted

Health insurance can oftentimes cover up to 100% of the cost of treatment.  One simple call with us, and we can quickly verify your coverage for you.  Don’t see your insurance? Don’t worry, call now to see if you’re covered!

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