HMO Insurance Coverage for Rehab & Addiction Treatment

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  • What is an HMO?
  • How Does It Work?
  • Which Insurance Companies Offer HMO Plans?
  • How is an HMO Different From a PPO?
  • Do HMOs Cover Substance Abuse Treatment?
  • Take Our Substance Abuse Self-Assessment

What is an HMO?

An HMO or Health Maintenance Organization is a medical insurance group that provides services at a fixed fee through a network of doctors and healthcare providers who are under contract. The benefit here s that HMOs come with fixed premiums keeping the cost lower.

How Does It Work?

When you have an HMO plan, you choose a primary care provider (PCP) who manages your overall health, while specialist visits will require a referral from your PCP.

Which Insurance Companies Offer HMO Plans?

Many of the major insurance companies offer their own versions of HMO plans. Some of the most popular companies include Aetna, Anthem, Blue Cross Blue Shield, and Cigna.

How is an HMO Different From a PPO?

The main difference is that with an HMO plan, you are restricted to in-network doctors for coverage to apply. Additionally, you must designate a PCP and be referred to specialists. With a PPO on the other hand, you have much more flexibility in that you can go to any doctor or provider without the need for a referral.

Do HMOs Cover Substance Abuse Treatment?

Coverage for substance abuse services will depend on the level of treatment needed and your insurance plan. Call us today at to learn more or fill in our insurance verification form to see if insurance may be able to cover all or part of the cost of rehab.

Insurance may typically cover at least part of the cost of:

Take Our Substance Abuse Self-Assessment

If you’re still unsure about treatment, take our free, 5-minute substance abuse self-assessment below if you think you or someone you love might be struggling with substance abuse. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result.

Last Updated on May 25, 2021
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