Bright HealthCare is an insurance company that provides individual, family, Medicare Advantage health plans, and small business plans in New York, North Carolina, Tennessee, South Carolina, Florida, Alabama, Oklahoma, Ohio, Illinois, Nebraska, Colorado, New Mexico, Arizona, and California.1 (Health Plans in 14 states and map of states)
Bright HealthCare, which is part of Bright Health Group, has achieved URAC accreditation status for all of their health plans, which means that they’ve proven to abide by federal and state legal and compliance standards.1 (at bottom of page, URAC Accreditation) The health group and insurance company work with a carefully curated network of hospitals, clinics, and doctors across the country, which are referred to as “Care Partners,” to help those who are covered by their plans receive the care they need at an affordable price.1 (Top of page, “how we do it”)
This means that if you have a Bright HealthCare plan and are seeking drug rehab, you may be able to receive care that is fully or partially covered under your health plan. To check if a specific rehab center is covered under your Bright Health insurance coverage, you should call the number on the back of your insurance card. You may also be able to have your desired rehab center review your benefits and determine whether they are a network provider of your insurance plan.
What will Bright Health insurance cover?
Your Bright Health plan will provide coverage for a variety of health and mental health benefits. While the level of coverage may vary based on your location and your plan type, many types of common rehab treatments are often covered under your benefits, including the following:
- Inpatient or residential rehab: Some people may benefit from an inpatient or residential rehab program, especially if they are trying to recover. Inpatient and residential programs provide around-the-clock supervision and medical care, so they are ideal for people undergoing detox and withdrawal symptoms. In these programs, you’d also receive counseling, any necessary medications, and therapy while you recover. For people who need intensive care for their substance use or mental health disorder or co-occurring disorders, inpatient or residential rehab may be recommended.2, (How are behavioral therapies used to treat drug addiction?)
- Outpatient rehab or therapy: For people who do not need around-the-clock rehab or medical supervision, an outpatient rehab or therapy program is typically the recommended course of treatment. Typically, an outpatient rehab or therapy program involves going to meetings and checking in but doesn’t require inpatient stays.2, (How are behavioral therapies used to treat drug addiction?)
- Intensive outpatient programs (IOPs): IOPs are seen as the middle ground between inpatient and outpatient rehab programs. They are typically recommended for patients that don’t need 24-hour care or supervision but need more help than a typical outpatient program provides.3 (under section after conclusion) In many cases, IOPs offer at least 9 hours of treatment per week, but some programs may provide more or less care.3 (under section after conclusion)
- Partial hospitalization programs (PHPs): PHPs combine elements of both outpatient and inpatient programs. Typically, they involve a structured day program for treatment, but a patient won’t stay overnight in the facility.4
In most cases, your Bright HealthCare insurance would provide coverage for the above treatment methods in some capacity, but coverage is not always guaranteed. Be sure to verify your coverage with your insurance company before receiving treatment.
Does Bright Health Insurance Cover Mental Health Care?
All health plans in the United States, including those provided by Bright HealthCare, are federally required under the Affordable Care Act (ACA) to provide coverage for 10 essential health benefits, including mental health and substance use disorder treatment.5 The ACA’s mandate means that behavioral treatment, mental and behavioral inpatient care, and substance use disorder treatment must be covered in some capacity by your health plan.5
The ACA’s mandate helps millions of Americans struggling with mental health, substance use, and co-occurring disorders to get the help they need at an affordable cost. If you’re struggling with a mental health or substance use disorder—or both, which is referred to as a co-occurring disorder—you’re not alone. According to the National Institute of Drug Abuse (NIDA), 7.7 million Americans experience co-occurring disorders, meaning that they have both a substance use and mental health disorder.6 For people with co-occurring disorders, it’s essential to the success of recovery that both disorders are treated.
Your Bright HealthCare mental health benefits should provide some level of coverage for the care that you need to treat your co-occurring, mental health or substance use disorder.
How Long Does Bright Health Insurance Cover Rehab?
How long Bright HealthCare plans will cover rehab depends on your location, plan, and your recommended course of treatment. Research shows that treatment for addiction or co-occurring disorders should last at least 3 months to be most effective and reduce negative outcomes.7, (Numbered list number 5)
However, because every patient is different, no two treatment paths will look the same. Your provider will determine the best course of treatment for you. Then you can contact your insurance company, or your facility can, to determine how long Bright Health insurance will cover your treatment. To do so, you should call the number on the back of your insurance card.
What if my Bright Health policy does not cover rehab?
Depending on your plan, location, and the facility, your health plan may not cover all your rehab costs. In this case, you will likely be responsible for paying the outstanding costs of treatment.
Don’t let this possibility deter you from getting treatment. In many cases, treatment facilities offer financing or scholarship options. These options are designed to help people get the care they need at a price they can afford. Cost shouldn’t deter you from getting the care you need. Delaying treatment can be harmful to your health and well-being.
Bright Health In Network vs. Out of Network Rehab Centers
It’s important to understand the difference between an in-network and out-of-network facility, especially when it comes to keeping your out-of-pocket healthcare costs low. An in-network provider is within Bright Health Group’s “Care Partners,” and they are typically covered at higher levels, which means lower out-of-pocket costs for you. An out-of-network provider is not a Care Partner. While you might be able to receive care from an out-of-network provider, it typically won’t be covered under your plan.
It is therefore important to choose an in-network provider whenever possible. Fortunately, American Addiction Centers accredited facilities are in-network providers for many health plans. Be sure to check with your insurance representative to see if your Bright HealthCare plan considers AAC locations to be in-network facilities by calling the number on the back of your insurance card.
Check Bright Health Insurance Coverage for Addiction Treatment
Checking your Bright HealthCare medical insurance coverage for addiction treatment is easy. You can either call the number on the back of your insurance card or visit their website. In many cases, you’ll be able to find an addiction rehab facility that’s an in-network provider.
While you’re checking for in-network providers in your area, be sure to investigate AAC local facilities, including Recovery First Treatment Center and River Oaks Treatment Center, two locations in Florida. AAC facilities are state-of-the-art and many are in-network providers. AAC can also help you verify your benefits and coverage quickly. Complete the form below or call our helpline today to find out more.