Most insurance plans will cover either all or a portion of the treatment.
Content Reviewed By:
SUD treatment executive, national news contributor & keynote speaker.
Navigation:
- Overview
- Determining Your Best Insurance Options for Addiction Treatment
- Aetna Addiction Treatment Coverage
- Blue Cross Blue Shield Addiction Treatment Coverage
- Cigna Addiction Treatment Coverage
- UnitedHealth Group Addiction Treatment Coverage
- Magellan Addiction Treatment Coverage
Overview
Private or employer-provided health insurance has emerged as one of the most common and viable means of paying for substance use disorder treatment. It can be hard, however, to determine which insurance companies offer the most robust coverage for drug and alcohol rehab. The reality for many is that they’re often confined to the parameters of their plans as they look for help, so it’s critical to know what they’re coverage offers and how to extract maximum value from their policies.
Generally speaking, the largest insurance companies with the most in-network resources will be able to offer the most comprehensive treatment coverage, but it’s not always a simple answer. Even after the passage of the Affordable Care Act, there remain significant insurance-related barriers to care, including but not limited to overtly rigid medical necessity reviews to approve treatment, gaps and shortcomings in Medicaid coverage, and substantial administrative burden.
Determining Your Best Insurance Options for Addiction Treatment
The truth is that there is no single company that provides the “best” options for coverage, but the larger companies, such as Aetna, Blue Cross Blue Shield, Cigna, UnitedHealth Group and Magellan, will be best equipped to offer the broadest coverage resources. They offer nationwide provider networks and coverage for a wide range of specialty treatment services.
It’s important to realize, however, that each one of these companies has multiple plan tiers that can affect the level and quality of coverage. You can find out precisely what your plan tier covers by contacting your company and speaking to a representative. In the meantime, an overview of each company’s products and coverage options can be found below.
PLEASE NOTE THAT THESE OVERVIEWS ARE MEANT FOR INFORMATIONAL PURPOSES ONLY AND ARE IN NO WAY AN ENDORSEMENT OF ANY SINGLE COMMERCIAL ORGANIZATION OR ENTERPRISE.
Aetna Addiction Treatment Coverage
Aetna covers a wide range of addiction treatment services, such as medically supervised detoxification, inpatient and outpatient behavioral rehab, as well as medication-assisted treatment (MAT) for opioid use disorder. Their Screening, Brief Intervention, and Referral to Treatment (SBRIT) program helps healthcare staff identify those who are battling or are vulnerable to addiction, but have not yet made the commitment to seek treatment. SBRIT is ideal for people who don’t have a diagnosis of substance use disorder but still need help under established clinical criteria. It offers early intervention to mitigate the potential health and lifestyle impact of addiction.
Blue Cross Blue Shield Addiction Treatment Coverage
Blue Cross Blue Shield has one of the most diverse inventories of insurance products, many of which offer different levels of substance use and mental health coverage. The exact scope of coverage depends on plan tier, state of residence, and other variables; however, plans generally cover outpatient therapy, residential rehab, medically supervised withdrawal management, and partial hospitalization programs. They also offer comprehensive and intuitive programs for dual-diagnosis disorder for continuity of care for co-occurring addiction and mental disorders. This includes behavioral therapy that is fully integrated with medical treatment.
Cigna Addiction Treatment Coverage
Cigna provides coverage for all phases of addiction treatment, including comprehensive screening and evaluation and medical detox, as well as inpatient, outpatient, and partial hospitalization rehab. They also provide a broad library of knowledge and support for individuals and families who are affected by substance use. Like other companies of similar size and resources, they offer multiple plan types, which range from Bronze to Gold. Bronze plans offer more limited coverage but lower out-of-pocket costs, while Gold plans provide more options but require a higher premium payment every period. Sticking with in-network providers helps to save costs and avoid time-consuming pre-certification.
UnitedHealth Group Addiction Treatment Coverage
UnitedHealth Group is one of the largest and most expansive providers of health insurance, serving members across all 50 states through dozens of plan types across two companies (United HealthCare and Optum). In addition to coverage for medical detox and all levels of behavioral rehab, they also offer comprehensive education and support for loved ones, as well as a free 24.7 hotline at 1-855-780-5955 for members affected by substance use. Their self-care app also provides helpful mental health resources and support with a library of knowledge and insights, as well as online appointment scheduling capabilities.
Magellan Addiction Treatment Coverage
Magellan focuses exclusively on behavioral health, covering millions of members across the United States. They cover a broad array of treatment services, including inpatient detox and rehab, addiction psychiatry, outpatient services, and more. They also provide comprehensive case management services for members with serious mental illness and help guide patients struggling with dual-diagnosis disorder toward medically appropriate care. Members can also get access to integrated medical and behavioral health services, medication-assisted treatment (MAT), digital cognitive behavioral therapy, and peer-to-peer support resources.
No matter what type of insurance you have, you can use your coverage to reclaim your life from addiction. Talk to a representative from your company to find out what your plan covers.
