HealthSmart Drug Rehab: Coverage for Substance Abuse Treatment

Key Takeaways

• HealthSmart is not an insurance company but a third-party health solutions provider that administers claims and network management, assisting policyholders in finding health care, including substance abuse treatment, at a more affordable price.
• HealthSmart drug rehab coverage can account for a significant amount of the cost of treatment, including detox, outpatient treatment, residential treatment, therapy, partial hospitalization programs, intensive outpatient programs, and acute treatment programs; however, the details of coverage can vary greatly from member to member.
• HealthSmart out-of-pocket costs generally include premiums, deductibles and co-pays, and may be higher if you use providers outside the network — so read your coverage information and select an in-network facility before beginning treatment.
• It’s simple to use your HealthSmart drug rehab coverage. Confirm your coverage, find a provider in the network, acquire any required referrals or pre-authorizations, and have cash on hand for any applicable out-of-pocket expenses.
• The Lakes Treatment Center accepts HealthSmart coverage and provides a full range of customized treatment programs.

Getting substance abuse treatment is something that you should pursue without delay. After all, addiction is a very serious condition that often grows worse the longer it is left untreated. So, the sooner you can join a drug rehab program, the better.

However, it isn’t uncommon for individuals to postpone treatment due to the cost of care. And even if you do have an insurance plan, you may not know whether rehab is covered or how much coverage you have access to.

In this article, we will discuss HealthSmart insurance and whether or not it provides drug rehab coverage.

What is HealthSmart Insurance?

Before we dive into the topic of whether or not HealthSmart insurance covers the cost of drug rehab, what is this type of coverage? Firstly, HealthSmart is not actually a true insurance company; rather, it operates as a health solutions provider. This means that it is a third-party administrator that helps to handle things like claims processing and network management.

So, although it may seem like insurance, it mainly handles all of the administrative tasks that go on behind the scenes. This can help you to have better access to healthcare solutions at a more affordable price.

Does HealthSmart Cover Drug Rehab?

Whether you already have HealthSmart coverage or are looking into it, the good news is that HealthSmart does provide drug rehab coverage. How much coverage you will get depends on the details of your plan, which is something that you should be familiar with.

Although everyone’s policy may look a bit different, here is a general example of the types of treatment HealthSmart drug rehab coverage can help with:

• Detox: HealthSmart typically covers the majority of detox programs, which help you to navigate the withdrawal process. To find out if your coverage extends to more specialized detox programs, such as medication-assisted treatment, you will need to research your specific policy terms.
• Outpatient Treatment: One of the most common types of drug rehab treatment comes in the form of outpatient care. This is when you join a program but you live off-site, allowing you to travel back-and-forth and maintain other lifestyle responsibilities, such as work or school. Most HealthSmart policies cover outpatient treatment and many of the associated recovery resources.
• Residential Treatment: Unlike outpatient treatment, residential treatment does require you to live on-site under the 24/7 supervision of your care team. This is often the best option for those who are going through serious withdrawals or need more assistance recovering from a severe form of addiction. Because HealthSmart drug rehab coverage is so different from member to member, you will need to carefully investigate the types of residential treatment resources your coverage includes.
• Therapy: HealthSmart often provides a certain level of coverage for mental health resources, or more specifically, therapy. So, it is very likely that you can get a large portion of your therapy expenses covered, whether that be for individual therapy, group therapy, family therapy, or other evidence-based therapy.

In addition to these standard forms of rehab treatment that HealthSmart may provide coverage for, there are some additional treatments your policy may include. This can include things like partial hospitalization programs, intensive outpatient programs, and acute treatment programs.

Understanding Your Out-of-Pocket Expenses With HealthSmart Drug Rehab Coverage

Having HealthSmart drug rehab coverage doesn’t mean that the total cost of your substance abuse treatment will be erased. In fact, most people, no matter the type of insurance policy they have, will have to pay some out-of-pocket expenses.

Here are the most common out-of-pocket expenses you may have to pay when you get treatment:

• Premiums: A premium is a fixed monthly payment that you have to pay to keep your insurance coverage going.
• Deductibles: A deductible is the amount that you have to pay for services covered by your policy before your coverage takes full effect.
• Co-pays: A co-pay is a fixed fee that you are personally responsible for paying when you receive specific services.

Keep in mind that your out-of-pocket expenses can be influenced by a variety of factors. For instance, if you see an out-of-network provider, this usually means that you will have to pay more out-of-pocket. Or, specific types of treatments may have higher co-pays than others.

How to Use HealthSmart Drug Rehab Coverage

Taking full advantage of your HealthSmart drug rehab coverage is relatively straightforward. However, it is essential that you understand exactly what type of coverage you have and how far this extends so that you can pay as little out-of-pocket as possible.

Here is the step-by-step process of how you can begin using your HealthSmart drug rehab coverage for substance abuse treatment:

• Confirm Your Coverage: You can usually do this by going to the HealthSmart website or by calling a live agent to understand what your policy provides.
• Choose a Provider: To get the lowest out-of-pocket costs possible, you need to choose an in-network provider covered by HealthSmart. You can do this by searching HealthSmart’s provider network or by contacting the provider or facility that you want to go to.
• Get a Referral or Pre-Authorization: Depending on the services you need, HealthSmart may require you to get a referral or pre-authorization before your coverage kicks in. So, you may need a physician to refer you for rehab, or you may need to provide your insurance with a formal diagnosis to prove the medical necessity of rehab.
• Pay Your Out-of-Pocket Costs: Once everything is set up and you are pursuing a treatment program covered by your policy, you also need to be prepared to pay any out-of-pocket expenses. This is why it is important that you choose a facility that offers transparent pricing so that there aren’t any unpleasant surprises later on.

