Does Beacon Health Options Insurance Cover Rehab for Drugs and Alcohol?

Does Beacon Health Options Insurance Cover Rehab for Drugs and Alcohol?

Beacon Health Options provides treatment coverage for behavioral health and substance use disorders (SUDs). 

The company is a blend of Beacon Health Strategies and ValueOptions. It offers insurance to more than 50 million customers. Many of them are part of the more than 350 corporate clients Beacon services.

Beacon Health Options specializes in mental health coverage, which includes substance use disorder (SUD) management. These services use hands-on therapeutic approaches to help people manage SUDs and mental health disorders. 

Some health insurance providers also coordinate with Beacon to provide additional coverage for treatment.

Keep in mind: Coverage for mental health care and substance abuse management varies by plan and state. 

Types of Addictions Beacon Covers

Beacon rehab offers coverage for a variety of addictions, including:

• Alcohol
• Prescription opioids
• Heroin and other non-prescription opioids
• Cocaine
• Methamphetamine
• Marijuana
• Benzodiazepines, such as Xanax and Valium

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Rehab Options Beacon Covers 

Beacon covers several short- and long-term rehab options, including:

Medical Detox

Medical detox offers constant medical supervision and pharmaceutical assistance during the drug or alcohol detoxification process.

The detox phase of recovery can be dangerous, especially if/when withdrawal occurs. Sometimes detox is life-threatening. Around-the-clock medical care ensures safe detox with fewer side effects and lower risk of relapse. 

Inpatient Treatment

Inpatient treatment allows patients to spend all of their time focused on recovery.

Participants live on-site at the rehab facility. They have constant access to medical supervision and support. 

Inpatient treatment includes:

• Medically supervised detox
• Nutritional support
• Individual therapy
• Group therapy
• 12-step meetings
• Recreation
• Relapse prevention
• Support for family members

Beacon Health Options covers most inpatient services. Exact coverage varies, and providers must be in-network unless there’s an emergency or extenuating circumstance. There are usually co-pays and deductibles.

Beacon rehab typically provides coverage for:

• Screening and assessments
• Medical exams
• Medical treatment
• Detox
• Inpatient stays
• Addiction medications
• Psychiatric evaluation and therapy
• Family counseling and support

Outpatient Treatment 

Outpatient programs offer addiction treatment with varying degrees of intensity. They commit to treatment for part or all of some days of the week. Some outpatient programs meet 2 to 3 times per week, others meet every day.

Beacon rehab covers a wide range of outpatient treatment options, primarily from in-network providers. Services might be covered in part or in full, depending on the specific plan. Co-pays and deductibles apply. 

Many people opt for outpatient treatment because it’s less expensive than inpatient treatment. However, for severe cases of addiction, inpatient treatment is the safest option. 

Intensive Outpatient Programs (IOPs)

Intensive outpatient programs (IOPs) offer outpatient treatment with much of the intensity of inpatient programs.

Participants can continue attending work or school while also getting the treatment they need. They receive ongoing medical, psychiatric, and peer support without a restrictive environment for several hours during the day. 

These programs are more suited for participants with stable home environments. They can reintegrate into their homes in the evenings, while receiving intensive treatment during the day.

Partial Hospitalization Programs (PHPs)

Partial hospitalization programs (PHPs) meet several days a week. These programs are similar to inpatient programs, but participants leave at the end of the day and live off-site.

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Other Rehab Services Beacon Covers 

Beacon rehab specializes in mental health and addiction treatment coverage. This includes short- and long-term rehab programs. 

Beacon also covers the following (in part or in full):

• Medical assessments
• Detox
• Medications and medication-assisted treatment (MAT)
• Therapy
• Cost of inpatient stay
• Treatment for co-occurring or dual diagnosis treatment

Speak to a Beacon representative, or someone at the treatment facility of your choice, for more information about your coverage. Options vary based on someone’s treatment plan and include short-term rehabilitation and long-term relapse services. 

How to Check Your Coverage

Coverage varies from plan to plan. Each plan has different limitations.

To check your coverage, contact a Beacon healthcare provider directly. They can explain your policy and help you understand your coverage, as well as whether you’ll have any out-of-pocket expenses.

You can reach a Beacon representative at (866) 929-7368.

If you have a specific treatment facility in mind, they will help you sort through your coverage and payment obligations.

Many Beacon rehabilitation plans have deductibles, copays, coinsurance, or a combination of these.

What is a deductible?

A deductible is the amount someone must pay for covered services before the insurance provider begins to pay any expenses.

For example, if your treatment costs $5,000 and you have a $500 deductible, you’ll pay the first $500. Beacon will then cover the remaining $4,500 owed to the treatment facility.

What is a co-pay?

A co-pay is a set amount a customer pays for a covered service before and after they’ve met the deductible.

For example, you might pay $20 out-of-pocket when you visit the doctor. Beacon rehabilitation then covers the remaining amount of care once you meet any deductible obligations.

What is coinsurance?

Coinsurance is the percentage of a covered service you pay before and after you’ve met your deductible.

For example, if your coinsurance is 10%, you’ll pay 10% of the cost of all medical care, as well as your deductible and co-pay.

In addition to understanding your out-of-pocket payments, it’s important to determine if you need pre-authorization for care. In some cases, you’ll need to have Beacon approve a service and/or service provider to guarantee care coverage.

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Paying for Uncovered Rehab Costs 

Despite the coverage Beacon rehabilitation provides to its customers, some people struggle to afford the cost of rehab. Unfortunately, some people neglect treatment or choose an inadequate treatment program due to cost.

There are payment options available for the uninsured or underinsured.

Both state and federal government programs, including Medicare, Medicaid, and the Affordable Health Care Act all help people in need of addiction treatment get the care they need.

Additionally, private lenders offer financing options. Some rehab facilities also offer flexible payment options and/or accept credit card payments.

Remember: Short-term rehabilitation might be more affordable than long-term and/or residential options. Long-term care that includes living expenses might not be an option. But this doesn’t mean you shouldn’t seek treatment altogether. Plenty of options are available. 

Immediate costs of addiction treatment are often far less than the long-term expense of not treating an addiction. 

People who continue in their substance use disorders usually have far worse financial issues than those in recovery programs, with individual costs included. 

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