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Drug & Alcohol Rehab Treatment Coverage: First Health Insurance

If you or a loved one is struggling with addiction, seeking treatment can be an overwhelming and daunting process. One of the main concerns for individuals seeking rehab treatment is often the cost.

Fortunately, many health insurance plans offer coverage for drug and alcohol rehabilitation programs. First Health Insurance is one such provider that offers coverage for substance abuse treatment services.

With a network of over 5,000 hospitals and more than 550,000 healthcare providers nationwide, First Health Insurance strives to provide affordable access to high-quality medical care for its members.

In this article, we will explore how First Health Insurance covers drug and alcohol rehab treatment, including what types of programs are covered, how much coverage is provided, and what factors may impact your out-of-pocket costs.


Understanding Addiction Treatment Coverage

Navigating the world of health insurance and addiction treatment coverage can be overwhelming. It's important to understand what your plan covers, as some policies may have exclusions for certain types of treatment or facilities.

Before seeking treatment, it's crucial to review your policy carefully and speak with a representative from your insurance provider. Insurance exclusions can vary depending on the type of policy you have. Some plans may not cover out-of-state treatment centers or alternative forms of therapy such as acupuncture or meditation. Others may require pre-authorization before covering any kind of substance abuse treatment.

Understanding these limitations is necessary in order to make informed decisions about where to seek care. If you find that your insurance does not provide sufficient coverage for addiction treatment, don't give up hope. There are many alternatives available, including sliding scale payment options at non-profit organizations or state-funded programs that offer free or low-cost services.

Additionally, some private facilities offer financing options or scholarships for those who cannot afford traditional payment methods. By exploring all possible avenues for obtaining help, you increase your chances of successfully overcoming addiction and reclaiming control over your life.

First Health Insurance: An Overview

Now that we have a better understanding of addiction treatment coverage, let's dive into First Health Insurance and what it has to offer.

As one of the largest healthcare networks in the United States, First Health provides comprehensive insurance plans for individuals seeking drug and alcohol rehab treatment.

One of the benefits of choosing First Health Insurance is their extensive provider network. With over 5,000 hospitals and more than 1 million healthcare professionals in their network, you can rest assured that you'll be able to find quality care no matter where you are located.

In addition, First Health is constantly expanding its provider network to ensure that their clients have access to the best possible care.

In recent years, First Health has made strides in improving their coverage for mental health and substance abuse services. This includes providing coverage for both inpatient and outpatient treatment programs as well as medication-assisted treatments.

Additionally, they offer resources such as counseling sessions, support groups, and helplines to help individuals achieve long-term recovery success.

Types Of Drug And Alcohol Rehab Programs Covered

There are different types of drug and alcohol rehab programs covered by first health insurance. One of the main distinctions is between residential and outpatient treatment.

Residential treatment involves staying at a facility for a certain period of time, usually 30 to 90 days, while receiving intensive therapy and support. Outpatient treatment allows patients to live at home but attend regular therapy sessions.

Another important distinction is between evidence-based therapies and alternative therapies. Evidence-based therapies are those that have been scientifically proven to be effective in treating addiction, such as cognitive-behavioral therapy (CBT) or medication-assisted treatment (MAT).

Alternative therapies include things like art therapy, yoga, or acupuncture, which may not have scientific backing but can still be beneficial for some individuals.

First health insurance covers both types of rehab programs, so it's important to choose the one that best suits your needs. If you need more structured support and are able to take time away from work or other responsibilities, residential treatment might be the best option for you. If you need flexibility with your schedule or want to continue living at home during recovery, outpatient treatment might be a better fit.

Here are four types of evidence-based treatments commonly used in rehab:

- Cognitive-behavioral therapy (CBT)

- Contingency management

- Motivational interviewing

- Medication-assisted treatment (MAT)

Choosing the right type of program depends on various factors including severity of addiction, personal preferences, and lifestyle constraints. It's important to discuss all options with healthcare professionals before making a decision. Remember that any form of help towards overcoming addiction is valuable in leading a healthier life free from substance abuse.

Coverage Limits And Out-Of-Pocket Costs

After discussing the various types of drug and alcohol rehab programs covered by your first health insurance, it's important to understand the coverage limits and out-of-pocket costs you may incur.

While treatment affordability is a major concern for most people seeking rehabilitation services, having comprehensive health insurance can alleviate some of those financial burdens.

Most insurance plans have deductibles that must be met before coverage kicks in. This means that you will likely need to pay a certain amount out-of-pocket before your insurer begins covering your treatment expenses.

However, many rehab facilities offer payment plans or financing options to help make treatment more affordable for those who cannot afford to cover their entire deductible upfront.

Additionally, it's important to note that there may be other limitations on your coverage depending on your specific plan.

For example, some insurers may only cover a certain number of days in residential treatment or require pre-authorization before approving any outpatient services.

Understanding these limitations beforehand can help you prepare financially for any potential out-of-pocket costs and avoid unexpected bills down the line.

How To Determine Eligibility For Coverage

Insurance types vary, so it's important to know which type of coverage you have. Benefit packages depend on the type of insurance, so it's important to understand what is included in yours. It's also important to know the financial requirements of coverage, such as co-pays, deductibles, and out-of-pocket limits.

These requirements vary from plan to plan, so it's important to be aware of what you're responsible for. Knowing the details of your plan can help you determine if your insurance covers drug or alcohol rehab treatment. It's also important to know if there are any pre-authorization requirements or other stipulations you need to be aware of.

