The Affordable Care Act makes it so that marketplace plans have to cover both substance abuse and mental health treatment.
Plus, Illinois has already passed comprehensive parity legislation. This means that insurance providers can’t make behavioral health benefits more restrictive than those of other medical conditions.
So, there’s support on the federal and state levels. Still, it’s only normal to worry about your coverage level and how it may affect your chances of getting admitted to a reputable program.
Read on to learn more about insurance verification, streamlined admissions, and dealing with coverage gaps.
Free, Confidential Verification of Benefits
The team at Illinois Recovery Center (IRC) handles insurance verification quickly and confidentially before you commit to treatment.
Let’s take a closer look at how this check works.
All You Need to Do
To check your behavioral health benefits, simply fill out an insurance verification form and wait for one of our representatives to get back to you.
How Long Does the Insurance Benefits Check Take
How long will you have to wait? Usually, the verification doesn’t take more than a few hours.
But if you submit the form outside of regular business hours, our team might not be able to get you on the same day. They’ll reply first thing in the morning, though.
What’s Included in the Benefits Check
Healthcare insurance can be full of nuances, complexities, and jargon. That’s why we make sure our insurance coverage reports are detailed but delivered in plain language.
Expect our admissions specialists to walk you through the following:
1. In-Network vs. Out-of-Network
The report lets you know whether IRC is in-network for your plan. It may still be possible to receive treatment at our center if it’s out-of-network, but the coverage will vary.
To reduce the odds of that happening, we try to work with a wide range of insurance providers. So far, we accept plans from most major companies, including Aetna, UnitedHealthcare, Blue Cross Blue Shield, Cigna, Humana, and Tricare.
2. A Breakdown of the Out-of-Pocket Costs (If Any)
Our friendly expert will explain to you what your insurance company will pay and what you’ll have to cover yourself.
Expect a breakdown of:
Your deductible
The money you must pay out-of-pocket before your insurance kicks in.
Your copay
The fixed fee for accessing the behavioral health service.
Your coinsurance
The percentage of the treatment cost you may have to cover.
3. Pre-Authorization
On certain plans, you need to get prior authorization from a primary care physician.
Our team will let you know if that’s true in your case and discuss how you can obtain the documents that show that substance abuse treatment is a medical necessity for you.
4. Coverage Level
Our experts will discuss how your coverage will look across the different treatment phases (detox, residential treatment, outpatient programs, aftercare, etc.).
5. Caps and Exclusions
Although insurance companies can’t put dollar limits on your addiction treatment journey, they can set duration caps.
If your provider does so, we’ll share with you the duration limit and how it’ll affect your treatment.
Who You’ll Be Talking To
Our admissions specialists, like everyone else on the team, are dedicated to creating a safe, welcoming space that nurtures long-lasting recovery.
They understand the struggles of addiction and know how much financial barriers can keep people from seeking the help they need and deserve.
Heading the admissions team is Angie Isam.
Angie herself is in recovery. And she uses her experience to connect with clients and their loved ones. A blend of authenticity and unwavering support is what she offers each and every client, from the moment they first interact with our rehab center.
What’s Expected of You
So, you ask our admissions team to verify your insurance, and they provide a detailed assessment. What is expected of you now?
Nothing.
There’s no obligation to enter a treatment program with us, no matter what the benefits check shows. And obviously, your private information is never shared.
Note that the verification doesn’t impact your premiums or coverage status in any way, either.
IRC’s Streamlined Admissions Process
At Illinois Recovery Center, we streamlined our admissions process. Our admissions professionals follow a three-step route:
- Step 1: Confidential evaluation of your substance use disorder treatment needs
- Step 2: Quick verification of your insurance coverage
- Step 3: Intake assessment of your medical history and mental health, to develop a personalized treatment plan
Once you’re in, you receive a warm and friendly welcome from our staff. We get you and your loved ones started with the orientation.
Questions to Ask the Admissions Team
A rehab representative can do more than just verify your insurance coverage. Odds are, there are at least a few questions bouncing around your mind. And you should never hesitate to ask them.
Some questions that are perfectly okay to ask are:
- What should I pack? Are toiletries, socks, snacks, etc. covered by the insurance?
- Can you help me prepare for rehab?
- What should I expect on my first day in rehab after admission?
- What amenities are available on the premises?
- Can I tour the facility?
- If I’m not from around Swansea, can you help with travel arrangements?
Dealing With Denials and Coverage Gaps
We never want your coverage status to stand between you and the care you need. If our facility isn’t the right fit, we may be able to point you toward a partner program best suited to your situation.
Our representatives can also discuss self-pay options and help you explore other paths forward.
Plus, the Illinois Department of Human Services (IDHS) can be an excellent resource for uninsured and underinsured individuals looking for grants and state-funded treatment options.
Choose the Simplified Insurance Verification and Admissions Process
Navigating the complexities of insurance coverage can be tricky. Preparing for admission and all the change that will come with it, as well, can be daunting.
But you don’t have to do any of that alone.
Our admissions team is here to handle things on your behalf and walk you through every step of the way. Whether you just want to explore payment options or need help appealing a denial, we’re here for you.
Give us a call to see how the accredited Illinois Recovery Center can help.
