Admitting you need help is the first step toward recovery. The next step is determining where to find affordable and compassionate care. At the United Recovery Project, our team is dedicated to helping individuals overcome substance abuse. However, you may wonder about the costs involved, which are important to know before you enter rehab.

The United Recovery Project is proud to partner with various insurance companies, including NYSHIP. With NYSHIP (New York State Health Insurance Program), many plans cover partial or total costs of rehab treatment. So, what should you know about NYSHIP rehab coverage? Below, we take a closer look at NYSHIP insurance coverage for rehab and how the United Recovery Project can help you navigate this process.

NYSHIP Insurance Coverage for Rehab Treatment - United Recovery Project
Source: www.cs.ny.gov
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Overview of NYSHIP Insurance for Addiction Treatment

NYSHIP provides various coverage for mental health and addiction treatments. With the Affordable Care Act (ACA), insurance companies are required to offer coverage for both mental health and addiction, similar to other health conditions. However, your specific plan with NYSHIP determines exactly what is covered. You may be responsible for some costs depending on your policy.

Types of Rehab Services Covered by NYSHIP

Generally, coverage with NYSHIP may include:

  • Detoxification programs: Detoxification is a necessary component of addiction treatment. This involves monitoring and supervision by healthcare professionals to ensure safe withdrawal from the abused substance. As such, it’s frequently considered medically necessary and is often covered by most insurance plans.
  • Inpatient programs: Inpatient programs mean you spend time in a facility or hospital for your rehab treatment. NYSHIP may cover total or partial costs for these programs, depending on their duration and services.
  • Outpatient programs: These programs, such as PHP and IOP, are similar to inpatient programs but allow you to attend rehab while living in your own home. This often includes multiple mulit-hour sessions per week.
  • Aftercare: Coverage for continued therapy, support groups, and additional rehab treatment sessions may depend on your specific plan. Verifying your insurance can help determine if this is available to you and at what cost.

With any medical treatment, it’s important to understand what your specific plan covers. We discuss more about this below.

Eligibility and Pre-Authorization

Pre-authorization involves your insurance reviewing and authorizing treatments with the use of your plan. Often, this means they evaluate the medical necessity of treatment, as well as what your plan includes. This step is essential to do before committing to a rehab treatment program, since it ensures you know the expected costs and coverage upfront.

For pre-authorization, you’ll need to verify your insurance coverage with NYSHIP. This means calling the number on the back of your insurance card. If this feels like a lot, the United Recovery Project is here to help. We can help verify your coverage and guide you on the next steps.

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Using NYSHIP Insurance at United Recovery Project

At the Unitred Recovery Project, we work with most major health insurance plans and providers to ensure accessible and affordable addiction treatment. We accept NYSHIP insurance, and can help you navigate and verify your plan. In turn, we can make sure you use all available options to alleviate any financial burden.

Out-of-Pocket Costs and Limitations

Keep in mind that having insurance could still be attached to potential expenses. For instance, copays, deductibles, and uncovered services must be paid out-of-pocket.

Deductibles refer to the amount you must before before your insurance kicks in. For instance, if your plan’s deductible is $2000, then you must pay this amount (within one year) before your insurance will begin to pay for anything. Meanwhile, copays are fixed amounts you pay for certain healthcare services; these continue to be paid even once you’ve met your deductible.

Certain plans may also include coinsurance. This is a percentage of medical costs that you pay after meeting your deductible. For example, your insurance may cover 80% of costs after your deductible, meaning you still need to pay 20%. Understanding all of the above is important for your financial planning and budgeting.

Steps to Verify NYSHIP Insurance Coverage for Rehab

NYSHIP insurance coverage can be verified by calling the number on your insurance card. Their customer service can help you understand what you plan involves, including your deductible, services covered, coinsurance, and copays.

At the United Recovery Project, we understand that insurance and finances isn’t everyone’s strength. We also understand how overwhelming this process can feel. This is why our team offers help in verifying your insurance with NYSHIP. Together, we can ensure you get the most out of your plan, paving your way toward the most affordable care.

Conclusion

With NYSHIP insurance addiction treatment coverage, you can significantly reduce your costs and alleviate any financial burden. From detoxification to inpatient and outpatient addiction treatment, your exact coverage will depend on you specific plan. The United Recovery Project is here to help you determine the next best step. Together, we can verify your insurance and help you understand your specific policy. Call us at 888-960-5121 for more information.

References

https://www.cs.ny.gov/employee-benefits/login/

Popular In-network Insurances at United Recovery Project:

Aetna
Blue Cross Blue Shield
NYSHIP
Cigna
United Healthcare
Anthem Blue Cross
Beacon
Presbyterian
Highmark
Optum