Key Takeaways
- Unlike a traditional insurance company, HMC HealthWorks is a highly customizable healthcare management company supporting over one million participants. Coverage varies widely from member to member depending upon the specifics of individual policies.
- HMC HealthWorks rehab coverage does exist for addiction. Most plans cover a significant portion of the cost of substance abuse treatment including inpatient treatment, outpatient treatment, detox, co-occurring disorder treatment and, in some cases, medication-assisted treatment.
- Because HMC HealthWorks plans are highly individualized, be sure to review the terms of your specific policy before you begin treatment. This includes deductibles, co-pays and whether the facility you plan to use is in-network (HMC HealthWorks will not cover out-of-network providers except in emergencies).
- Inpatient treatment may include screens and assessments, psychiatric assessments, individual therapy, medical examinations and aftercare, and may be covered by HMC HealthWorks. Outpatient coverage may include partial hospitalization, intensive outpatient care, group therapy and more.
- The Lakes Treatment Center is in-network with HMC HealthWorks insurance and offers a full range of flexible, customized treatment programs.
If you are ready to take that first step and join a drug rehab program in California, this is one of the bravest things you can do. However, one concern many people have when getting substance abuse treatment is how much their program will cost.
Covering the cost of addiction treatment services out-of-pocket isn’t feasible for the vast majority of people. That is why it is important that you have an insurance plan that provides coverage for substance abuse treatment.
In this article, we will be discussing what HMC HealthWorks insurance is and whether or not it provides drug rehab coverage.
What is HMC HealthWorks?
Before we discuss HMC HealthWorks rehab coverage, you first need to understand what this insurance actually is. It isn’t a standard insurance company; rather, it is a healthcare management company that has over 1 million participants. It is known for being highly customizable, allowing policyholders to tailor their plans to cover the type of healthcare they need.
Because of these tailored plans, coverage varies significantly from member to member. However, most people use HMC HealthWorks for things like chronic care management, behavioral health, wellness, and substance abuse treatment.
Does HMC HealthWorks Provide Coverage For Rehab?
HMC HealthWorks does provide coverage for rehab, which can help you cover a large portion of your treatment expenses. But how much HMC HealthWorks rehab coverage you will get will depend on your individual policy, the facility, and the type of treatment you are seeking.
Here is a breakdown of the types of substance abuse treatment programs and essential services that HMC HealthWorks may provide coverage for.
Inpatient Treatment
The majority of HMC HealthWorks plans provide coverage for inpatient treatment, which is one of the most standard forms of substance abuse treatment. This allows you to live on-site under the supervision of your care team 24/7.
Inpatient treatment is usually more intensive, specifically designed for those with withdrawal concerns or those who are battling more severe forms of addiction. Because of this, inpatient treatment is also usually one of the most expensive types of rehab.
Depending on the details of your policy, HMC HealthWorks can help cover things like:
- Screenings and assessments
- Psychiatric evaluations
- Individual therapy
- Medical examinations and treatment
- Aftercare
Outpatient Treatment
Another type of rehab program often covered by HMC HealthWorks rehab coverage is outpatient treatment. Outpatient treatment provides many of the same resources as inpatient treatment, except you won’t have to live on-site. Because of this, outpatient treatment is usually a bit more affordable and allows you to continue living at home throughout the duration of your program.
HMC HealthWorks coverage can often help cover a comprehensive range of outpatient resources, such as:
- Partial hospitalization
- Intensive outpatient care
- Group therapy
- Individual therapy
- Screening and assessments
- Medical examinations and treatment
- Psychiatric evaluations
- Aftercare
Detox
Detox is a process that many people who are battling addiction will need to go through, as it helps to manage withdrawals. Standard detox provides a safe environment where you will receive professional medical support, monitoring, and medication, if appropriate.
HMC HealthWorks rehab coverage can help to cover the cost of detox for most policyholders, especially if it is a part of their overall treatment program. However, how much coverage you will get is very dependent on the details of your individual plan.
Co-Occurring Disorder Treatment
Depending on your level of coverage, HMC HealthWorks may also help to cover the cost of co-occurring disorder treatment. This most often takes the form of dual diagnosis treatment, which helps to address co-occurring disorders, such as mental illness and substance abuse.
Dual diagnosis treatment combines different behavioral health services to help you get to the root of the problem and manage both conditions. So, before you join a dual diagnosis program, you need to see if it is part of your policy, and if so, how much it will cover.
Medication-Assisted Treatment
Although not the standard, HMC HealthWorks does have a few plans within its network that can cover the cost of medication-assisted treatment. Medication-assisted treatment is a type of detox program, also known as MAT, which offers the necessary support to manage withdrawals through medication.
A doctor or a psychiatrist will prescribe the right medication for your withdrawal symptoms, helping to keep you more stable and comfortable. Medication-assisted treatment also has a track record of improving the effectiveness of detox, client well being, and the chances of lasting recovery.
Does HMC HealthWorks Rehab Coverage Cover All Treatment Expenses?
No matter what HMC HealthWorks rehab coverage you have as part of your policy, it is very likely that you will still have out-of-pocket expenses. This is just a reality of insurance coverage since it very rarely covers the full cost of care.
To better understand what your out of pocket expenses will look like, you will need to investigate your individual policy terms. But you can usually expect to have to pay a deductible as well as a co-pay for treatment. You should also research the facility you want to go to, making sure they accept your policy and have transparent pricing.
It’s also worth mentioning that HMC HealthWorks does not provide coverage for out-of-network providers unless it is an emergency situation. Speak with your case management provider for more information about your specific HMC policy.
