Can health insurance through AARP help me to pay for drug and alcohol addiction treatment?
AARP doesn’t provide a health insurance program, and the health discounts provided through AARP membership may not help with addiction treatment.
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AARP, the American Association of Retired Persons, has a membership base of over 37 million people.
The organization is an advocate of issues relevant to those who are retired, which, of course, includes healthcare.
AARP offers a wide variety of benefits with membership to the organization, though it does not offer its own healthcare plan. You can, however, get many member discounts as a part of AARP, and the organization will help you by providing information about insurance plans so you can make the right decision on the plan that is right for you.
AARP Health Benefits
The health benefits offered by AARP include:
- Vision discounts, offered by EyeMed
- Hearing care program, offered by HearUSA
- Prescription discounts, offered by Catamaran
As far as health insurance goes, AARP will provide you with many resources about Medicare. If you are insured through Medicare (parts A and B), you are eligible to enroll in what is called a Medicare Advantage Program (part C). A Medicare Advantage Program includes Part A and Part B benefits, plus additional benefits, and it is administered by a private health insurance company. Often, there is no additional premium beyond the Medicare Part B premium. The AARP MedicareComplete Plan is one such Medicare Advantage Program, administered by UnitedHealthcare. As a member of AARP, you have access to this program.
The MedicareComplete Medicare Advantage plans are separated into three types of plans, which are:
- HMO (Health Maintenance Organization) Plans: These plans require that participants receive services from in-network providers. They typically offer lower out-of-pocket costs than PPO and POS plans.
- POS (Point-of-Service) Plans: With these plans, participants can see out-of-network providers for specific services at higher costs. These plans typically involve higher out-of-pocket costs than HMO plans but lower out-of-pocket costs than PPO plans.
- PPO (Preferred Provider Organization) Plans: These plans allow participants to see both in-network and out-of-network providers, though participants pay more to see out-of-network providers. These plans involve the highest out-of-pocket costs among the options.
Alcohol and Drug Treatment by MedicareComplete
For a summary of coverage by the Medicare Advantage program offered by UnitedHealthcare, you can visit UnitedHealthcare’s website. For a summary of coverage involving alcohol and substance abuse, you can view their coverage summary.
When you meet Medicare coverage criteria, UnitedHealthcare will offer coverage for treatment services related to alcohol and substance abuse. Specific services covered include:
- Inpatient hospital detoxification: During the acute phases of withdrawal, medical detox is often required. This is generally for severe addictions to alcohol, benzodiazepines, and opiates; however, the necessity of medical detox is always determined on a case-by-case basis. Often, up to five days of medical detox are covered, with no limit on the number of treatment episodes per year.
- Outpatient detoxification: In some instances, 24-hour medical supervision may not be required for detox. In these cases, detox may occur on an outpatient basis. This is generally applicable for less severe or short-term addictions.
- Chemical aversion therapy: This may be covered if medically necessary. Documentation is required for inpatient stays.
- Narcotic withdrawal treatment: This may be covered if deemed reasonable and necessary. If this type of withdrawal is performed under the personal supervision of the physician, drugs used by the physician are often also covered.
- Inpatient rehabilitation: This benefit is often limited to 190 days in a member’s lifetime, and it is only for services in a psychiatric hospital. Subsequent rehabilitation is considered a readmission and has to meet readmission criteria under Medicare.
- Outpatient alcohol and drug abuse rehabilitation: Outpatient care means that individuals participate in therapy during scheduled times – in either an individual or group setting – but they live at home.
Finding a Treatment Provider with MedicareComplete
On the MedicareComplete website (Medicare plans from UnitedHealthcare), navigate under Our Plans, then choose Medicare Advantage Plans, and then select Resources and Plan Materials. From here, select Search for a provider from the sidebar, and use their tool to find a provider near you that is within MedicareComplete’s network. You will then be prompted to enter your zip code, and you can search for rehabilitation facilities that accept this insurance plan.
While AARP is not an insurance provider, nor affiliated with any specific provider, they can be a good source of information regarding health insurance coverage for older Americans.