AvMed insurance covers substance abuse and mental health treatment, though the amount and type of coverage will vary from one plan to another. If you have AvMed health insurance and you need drug rehab, confirm your benefits and learn more about payment options with American Addiction Centers.
Inpatient/residential occurs in settings where you stay overnight for periods of a few days to several months.
Most health insurance plans, including AvMed, cover substance abuse treatment. However, the types of treatment covered and the level of coverage will depend on your plan. Forms of rehab that may be covered include:
After reading these descriptions, you may be wondering which type of program is the best fit for you. Some of the factors used to determine the right rehab setting for someone include:2
Abruptly quitting some substances, such as alcohol or benzodiazepines, can trigger seizures during withdrawal.3 Often, if you have been using these substances for a few months or more, you will need medical management of your withdrawal before you begin treatment. A medical detox can be conducted in an inpatient program or a freestanding detox center. After detox, it is recommended that you transition into a formal treatment program.
Many rehab programs treat all types of substance addiction, and AvMed plans typically cover the full range, including addictions to:
AvMed coverage varies from one plan to another; however, AvMed plans with rehab coverage often cover the standard services of treatment, which include:
Your treatment center is not allowed to inform someone outside the facility that you are a patient.
Your treatment center is not allowed to inform someone outside the facility that you are a patient. The confidentiality of your health information is protected by law. As a result, providers go to great lengths to guard what is known as your your PHI, or protected health information. Your PHI includes information such as physical or mental health conditions you may have, healthcare services provided to you, and payment for healthcare services.
There are only a few exceptions when a provider can reveal your information, such as providing information to another healthcare provider if you need emergency treatment or if the information is ordered by a court. There are a few other circumstances that compel your treatment provider to reveal your PHI, which they can explain to you in depth, but those circumstances are rare and would not involve your employer.
Consequently, you can seek drug rehab without being concerned that your employer will discover that you are receiving substance abuse treatment.
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Many insurance policies encourage you to see in-network providers. In-network providers typically have negotiated prices for services and benefits for plan members. Your out-of-pocket costs may be higher if you see an out-of-network provider than if you see an in-network provider.4
For many drug rehab programs, you will also have to get preauthorization from AvMed, where they will make a determination about whether your care is medically necessary.8 Preauthorization may or may not be required for outpatient services. In some cases, you will need to get preauthorization within 48 hours of admission, but in other cases, it may be required before you are admitted.
This process may sound difficult and confusing, but one of our admissions navigators can help you understand your specific benefits and what to expect in terms of your out-of-pocket costs and the steps necessary to begin treatment.
American Addiction Centers can verify your AvMed insurance benefits and let you know what may be covered. After determining your benefits, we can then help you find the right treatment provider for your specific needs. Rest assured that your call is confidential and there will be no pressure put on you. You can call us today at 888-825-1364 to speak to an admissions navigator, use the chat feature on our site, or check your benefits using the form on this page.