Why HMC HealthWorks Policyholders Choose The Lakes Treatment Center
At The Lakes Treatment Center, one of our goals is to make rehab as accessible as possible for everyone, regardless of their budget. Part of achieving this includes accepting a wide variety of insurance plans so that the majority of your treatment can be covered.
But besides the types of policies we accept, there are many other reasons why HMC HealthWorks policyholders choose The Lakes Treatment Center for their recovery needs:
- Program Flexibility: Joining a rehab program is a big step and often requires a great deal of time and energy. And at The Lakes Treatment Center, we understand that you may still have obligations that you need to maintain during your treatment. That is why we provide access to a wide variety of programs at different levels so that you can choose the program that fits your lifestyle and recovery needs. This includes options like our inpatient, outpatient, dual diagnosis, multiple relapse, couples, and MAT programs.
- Comprehensive Treatment Provider: At The Lakes Treatment Center, we take a whole-person approach instead of having one rehab model for every person. Our comprehensive care approach customizes every program to fit each individual’s needs and goals so that you can get the most out of your care. We also offer evidence based treatments that promote healing and recovery from substance use disorders.
- Community-Focused Care: A big part of addiction recovery success is becoming part of a community that can hold you accountable and supports you long-term. That is why, at The Lakes Treatment Center, we provide community-focused care through things like counseling, therapy, and extended aftercare resources.
- Mental Health Resources: It isn’t uncommon for those battling addiction to have co-occurring disorders, such as mental health disorders. And if that is the case, it’s crucial that both conditions are addressed during recovery to improve the chances of lasting sobriety. At The Lakes Treatment Center, we provide additional mental health resources like therapy and counseling, as well as our dual diagnosis program, to ensure the best possible health outcomes.
Join a Rehab Program Today at The Lakes Treatment Center
If you are worried about the cost of substance abuse treatment, you need to have an insurance policy like HMC HealthWorks. With HMC HealthWorks rehab coverage, the majority of your treatment can be covered so that your out-of-pocket expenses are as minimal as possible.
At The Lakes Treatment Center, we understand how challenging it can be for individuals who are seeking substance abuse treatment, especially when it comes to the cost of care. That is why we accept a variety of insurance plans and provide all of the treatment options that are usually covered by insurance policies within a supportive environment.
So, are you seeking addiction treatment and ready to begin your recovery journey? If so, contact us today at The Lakes Treatment Center to learn more about how we accept HMC Healthworks Insurance coverage.
Frequently Asked Questions
Q: What does HMC Healthworks insurance cover for drug and alcohol addiction treatment?
This depends on the specific rehab centers and inpatient/outpatient services provided. Contact your treatment provider’s admissions team, as well as HMC Healthworks, to learn more about fully and partially covered programs.
Q: Does HMC HealthWorks cover inpatient rehabilitation?
Yes, most plans thru HMC HealthWorks do cover inpatient—or residential—treatment, which is one of the most comprehensive levels of care available for substance abuse. Inpatient treatment means you live on-site and have a medical care team watching over you 24/7, which is ideal for those with serious addictions or withdrawal concerns. Most HMC HealthWorks plans cover screenings and assessments, psychiatric evaluations, individual therapy, medical exams and aftercare planning. The coverage amount will depend on your policy, so it’s best to check the specifics with HMC HealthWorks before enrolling in a program.
Q: Will HMC HealthWorks pay for outpatient rehab?
Yes. HMC HealthWorks rehab coverage generally covers a variety of outpatient treatment options, including standard outpatient programs, intensive outpatient care and partial hospitalization programs. Outpatient treatment, like inpatient treatment, provides many of the same resources, including group therapy, individual therapy, psychiatric evaluations, screenings and aftercare, without the need to live on site. This provides a lower-cost and more flexible option for those who need to juggle work, school or family responsibilities while recovering. As with all HMC HealthWorks coverage, the amount of your outpatient benefits depends on your particular plan.
Q: Does HMC HealthWorks cover dual diagnosis treatment?
Depending on the level of your coverage, HMC Healthworks may pay for dual diagnosis treatment, a special program that treats co-occurring disorders (mental illness and substance abuse) simultaneously. People struggling with addiction often have co-occurring conditions. Treating both conditions at the same time is often imperative for long-term recovery. Before enrolling in a dual diagnosis program, check that it is covered by your insurance policy and how much of the cost it will cover. The admissions team at The Lakes Treatment Center can help you thru this process.
Q: Will HMC HealthWorks pay for treatment at out-of-network facilities?
No, not in general. HMC HealthWorks does not cover out-of-network providers, except in emergencies. This means that you must ensure that any treatment facility you are considering is in the HMC HealthWorks network before you start a program – or you could be responsible for the full cost of care. Please speak with your case management provider or call HMC HealthWorks to get a list of in-network facilities in your area and to verify that the rehab center you choose will accept your specific policy.
Q: How do I begin addiction treatment at The Lakes Treatment Center with my HMC HealthWorks coverage?
It is easy to get going. Have your insurance information ready and call The Lakes Treatment Center today. Our admissions team will confirm your HMC HealthWorks coverage, help you identify your out-of-pocket costs, and connect you with the right treatment program for your needs and goals, whether that’s inpatient care, outpatient treatment, dual diagnosis, medication-assisted treatment, or another level of support. We are committed to providing you with the thorough, individualized care you require for a lasting recovery, from the initial conversation with our team to long-term aftercare.
