Conveniently located on Seacrest Blvd. in Boynton Beach, Recreate Life Counseling offers a three-step admissions process and instant insurance verification.
This guide walks you through our admissions process, accepted insurances, and how insurance plans work for addiction treatment.
The Admission Process at a Glance
Each rehab center has its own admission protocols. At Recreate Life Counseling, we wanted to simplify things as much as possible and make it easier for people to begin their recovery journeys.
So, we came up with this simplified admissions process:
- Confidential Evaluation
- Insurance Verification
- Intake Assessment
In these three steps, our addiction treatment specialists outline your clinical needs, figure out if our programs are a good fit for you, check your insurance benefits, and prepare you for admission.
The assessment also helps clinicians better understand your substance use issue and whether there’s a mental health condition feeding into the cycle of addiction. If that’s the case, they incorporate the right therapeutic interventions into the dual diagnosis treatment plan.
How Insurance Works for Addiction Treatment
Both mental health treatment and substance abuse treatment are considered essential benefits. This means that insurance companies have to cover them, at least in part.
Let’s check how that works:
Common Plan Types and Coverage Levels
Not all marketplace plans are created equal. Some are more restrictive than others.
One common option is the Health Maintenance Organization (HMO) plan. This plan limits coverage to care from facilities contracted with the organization. Services from out-of-network doctors and facilities are covered only if it’s an emergency.
Exclusive Provider Organization (EPO) plans also limit their coverage to facilities in the plan’s selected network.
That said, there’s also the Preferred Provider Organization (PPO) plan type. On these plans, you pay less if you enter in-network rehab centers. Still, it’s possible to seek treatment elsewhere if you’re willing to pay extra.
Point-of-Service (POS) plans, too, allow out-of-network treatment. However, they do require policyholders to get a referral before seeing a specialist.
| HMO | PPO | EPO | POS | |
| Referral | Required | Not required | Not required | Required |
| Facility Options | In-network only | Out-of-network allowed | In-network only | Out-of-network allowed |
| Network Size | Small | Large | Small | Large |
Services Covered by Insurance Providers
Most major insurance companies cover rehab programs, including inpatient or residential treatment. Note that residential programs are usually at the top of the price range. They offer, after all, a high level of care.
Notably, the U.S. Centers for Medicare & Medicaid Services mandates that all plans cover counseling and psychotherapy (group and individual therapy).
Insurance providers can also help with the medication-assisted treatment (MAT) program if it’s deemed a medical necessity for the patient.
But, of course, there are lots of other healthcare services offered within the program. And it’s normal to wonder which is going to be paid for by insurance and which is on you to cover.
Some of the aspects that may be covered by the plans are:
- Medical detox
- Prescribed medications
- Meals
On the other hand, private rooms, gourmet food, extra amenities (think TV in your room), recreational programs, and personal items (socks, toothpaste, etc.) are usually not covered.
It’s also critical to point out that your recovery needs don’t end just because your 30 or 60 days of rehab are up. Aftercare is essential in preventing relapses, especially in the first few months as you transition from the safety of the treatment center and back to normal life.
So, you’ll also want to check whether your insurance provider will cover the services included in your aftercare plan.
Sober living accommodations, for instance, aren’t covered under most plans. You may have to pay your way as you go. And halfway houses are often state-sponsored, but the stay duration can be limited.
Teletherapy, however, is covered by many plans. That’s why it can be a reliable yet flexible post-discharge treatment option.
Expenses You May Have to Cover
Depending on the plan specifics, your insurance policy may not even kick in until you pay a certain amount out of pocket in a single year, which is your deductible.
After meeting your deductible, you may still have to cover copays or coinsurance.
A copay is the flat fee you’re required to pay to receive covered medical services. Coinsurance is also paid by you, the policyholder, once you’ve met your deductible. However, it’s a set percentage of the service cost, rather than a flat rate.
