What Type of Rehab Coverage Does CareFirst Offer?
CareFirst Inpatient and Outpatient Coverages
CareFirst will cover the following services for outpatient care:
- Diagnosis and treatment of substance abuse. This covers detox and rehab services as an outpatient.
- Partial Hospitalization Programs (PHP)
- Office visits for medication management. This covers physician visits that are related to your rehab.
- Methadone Maintenance Treatment: Methadone is a long-term treatment for opioid addiction. Carefirst covers the entire duration.
- Diagnosis and Treatment of Behavioral and Emotional Disorders
The following are what Carefirst will cover for inpatient programs:
- All rehab-related hospital benefits, both medical and non-medical.
- Physician visits, intensive care and consultation services.
- Inpatient Detoxification Programs
- Rehabilitation services in acute hospitals
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Inpatient services are only covered if the patient is in a CareFirst-approved facility. Members must also meet the criteria for acceptance and participations for the facilities.
Addiction is a slippery slope. One moment, you’re enjoying your nightly glass of whiskey, the next, you can’t sleep without three glasses of it. It gets worse because before you know it, you’re not just hurting yourself, but the people close to you.
Most people who are in similar situations don’t want to seek help because it’s “expensive”. The responsibilities they’ll face after treatment may become a trigger to relapse. After the launch of the Affordable Care Act, addiction treatment is now within financial reach. CareFirst provides coverage and helps for your rehabilitation needs.
Before you contact Carefirst, it’s best to speak to your physician first. Confirm what kind of treatment or therapy will be best for you. When you have your recommendation, you can then consult with CareFirst. In this way, you can determine their coverage and the facilities and services they can recommend.
Carefirst drug rehabilitation coverage can assist patients with their treatments, both for inpatient and outpatient services. Coverage will depend on the patient’s insurance plan.
Duration of Coverage
CareFirst will cover the total duration of your treatment. It can be as short as 28 days to as long as 90 days, depending on your physician’s advice. For extensions, you need your doctor’s recommendation and CareFirst’s approval.
Inpatient vs Outpatient:Which One Should I Use?
Your program will depend on the severity of your condition. Outpatient care for detox and rehab are best suited for patients with moderate issues. Mostly, outpatient programs require you to attend group meeting and 2-3 hour treatments.
On the other hand, inpatient programs require long term stays often lasting for 3 months or longer. Inpatient programs require you to stay in rehabilitation centers. Plus, some centers offer luxury or executive programs. Check with CareFirst if your plan will cover these extra amenities.
Levels of Coverage
CareFirst’s amount of coverage will vary depending on the member’s Metal Level. While the exact costs will vary, the levels and covered prices are as follows:
- Bronze: The company will pay 60% of the total cost and you’ll pay 40%
- Silver: The company will pay 70% of the total cost and you’ll pay 30%
- Gold: The company will pay 80% of the total cost and you’ll pay 20%
- Platinum:(Washington, D.C. only) The company will pay 90% of the total cost and you’ll pay 10%
With addiction care within reach, it’s now possible to get the help you need. The ultimate goal is to prevent relapse and pursue a sober, healthier lifestyle so it’s never too late to start. For you who have loved ones in rehab, make sure you show your support. The smallest things have the biggest effects effects.
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