Modified: 20th Aug 2019

Many people are learning that their insurance coverage will cover at least some of the cost of addiction treatments. First Health Network Insurance has several different treatment plans for individuals looking for alcohol and drug treatment coverage.

People often do not seek the proper help for additions because of the cost. First Health Network has a variety of plans to cover addiction treatments in all 50 states. Health services are also available in Puerto Rico and the District of Columbia. As a PPO provider, First Health is considered as one of the leading Preferred Provider Organizations nationwide.

Coverage for Addiction Treatment Services

As a Subsidiary of Aetna Insurance, First Health provides addiction services through thousands of hospitals, health facilities, and doctors’ offices. 

Substance abuse treatments are covered in most of First Health Network’s plans. The amount of coverage will depend on if the services are in-network and which program you are covered by. 

Patients can receive some coverage by First Health Network through the Strategic Solutions Program, whether or not they receive treatments in or out of network. The program has coverage through Primary Network, Secondary Network, or Non-Network Negotiation services. It is always best to try and stay within the Primary Network because coverage will be higher. 

Covered Substance Abuse Services and Treatments that are Covered

First Health Network has many different options that a patient can choose from for drug and alcohol addiction treatments. Your necessities and your condition will govern the type of services you are looking into.

First Health Network Insurance plans differ in what they cover and how much they will pay in each plan. Some of the collective addiction services that are covered under most of the plans are:

  • counseling
  • detoxification programs
  • drug tests
  • medications used during detoxification and treatment
  • mental health treatment

The network also has plans that cover more intensive treatments like outpatient and inpatient treatments. 

Inpatient Treatments

Inpatient treatment is a program where the patient stays overnight for several days that is usually determined during the consultation service. The program has daily therapy along with group therapy and other treatments for addiction. Some patients may need medication-assisted treatment (MAT), support group meetings, and individual therapy. 

Alcohol and Drug Rehab Centers for 28-30 Days

Individuals who need to start a rehab program or who have relapsed back to using alcohol and drugs can benefit from a short-term rehab center. A short inpatient program is an intense treatment program. It can help many people with addiction problems better than an outpatient program. Most short-term rehab centers will also allow a patient to stay longer if the patient feels he or she is not ready to leave treatment. 

Using drugs and alcohol for a long time can cause individuals to have severe problems. Some health effects that are created from addictions are dangerous illnesses, disease, overdose, and intense withdrawal symptoms. Individuals can also develop marital, financial, and social problems.

Individuals must work to regain physical, mental, and social well-being while in rehab treatments. A good 28-30-day inpatient program can help individuals get back on track and become an asset to society. 

Patients will have individual therapy, peer support group therapy, family therapy, and support sessions. Each session is designed for the patient to learn interpersonal skills, communication skills, and help the patient learn about his or her deep issues.  

A portion of a patient’s inpatient program is usually covered when the program is within the network. Other services covered for inpatient treatments are lab tests, screening, medication, and counseling. 

Outpatient Treatments

Patients who can handle an outpatient treatment program has a less intensive program to follow. They have more freedom to come and go. Outpatients can return to school or work and participate in group or individual addiction programs during the day or evening. 

For those who have a smaller budget or who need to be at home can benefit from an outpatient drug rehab program. Outpatient programs usually are for those patients who have mild or moderate addictions. A patient who has tried to quit their addiction and failed is not the right candidate for an outpatient program.

Patients who have recently relapsed after having a time of sobriety or those patients who are leaving an inpatient rehab will benefit most from an outpatient treatment program. The patient that has a sound support system on the outside will gain more significant success with an outpatient service. 

How to Determine if Outpatient Services is Right for You

The patient needs to be honest about his or her personal needs for treatment. Outpatient drug and alcohol treatments are best for people who:

  • Have a great support system.
  • Lives in a location with few addiction triggers.
  • Their addiction is mild to moderate for less than a year.
  • Does not show active withdrawal symptoms.
  • One who is not suffering from a co-occurring mental health disorder.

Length of Outpatient Alcohol and Drug Rehab Programs

Depending on the needs of the patient and the facility, most outpatient programs run from 1 to 3 months. Most will also require that the patient put in a certain number of hours or days that they spend in treatment. The programs have day and evening classes to accommodate everyone that needs outpatient treatment.

Many of the programs are intense programs and require patients to spend anywhere between three and eight-hours per session. The sessions run five to seven days a week.

When looking for an outpatient group, patients should not just pick the shortest hours or fewer days that are required to attend. Fighting an addiction is not easy, and it will take time and hard work. Without effort and work in therapy that is needed, many patients end up being ill-suited to face the challenges of being sober. 

Day programs are highly-structured and require patients to meet five to seven days a week for six to eight hours each time. Patients will participate in counseling, therapy, and peer support groups.

Intensive Outpatient Programs or (IOP) have shorter hours during each session and fewer days. The sessions run from three to four hours per session, and you meet only four times a week. The time spent in sessions is reduced as you progress through the program.

Outpatient programs are either covered partially or entirely, depending on the plan in which the patient is covered. Coverage will also depend on if the services are in or out of network. 

Using First Health

You should first consider if the rehab program or facility that you plan are using is in-network with First Health. You need to know which services for treatment will best suit your needs. Each individual has unique needs, and a treatment specialist can help you plan a program that is best for you. 

Learn what your insurance coverage from First Health Network will cover. A representative can go over your coverage and help you to understand exactly what your plan covers. You will learn all about your copays, out-of-pocket expenses and your deductibles that you will have to pay.

Some of the plans offered by First Health Network will require you to get prior authorization before beginning an addiction program. It is especially needed if you plan on an intensive program such as an inpatient treatment center. 

With the help of your representative from First Health, you will be able to find a treatment center that is best for you. Your insurance plan can help with the cost of your alcohol and drug addiction treatments. It will lessen the financial obligation that you need to pay and get you the services you deserve.

Talk with your treatment representative specialist at First Health Network Insurance and review all your insurance plan coverage. You will be able to maximize your coverage options and save yourself some money. 

Article Reviewed by Dr. Keerthy Sunder, MD, DFAPA

Dr. Keerthy Sunder, MD, DFAPADr. Keerthy Sunder, MD is an accomplished and internationally recognized expert in the field of addiction. He has earned diplomates from the American Board of Psychiatry and Neurology, the American Board of Addiction Medicine, and the Royal College of Obstetricians and Gynecologists.