The good news is that spending limits are not allowed by the U.S. Centers for Medicare & Medicaid Services. Marketplace plans can’t enforce yearly or lifetime dollar limits on substance use disorder treatment since they’re essential services.
Providers can, however, set limits for the number of rehab days or therapy sessions covered by their healthcare plans.
Payment Processing
So how do you pay the out-of-pocket costs? You can always make the payment online for more flexibility and convenience. Just make sure your treatment center is using secure payment forms.
At Recreate Life Counseling, we maintain LegitScript certification, which reflects our dedication to ethical practices and trustworthy payment processing.
How to Verify Your Insurance Before Admission
Now that you know the basics of insurance coverage for rehab, you may be wondering about the nuances of your own plan.
Here are two ways to find out the details:
Option #1: Inquiring on Your Own
You can always get in touch with your insurance provider to inquire about your behavioral health benefits. Just note that the interaction can feel overwhelming and frustrating at times.
Some tips to help guide your call are:
- Do prior research into the nearby facilities and treatment options so you can ask about them specifically.
- Prepare all your personal information (member ID, group number, plan name, etc.).
- Take detailed notes during the call.
- If you’re told a service isn’t covered, don’t be afraid to ask for more details. Ask what documentation is needed for an approval or what your alternatives are, for instance.
- Be assertive but not aggressive. The person on the other end of the line is just doing their job.
Option #2: Letting the Admissions Team Handle It
Instead of having to figure out your insurance benefits yourself, you can leave it to the staff at the rehab facility.
Our admissions specialists can communicate with providers on your behalf. Then, they come back to you with a detailed overview of your coverage level and expected out-of-pocket expenses. And they’ll do all that at no extra cost to you.
All you need to do is fill out a confidential insurance verification form and wait for one of our friendly specialists to contact you.
Insurances Accepted at Recreate Life Counseling
Our treatment programs and services are covered by most major health insurance companies.
You can contact us to find out if your provider is accepted, but here’s a list of some of the insurances we accept at Recreate Life Counseling:
- Medical Mutual
- Horizon
- Meritain Health
- Humana
- Magellan Health
- CoreSource
- Cigna
- Blue Cross Blue Shield
- Beacon
- Anthem Blue Cross
- Empire Blue Cross Blue Shield
- Aetna
- G.E.H.A.
- Tricare
Not Covered? Seeking Treatment Without Insurance
Insurance definitely helps with the financial burden. But that doesn’t mean you can get admitted and receive treatment without it. Between sliding-scale fees and state-funded programs, there are other routes to pursue.
Let’s take a closer look.
Medicare
If you’re 65 (or turning 65 soon), you might be eligible for FHCP Medicare.
Contact your local Social Security Administration (SSA) office to learn more about your Medicare benefits. To find the nearest office, search for locations near Boynton Beach on the SSA’s locator tool.
Medicaid
The federal- and state-funded program Medicaid can be a valid option for low-income people suffering from substance use disorders.
Note that even MATs like methadone can be covered by Medicaid benefits. The Florida Department of Children and Families lists the licensed providers and their accepted payment methods.
Payment Plans
If you’ll end up paying for treatment yourself, ask about the center’s financing options.
You might be able to arrange a plan with the facility itself. This way, you can make small monthly payments over a certain period of time rather than paying a lump sum.
It’s also possible to settle on a post-treatment plan, so that you only start paying as you build your life up and regain control of your finances.
Sliding-Scale Fees
Some treatment facilities adjust the fees based on the patient’s income, giving them a quote that they can realistically work with.
Take the First Step Towards a Healthier Life Today
Entering rehab can be daunting. Everything from choosing a facility to sorting your financial situation out and packing your bags can feel like too much effort.
But it’s an effort that will pay off in the long run. Simply making that first call will take you one step closer to sobriety.
Our admissions team is here to make this step easier any way they can.
Whether you want to verify your insurance, ask about financing options, schedule a tour of our facility, or get help with the admission logistics, don’t hesitate to pick up the phone and give us a call.
