Oregon residents in need of drug or alcohol rehab should look closely at their insurance options. Health insurance can help shoulder the financial burden of substance abuse treatment, so you can focus on getting healthy. In Oregon, there are many good choices for health insurance, but one of the better ones may be Aetna. In this state, Aetna works under an affiliate name to provide people with comprehensive insurance options that include coverage for essential services like substance abuse treatment.
Aetna offers a diverse health insurance portfolio working under the Coventry Health brand Altius. Like all insurance companies involved in health care reform, Aetna uses metal levels to structure their programs. Purchasing a bronze level plan allows you to pay just 40 percent of your overall health care expenses in a year. Bronze plans come with high deductibles, but lower monthly premiums, making them a practical choice for individuals with access to a health savings account.
Silver plans, on the other hand, offer lower deductibles, but you can expect to pay more each month for care. The insured contribution at the silver level is around 30 percent for overall health care. For gold plan buyers, that deductible drops even more, but the premiums go up higher. With a gold policy, you pay only around 20 percent of your annual health care.
Most Aetna plans in this region may fall under one of the Altius labels like Peak Preference. The coverage offered will depend on the policy you purchase and the metal level. For bronze plans, they provide both HMO and POS programs. With an HMO policy, you are expected to stay in-network for all services including substance abuse detox and treatment. A POS plan may offer more flexibility, but you pay less if you stay in-network.
The bronze plans have an average deductible ranging from $5,500 to $6,850. At least some of the plans are only available to those with a health savings account.
What the company pays towards drug treatment varies greatly by the plan. For example, Coventry: Bronze $35 Copay Peak Preference PD, Coventry is an affiliate of Aetna, allows you to make a $75 copay for outpatient care and a $250 copay for residential, or inpatient, treatment. However, the Coventry: Bronze HSA Eligible Peak Preference PD uses the coinsurance model, meaning you pay a percentage after you meet the deductible. For this plan, it’s 30 percent for both inpatient and outpatient care.
With the HMO plans, you do have the option to choose a non-designated-network provider, as well. This would be a facility that is not labeled either in or out-of-network. That may affect how much you pay towards your care.
Opting for a silver level plan will bring the deductible down to around $3,500 for individuals and $7,000 for families. The total may vary by policy, though. With POS plans at any level, you have the option to go out-of-network for care. The Coventry Silver $10 Copay PD policy will pay 50 percent of the cost of drug treatment after the deductible if you go out-of-network.
Staying in-network allows you to make a copayment instead. For outpatient treatment, it is $75 per visit. For inpatient service, you pay $500 per admission and then a 30 percent coinsurance fee after you meet the deductible.
Gold plans have a similar set-up, but the deductible drops to just $1,400 for individuals and $2,800 for families. Like the lower metal levels, the gold plans include at least one HMO and one POS program, so you have choices. The Coventry: Gold $5 Copay Peak Preference PD comes with a deductible of $1,000 for individuals and $2,000 for families.
The treatment options are different at this level, as well. With the Gold Copay plan, you make a $40 copay for outpatient care regardless of your deductible status. For inpatient service, your contribution is 20 percent after you meet the deductible. This is true for the Gold POS plans, too, but you have the option to go out-of-network and pay half the bill.
Finding the right health insurance provider is tricky. Aetna is one company that works with most states in some way, so this is a practical place to start. To start your road to addiction recovery, contact us today at DrugRehab.org.