Providence Health Insurance Coverage for Drug and Alcohol Rehab Treatment

Does Providence Health Insurance Cover Drug or Alcohol Rehab?

Most insurance plans offer some form of drug and alcohol rehab coverage to their members. For members who have a Providence Health insurance plan, addiction treatment may be completely free or require minimal out-of-pocket payments. However, insurance coverage varies from plan to plan and state to state. To find out whether you qualify for addiction treatment coverage through your Providence Health plan, call the phone number on the back of your insurance card to speak with a representative and find out more about your particular benefits.

Checking Your Insurance Benefits

If you’d like to check your insurance coverage or benefits, you can call the telephone number on the back of your insurance card. This allows you to speak to a customer service agent who can answer questions. You can also use myProvidence to access your health plan benefits information.

Providence Medicare Advantage Plans offer specific benefits for retirees and others meeting specific criteria.⁶ To qualify for Providence Medicare Advantage Plans, you must be a U.S. citizen or permanent legal resident for a minimum of 5 years and be 65 or older. Once you turn 65, if you receive Social Security or a Railroad Retirement Pension, you automatically become enrolled in original Medicare and can apply for a Providence Medicare Advantage Plan.

This allows you to access more services for a lower cost and from a wider range of providers than you would be able to with original Medicare. This type of plan makes it easier to seek treatment for addiction.

Does Providence Health Cover Addiction Treatment?

Providence Health does cover addiction treatment at similar levels as treatment for other health conditions. In emergency situations, care will be provided. For non-emergency situations, prior authorization may be required before treatment can be received, depending on the circumstances and your coverage.⁷

As part of its substance abuse treatment, Providence Health provides a spectrum of care, including:^8,9

• Detoxification. The initial step for individuals with a chemical dependency, detoxification is typically conducted in a medically managed setting with 24-hour medical supervision, where doctors may prescribe medications as needed to ensure safety and comfort while an individual’s body clears itself of drugs and alcohol. It can be dangerous or life-threatening to withdraw from some substances without medical supervision.
• Inpatient treatment. Individuals learn to manage their substance use at inpatient or residential rehab centers, where medication, individual and group counseling, education, and therapies such as cognitive behavioral therapy (CBT) can be supported 24/7 by a staff of medical and behavioral health specialists.
• Intensive outpatient. Outpatient coverage looks similar—if not identical—in terms of services, therapies, and treatment to inpatient care, but individuals return home, to sober living, or other housing situation each day.
• Medications. Certain medications—as part of a treatment plan that includes counseling, therapy, and drug testing—that aid in an individual’s recovery may be covered, including methadone, buprenorphine, naltrexone, naloxone, acamprosate, and disulfiram.¹⁰

Since benefits range by location, it can be confusing to understand what is covered and where your insurance is accepted. You can call the number on your insurance card, or got to myProvidence to check your benefit coverage and find approved providers.

Providence Health has been a pioneering force in the West for over a century. They offer a range of plans and levels of coverage, which are available individually, commercially, or through Medicaid or Medicare. You can easily check your plan benefits by telephone or through a secured website. Addiction treatment is covered, although coverage may vary. Checking what is covered can set your mind at ease and allow you to concentrate on recovering from addiction and learning to live without substances.

Verify Your Insurance

Please note: While American Addiction Centers (AAC) aims to provide the most accurate and up-to-date information on each carrier’s addiction insurance coverage, policy changes, and errors do occur. Please double check with your insurance provider directly to confirm your coverage levels. AAC is not affiliated with or endorsed by Providence Health Insurance or any of its licensees.