Planning ahead can make entering a program for drug or alcohol abuse easier because it gives you more options. A big part of that is finding an insurance company that offers reasonable coverage for treatment programs. The Affordable Care Act requires all insurance policies to essential services like substance abuse, but not all providers offer the same levels of coverage. Aetna is an insurance company that works in most states and may provide New Hampshire residents with a solution.
Aetna Metal Levels
As part of health care reform, insurance companies established metal levels to make shopping for policies easier. First, you pick a metal level that fits your life. Bronze plans tend to carry high deductibles, but have lower monthly payments. They also work very well when partnered with a health savings account. By definition, a bronze healthcare plan will pay around 60 percent of the overall healthcare costs, including coverage for medically managed detox, outpatient individual and group therapy, as well as inpatient treatment.
Silver plans introduce a lower annual deductible, but a higher monthly premium. The lower deductible scenario makes the plan more affordable for those who do not have a health savings account to subsidize their insurance. A silver plan will pay around 70 percent of the policyholder’s total costs for medical and health services.
The gold plans bring with them an even lower deductible, but a higher monthly premium. A gold plan covers more of the total cost of care, usually paying up to 80 percent of each service.
Aetna offers coverage in most areas of New England, but the policies can change from place to place. At the bronze level, there are several choices available. These plans give you the option to go out-of-network for treatment and pay more of the overall costs. With Aetna, that means you will pay 50 percent of the bill for drug or alcohol treatment whether you get outpatient or inpatient care.
If you stay in-network, however; that cost drops. The Aetna Bronze $15 Copay plan, for example, pays 100 percent of the cost for drug treatment after you meet the deductible. The deductible on bronze plans range from $5,750 to $6,850 per individual depending on your policy. Family policies carry a deductible of between $11,500 and $13,700.
With the Aetna Whole Health Bronze plans, you also have the option to use a “non-designated network provider.” This is a provider not listed as out-of-network or in-network. With this plan, you pay $50 for each outpatient session with a in-network or non-designated network provider. The deductible is waived only if you stay in-network. For inpatient care, you pay a $250 copay per admission fee for an in-network facility and $500 per admission for a non-designated network treatment center. The copayment per admission for an in-network facility is $500 per admission.
For some of the New England states, Aetna offers both Copay and Whole Health plans at the silver and gold levels. The Aetna Silver $10 Copay requires a $4,000 annual deductible for individual policies and $8,000 for families if you stay in-network. The deductible goes up to $7,500 and $15,000 if you get care out-of-network. For outpatient care, you can pay just a $50 copayment, however, regardless of your deductible status. If you need inpatient treatment, your portion of the bill changes to 30 percent after you meet the deductible.
As with the bronze level Whole Health plan, you have the option to use a non-designated provider with a silver policy. Whole Health buyers pay $50 for an office visit with the deductible waived for in-network only. For out-of-network, the cost goes up to a 50 percent coinsurance fee after the deductible.
The gold plans follow that same basic structure. The deductible is around $1,400 for individual policies and $2,800 for families. Your contribution changes to a small copayment, around $40 for outpatient treatment and a 20 percent coinsurance fee for inpatient care with a copayment around $40 for outpatient treatment and a 20 percent coinsurance fee for inpatient care.
Finding the right insurance plan is important for everyone. If you need to pay for drug or alcohol treatment, insurance can help you get on your way to a healthy new life. Start your journey today by contacting us at DrugRehab.org.