Does Health Plan of Nevada cover Alcohol and Drug Rehab Centers?
If you have a Health Plan of Nevada (HPN) plan and are struggling with addiction, you may be wondering if you can use your insurance to cover the cost of drug rehab. HPN, which is a part of UnitedHealthcare, provides individual health plans to residents of Nevada. Like many other health plans in the United States, HPN plans provide a wide variety of coverage, including coverage for mental health disorders and substance use disorders.
Depending on the plan you have, you may be able to have your drug rehab fully or partially covered under your Health Plan Nevada health plan. You can call the number on the back of your insurance card or talk to a rehab center representative to verify your benefits and coverage.
What will Health Plan of Nevada cover?
What is exactly covered under your HPN plan will vary based on the plan you select. Some plans have higher levels of coverage than other plans. Despite this, there are certain healthcare services, which are known as essential health benefits, that must be covered in some capacity, as mandated by the Affordable Care Act (ACA).1 Mental health and substance use disorder coverage is considered 1 of the 10 essential health benefits, meaning that your HPN health plan must provide some type of coverage for such services and treatments.
Your plan’s coverage may vary, but often, the following common treatment methods are covered in some capacity under HPN plans:
- Outpatient program rehab or therapy: Outpatient drug rehab and therapy is designed for those who don’t need round-the-clock care. Instead of staying in a facility 24/7, you’d go to the facility for treatment and then go home in the evenings. Your HPN should provide some sort of coverage for this type of mental health care service. For those who do not need around-the-clock rehab or detox, an outpatient rehab or therapy program may work best. 2, (How are behavioral therapies used to treat drug addiction?)
- Intensive outpatient programs (IOPs): IOPs are usually recommended to treat people who need a structured program but don’t necessarily need round-the-clock supervision or care.3 (under section after conclusion) Care may be provided every day for a few hours at a time, but the structure varies by facility.
- Inpatient or residential rehab: Inpatient or residential rehab treatment involves intensive care for substance use or another mental health disorder, or a co-occurring disorder. It involves receiving medical care and/or therapy within a treatment facility for a predetermined length of time.2, (How are behavioral therapies used to treat drug addiction?) Your HPN may provide some level of coverage if you need to enter an inpatient or residential rehab program.
- Partial hospitalization programs: Partial hospitalization programs are a combination of inpatient and outpatient programs. Often, a partial hospitalization program will involve a structured day program, similar to inpatient programs. However, you won’t be required to stay overnight in a facility, similar to an outpatient program.4 Your HPN drug rehab coverage will likely cover partial hospitalization programs in some capacity.
There may be other treatments that your Health Plan of Nevada medical insurance may fully or partially cover, and this list is not exhaustive. Please note, what your plan covers may vary, and it’s important to verify your Health Plan of Nevada network coverage before obtaining treatment to avoid any surprise medical costs.
Does Health Plan of Nevada Cover Mental Health Care?
Under the ACA, all health plans must provide some coverage for mental health and substance use disorders and their subsequent treatments.1 Specifically, the essential health benefit for mental health mandates that behavioral treatment, mental and behavioral inpatient care, and substance use disorder treatment is covered in some capacity by a health plan, including your HPN plan.1
Your Health Plan of Nevada coverage, under the ACA’s mandate, extends to the treatment of co-occurring disorders. A co-occurring disorder is a term that mental health experts use to refer to the simultaneous instance of substance use and mental health disorder. According to the National Institute of Drug Abuse (NIDA), 7.7 million Americans have a co-occurring disorder,5 20.3 million Americans have a substance abuse disorder, and 42.1 million have a mental illness.5These numbers show that, if you have a co-occurring disorder, you’re not alone. Thanks to the ACA’s mandate, your Health Plan of Nevada benefits may provide some level of coverage for treatment for both a co-occurring disorder or stand-alone drug or heroin rehab.
How Long Does Health Plan of Nevada Cover Drug Rehab Programs?
Your rehab treatment length will vary depending on your personal situation. Only your mental health provider will determine how long your course of treatment should be. According to NIDA, research suggests that those seeking treatment for addiction or co-occurring disorders should be in treatment for at least 3 months to significantly improve the odds for positive outcomes.6, (Numbered list number 5) Because treatment length varies, there is not a standardized timeframe that is covered across all plans. Rather, it will depend on your specific Health Plan of Nevada mental health benefits and coverage.
Your HPN rehab coverage will depend on whether your selected facility is an in-network provider and your personal recovery. You should work with your mental health provider and facility to determine the best course of treatment for you. From there, you’ll want to contact an HPN representative to check your benefits and coverage limits. To do this, call the number on the back of your insurance card to speak to a representative and request a summary of benefits and coverage. An American Addiction Centers agent can also help you determine your HPN coverage, so be sure to ask a facility agent.
What if my Health Plan of Nevada policy does not cover drug rehab facilities?
In some cases, your Health Plan of Nevada rehabilitation coverage may not fully or partially cover your drug rehab. If this happens, you may be fully or partially responsible for paying for your drug rehab. However, don’t panic; you may still have financial assistance options.
To begin, it’s important to determine if the facility is an in- or out-of-network provider. If the facility is an out-of-network provider, you may be able to submit claims to your HPN insurance to potentially recover some of your treatment costs. Any out-of-pocket costs you do incur may count toward your out-of-pocket maximum limits. For more information about this, contact your HPN insurance representative.
You may also be able to seek alternative funding arrangements at the treatment facility. Be sure to ask a treatment facility representative if they offer financing options to help you pay for the cost of treatment or if they have scholarship opportunities that you can apply for. Many facilities, including American Addiction Centers facilities, offer financing and scholarship opportunities to ensure that people don’t delay the care they need due to cost constraints or insurance difficulties.
Health Plan of Nevada In Network vs. Out of Network Drug Rehab Centers
Understanding the differences between in- and out-of-network rehab centers will help you control your rehab costs. For example, an in-network provider is typically covered at a higher level under your insurance plan, which means that your out-of-pocket costs may be lower. An out-of-network provider isn’t typically fully covered under your health insurance plan, and, consequently, you may pay more to receive care at that facility.
To determine whether a facility is in or out of network, be sure to call your Health Plan of Nevada insurance company or talk to the representatives at the rehab facility. Either agent should be able to help you determine whether they are an in- or out-of-network provider.
Check Health Plan of Nevada Coverage for Addiction Treatment
If you have a Health Plan of Nevada medical plan, you likely have some coverage for addiction treatment. American Addiction Centers is an in-network provider under many plans and may be an in-network provider under your plan. American Addiction Centers, particularly the nationally recognized DesertHope facility, which is close in proximity to you, is known for its successful programs. At Desert Hope, you can count on our qualified team to use evidence-based therapies and programs to deliver top-quality service. Additionally, we have a high staff-to-patient ratio, ensuring you get personalized care. We work with board-certified therapists, clinicians, and other professionals, such as physicians and psychiatrists.
Contact our helpline today at to determine whether your treatment at an American Addiction Centers facility would be covered under your Health Plan of Nevada benefits. An agent can help you check network coverage over the phone. You can also complete the form at the bottom of this page, entering your insurance information and some other basic information, to immediately determine your benefits.