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AvMed Health Insurance Coverage for Addiction Treatment

Using AvMed Health Insurance Coverage to pay for addiction treatment: Many drug and alcohol treatment centers accept AvMed insurance. Depending on your plan and the treatment provider that you choose will determine what AvMed will cover. With so many addiction rehab centers that accept AvMed insurance, it is best to know exactly what your coverage will pay before deciding which program to choose for your recovery. Some rehabs we work with are in-network with many providers including AvMed, which means that your treatment may be fully covered or partially covered depending on your insurance plan. You can also call us to find out if there are any drug rehab centers nearby that take AvMed Insurance. Most insurance plans will cover drug and alcohol rehab treatment programs. If you would like to find out more about drug rehab programs near you, give us a call and we can get your insurance verified today. 

1-800-513-5423


What you will learn:

  • About AvMed Insurance Group
  • Does AvMed pay for alcohol and drug rehab center programs?
  • Types of substance abuse treatment programs that AvMed typically covers
  • Types of Addition covered by AvMed
  • Will my employer find out that I went to treatment?
  • Out-of-Network costs
  • How to cover deductibles for insurance

About AvMed Insurance Group

The AvMed insurance group started in 1969 as an aviation medicine company, a prepaid health care system. AvMed has grown over the last 50 years to become one of the oldest not-for-profit healthcare plans. AvMed is one of Florida’s largest not-for-profit health plans providing Medicare Advantage plans and coverage in many counties throughout Florida. Individual and family coverage is available in Miami Dade, Boward, Palm Beach, and Alachua counties. Coverage for employers is available in most counties in the state of Florida.

Does AvMed pay for alcohol and drug rehab center programs?

AvMed will cover drug and alcohol rehab center programs. AvMed is in-network with many programs through its partnered rehab center programs. To check your eligibility and coverage amounts give us a call and one of our insurance verification specialists will help you determine if your specific policy is in-network with one of our preferred providers. Our addiction specialists can verify that your specific insurance plan is in-network with the program you want to go to. Once we verify your insurance, we will be able to tell you how much out-of-pocket costs, if any, you are responsible for. You can also call the number on the back of your insurance card to verify what your benefits are and get a list of treatment programs that are in-network with AvMed. Avmed also has a portal that will give you a good idea of services offered and a provider list for you to choose from.

Types of substance abuse treatment programs that AvMed typically covers



Detox and medication-assisted treatment: Detoxification programs are the first step in the recovery process for many people who are entering rehab for addiction. AvMed will cover part, or all of your detox stay depending on the provider, type of drugs detoxing from, and co-payment of your policy. You may need to get a doctor’s approval before being covered just to make sure that it is necessary and medically needed to ensure your safety.


Medication-Assisted Treatment Programs (MAT): AvMed uses ASAM criteria to determine which services are medically necessary including  MAT  services. Mat is approved by the (FDA) food and drug administration and is used in conjunction with counseling and therapy to help address the underlying issues that have led to addiction in the first place.


Residential and inpatient rehab centers: AvMed covers Inpatient treatment centers. Inpatient treatment programs offer a safe place to stay with 24-hour supervision while you undergo therapy at their center. These programs can last from 2 weeks and up to a year depending on your chosen program. AvMed may limit the number of days you can receive treatment for addiction by calendar year.


PHP Treatment Programs:
Partial hospitalization programs (PHP) offer treatment for those who do not want to commit to a residential treatment program. Usually, treatment at a PHP program will consist of treatment several times a week during the day or several times a day. This type of program emulates residential treatment programs with being able to go home or to a sober living house during the treatment process.


Outpatient treatment programs: Outpatient services can vary in frequency and intensity depending on the program you have chosen. AvMed will cover outpatient treatment programs through their network of providers with treatment consisting of a few times a week or less.


Intensive outpatient treatment programs: Intensive outpatient usually consists of therapy and activities a few times a week for a few hours at a time. This type of program offers support and treatment for those who do not want to enter a residential program for their addiction. Some people who enroll in intensive outpatient treatment may choose to also enter a sober living house to offer additional support.

Types of Addition covered by AvMed

AvMed will cover other addictive substances including opioids and other prescription medication in misuse. Many treatment centers are in-network with AvMed insurance group and choosing the best program for your specific needs is the most important first step in the recovery process. No two people who enter treatment are the same, which is why there are different approaches used in the treatment of addictions. Addictions covered by AvMed include most types of drugs and alcohol that can be habit-forming including:

Will my employer find out that I went to treatment?

The treatment center you choose is not allowed to divulge any patient information to anyone including family members or your employer that you are seeking or entering a treatment facility. Your rehab center must comply with HIPAA laws that prohibit any information regarding a patient from being shared with anyone outside the facility unless you sign a waiver releasing that information with few exceptions. Providers safeguard your information and go to great lengths to safeguard your Protected health information (PHI). Exceptions for the release of information could include: if you need emergency services and need to see another health care provider or court order. Other circumstances that would obligate a provider to reveal your PHI are rare but do happen, if this happens your provider will explain in detail to you why they need to release your PHI, these instances never include your employer.

Out-of-Network costs

AvMed insurance may cover the program that you have chosen but there will usually be a larger co-insurance payment, deductible, and or co-payments. Staying in-network is usually the best option for someone who would like to save money on their inpatient rehab center program. Out-of-network programs do not have a contract with AvMed insurance like in-network programs do. In-network providers have negotiated a set price and number of days that insurance through Avmed will cover. This lowers the out-of-pocket costs and in turn, saves you money.

How to cover deductibles for insurance

Coming up with co-pays, deductibles, or co-insurance payments is something that not many of us have thought about before. This can be a huge deterrent for those seeking treatment for addictions but do not worry there are programs that can help you cover the costs. Some programs have scholarships to help, third-party lending with low-interest rates, and some will even work with AvMed to negotiate a rate that you can afford. Do not let the lack of money be the only barrier to getting the help you need as you have options that you may not have thought about.

If you would like to see if any of the programs we work with are in-network with AvMed call to speak with a counselor 24 hours a day, 7 days a week. We can verify your insurance quickly to let you know if we are in-network with your insurance provider.

1-800-513-5423




Sources

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HIPAA Privacy Rules

Medications, Counseling, and Related Conditions

Erik Epp – Content Author
Summary
AvMed Health Insurance Coverage for Addiction Treatment
Service Type
AvMed Health Insurance Coverage for Addiction Treatment
Area
Nationwide
Description
There are many drug and alcohol treatment centers that accept AvMed insurance. Depending on your plan and the treatment provider that you choose will determine what AvMed will cover. With so many addiction rehab centers that accept AvMed insurance, it is best to know exactly what your coverage will pay before deciding which program to choose for your recovery.

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