Why Choose The Lakes Treatment Center For Your Rehab Needs?

At The Lakes Treatment Center, one of our goals is to make recovery as accessible as possible to everyone. Part of this involves making the intake process as simple as possible by offering transparent pricing and accepting a wide variety of policies.

We understand that most people cannot afford the cost of substance abuse treatment completely out of pocket, which is why we are here to help. We can help you understand what your policy includes, who your in-network providers are, and whether you need a referral or pre-authorization.

Additionally, here are some of the other benefits you will get when you join one of the rehab programs at The Lakes Treatment Center:

• Comprehensive treatment that is customized to fit each individual’s recovery needs and goals.
• Dual diagnosis treatment for those with co-occurring substance abuse and mental health disorders.
• Extensive aftercare resources and access to like-minded communities.
• A variety of evidence-based therapies, including physical therapy, family therapy, group therapy, and individual therapy.
• Medication-assisted treatment for those going through withdrawals.
• Multiple relapse programs for individuals who have struggled with sobriety in the past.
• Extensive treatment options to cover different addictions, such as alcohol, fentanyl, heroin, marijuana, meth, opioids, prescription, cocaine, benzo, and psychedelic addictions.
• Residential and outpatient programs for individuals who may need more flexibility or more intensive care.
• Life-skills training to help prepare you for living a sober life post-treatment.

Join a Drug Rehab Program Today at The Lakes Treatment Center

Once you realize that you have a problem with substance abuse, the very next step you need to take is to join a drug rehab program. And when you have coverage, like HealthSmart drug rehab coverage, this step becomes that much more accessible and affordable.

At The Lakes Treatment Center, we strive to make the recovery process as easy as possible by accepting a variety of insurance policies and providing all of the rehab programs you could possibly need. This includes programs commonly covered by insurance, such as inpatient, outpatient, dual diagnosis, MAT, and detox programs.

Are you ready to choose a substance abuse treatment program that fits your recovery needs? If so, contact us today at The Lakes Treatment Center to learn more about our intake process and the insurance policies we accept.

Frequently Asked Questions

Q: What is HealthSmart and does it cover drug rehab?

HealthSmart is a third-party health solutions company, not a traditional insurance company, specializing in claims processing, network management, and helping members access healthcare at reduced costs. HealthSmart is not an insurance company, but it does offer drug rehab coverage, and most plans cover a large percentage of the cost of substance abuse treatment. Coverage typically includes detox, outpatient treatment, residential treatment, therapy services and in many cases, partial hospitalization programs, intensive outpatient programs and acute treatment programs. How much coverage you get will depend on the details of your individual policy.

Q: What kinds of drug rehab does HealthSmart cover?

HealthSmart’s drug rehab coverage typically includes detox programs to help manage withdrawal, outpatient treatment for those who need the flexibility to continue working or going to school, residential treatment for those with more serious addictions or withdrawal concerns, and therapy services including individual, group, family and evidence-based therapy. Depending on your policy, your coverage may also include partial hospitalization programs, intensive outpatient programs, medication-assisted treatment and acute treatment programs. Because HealthSmart plans are so flexible, it’s a good idea to review your particular policy terms to be sure you know what’s covered and what’s not.

Q: What out-of-pocket costs will I have with HealthSmart drug rehab coverage?

Even policyholders who have HealthSmart coverage will still incur some out-of-pocket costs. These typically include a monthly premium to maintain your coverage, a deductible (how much you pay before your coverage kicks in), and co-pays (a flat fee you pay for certain services). You also might pay more out of pocket if you get care at an out-of-network facility or if some types of care have higher co-pays than others. The best way to minimize your out-of-pocket costs is to choose an in-network provider and understand the terms of your policy upfront.

Q: Do I need a referral or pre-authorization to use HealthSmart for drug rehab?

That depends on your particular plan. For some HealthSmart policies, a physician referral or formal diagnosis indicating medical necessity for rehab is required before your coverage will begin. Others may require pre-approval for some types of care, such as residential treatment or special detox programs. The best way to know what your plan requires is to call HealthSmart directly or talk to the admissions team at The Lakes Treatment Center. Our staff can help you thru the pre-authorization process so there are no delays in getting started.

Q: How do I start drug rehab with my HealthSmart coverage at The Lakes Treatment Center?

It’s easy to begin. Call The Lakes Treatment Center today with your HealthSmart insurance information. Our admissions team will help you verify your coverage, check to see if The Lakes Treatment Center is in-network with your plan, and if any referrals or pre-authorization are needed before you begin. Our pricing is transparent from start to finish so there are no surprises and we’ll match you with the right treatment program — whether that’s inpatient care, outpatient treatment, dual diagnosis, medication-assisted treatment, or any other level of support — so you can begin your recovery journey as quickly and cost-effectively as possible.