Having an understanding of your insurance type, benefit packages, and financial requirements can make it easier to find out if you're eligible for coverage.

Insurance Types

When it comes to determining eligibility for drug and alcohol rehab treatment coverage, understanding insurance types is crucial.

Two common insurance types are PPO (Preferred Provider Organization) and HMO (Health Maintenance Organization). A PPO plan typically offers more flexibility in choosing healthcare providers, while an HMO plan usually requires patients to choose a primary care physician who then refers them to specialists within the network.

Another important consideration is whether there is a copay or deductible associated with the insurance plan. Copays are fixed amounts that patients pay out of pocket for each visit or service received, while deductibles refer to the amount patients must pay before their insurance starts covering costs. Some plans may have both, so it's important to read through policy details carefully.

Ultimately, having an understanding of these terms can help individuals better navigate their health insurance options when seeking addiction treatment.

It's also important to note that every insurance plan is unique, so it's best to consult with a representative from your specific provider to fully understand your coverage eligibility.

Benefit Packages

Now that we have discussed the importance of understanding insurance types, let's move on to another crucial aspect of determining eligibility for drug and alcohol rehab treatment coverage: benefit packages.

Benefit packages refer to the specific services and costs covered by an insurance plan. It is important to carefully review your policy's cost breakdown to understand what you will be responsible for paying out of pocket.

In addition, it is essential to be aware of any policy exclusions, such as certain treatments or medications not being covered under your plan.

When seeking addiction treatment, it is important to fully understand your benefit package in order to make informed decisions about which providers and treatments are covered by your insurance. This can help prevent unexpected expenses or denials of coverage down the line, allowing individuals to focus on their recovery without added financial stress.

Financial Requirements

Now that we have covered the importance of understanding insurance types and benefit packages, let's move on to another crucial aspect of determining eligibility for drug and alcohol rehab treatment coverage: financial requirements.

Insurance verification is a vital step in this process, as it allows individuals to determine their coverage limits and any out-of-pocket costs they may be responsible for before seeking treatment.

It is also important to consider payment options when reviewing your financial requirements. Many rehab facilities offer flexible payment plans or financing options to help ease the burden of upfront costs. Some programs may even accept Medicaid or provide scholarships for those who are unable to afford treatment.

Overall, being aware of your financial obligations can help ensure that you receive the care you need without facing undue financial stress. By taking the time to understand your insurance policy's benefit package and exploring available payment options, you can make informed decisions about which addiction treatment providers will best meet your needs.

Finding In-Network Providers

Now that you have a better understanding of your insurance coverage, it's time to find an in-network provider.

This can be done by using your insurance company's website or contacting their customer service line.

When searching for a provider, make sure they meet the qualifications set forth by your insurance plan. Provider qualifications may include being licensed and accredited in addiction treatment, having experience with mental health diagnoses, and offering evidence-based treatments such as cognitive-behavioral therapy or medication-assisted treatment.

It's important to ensure that the provider you choose is qualified to treat both substance use disorders and any co-occurring mental health issues. Additionally, it's crucial to verify that the provider is within your insurance network.

Out-of-network providers may result in higher out-of-pocket costs for you. By selecting an in-network provider, you can maximize your benefits and minimize expenses while receiving quality care from a qualified professional.

Navigating The Claims Process

Dealing with insurance claims can be a daunting task, especially when it comes to drug and alcohol rehab treatment coverage. However, understanding the claims process is crucial in ensuring that you receive the maximum benefits your health insurance offers.

The first step is to understand your insurance policy's documentation requirements. Your insurer may require specific forms or documents from your healthcare provider before approving your claim for addiction treatment coverage. Make sure you have all the necessary paperwork to avoid any delays or denials of your claim.

If your claim is denied, don't panic yet. You have the right to appeal the denial and request a review of your case. It's essential to provide additional documentation supporting why you believe you should receive benefits for addiction treatment services. Remember that appealing denials requires patience and persistence, but it's worth fighting for what you deserve.

Here are three things to keep in mind while navigating the claims process:

  1. Be proactive - Start by reviewing your insurance policy and familiarizing yourself with its terms and conditions.
  2. Keep records - Keep track of all communication with insurers and providers, including dates, times, names of representatives involved, and what was discussed.
  3. Seek guidance - Don't hesitate to ask for help from professionals who specialize in dealing with health insurance companies or seek advice from support groups dedicated to helping people navigate through this process.

Navigating the claims process can be challenging but being prepared and informed helps ensure that you get the most out of your health insurance benefits for addiction treatment coverage!


In conclusion, addiction treatment coverage can be a complex and confusing topic. However, with the right insurance provider such as First Health Insurance, individuals struggling with substance abuse can receive comprehensive care without facing exorbitant costs.

It is important to understand what types of rehab programs are covered under your plan and any limitations or out-of-pocket expenses that may apply.

If you or a loved one needs help for drug or alcohol addiction, don't let concerns about finances hold you back from seeking treatment. Take advantage of resources like in-network providers and work closely with your insurance company to navigate the claims process.

With the support of an understanding insurer like First Health Insurance, recovery is within reach.

Don’t suffer another day. Call us today at 866.825-1171 . We can help you move from pain to healing and freedom.

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For more information about our inpatient or outpatient treatment programs, call us today at 866.825-1171 and let one of our caring admissions counselors help you with any questions or concerns regarding cost, eligibility and insurance.

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