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Beacon Health Options Insurance Coverage for Drug and Alcohol Rehab

Written by: Goeffrey Andaria, Mental Health Writer

Reviewed by: Dr. Carl Williams, Ph.D., LCADC

With nearly half of the American adult population abusing a drug or alcohol at least once in their lifetime, 4% meet the criteria for substance use disorder, and about 10% have had a drug abuse disorder at some point in their life.

While the number of people addicted to drugs and alcohol is astounding, only 2.5 million people receive treatment at a specialty facility; 37.3% of people who don't seek treatment blame the high cost of treatment, while 24.5% are not ready to seek treatment.

Beacon Health is the largest independently held behavioral health organization seeking to address the high-cost treatment issue for drug and alcohol users, particularly those interested in getting help. This post looks at all you need to know about Beacon Health Options insurance coverage for drug and alcohol rehab.

Does Beacon Health insurance cover drug and alcohol rehab?

Types of treatment covered under Beacon Health Options insurance

How Beacon Health Options drug and alcohol rehab coverage works

Estimating the costs of out-of-network services

Deductibles, co-pays, and out-of-pocket payments

Getting help at Rolling Hills Recovery Center

What To Know About Your Beacon Health Insurance

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Co-Insurance

Deductibles

Co-Payment

Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.

The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.

Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.

Does Beacon Health Insurance Cover Drug and Alcohol Treatment?

Drug and alcohol treatment is the primary focus of Beacon Health, which also covers mental health issues, making them a leader in healthcare when it comes to rehab treatments. While they are not a healthcare provider, Beacon Health Options provides clients access to clinical substance use disorder management, specialty programs for addiction, and employee assistance programs.

They provide addiction treatment coverage to 40 million people across the United States, with providers in all 50 states. They are partners with 65 additional health plans to ensure people find treatment for various substance abuse needs. If you have Beacon Health Option's insurance coverage, you can use it to cater to some or all of your drug and alcohol rehab treatment.

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Types of Treatments Covered Under Beacon Health Options Insurance

Beacon Health Options insurance coverage for drug and alcohol abuse treatment typically varies based on your insurance plan. The organization covers most addictions, including benzodiazepines, heroin, methamphetamine, and cocaine, some of the most commonly abused drugs.

Beacon Health offers numerous rehab programs to manage drug and alcohol use disorders. It is important to note that people suffering from substance use disorder are different, meaning the appropriate treatment intensity depends on your situation and needs. Here are some types of addiction treatment options Beacon Health covers:

Inpatient or residential rehab: With this treatment, you live at the rehab facility and are required to participate in a recovery program that can include group and individual therapy, 12-step activities, and other group activities. Residential rehab could also offer medically supervised detox. The organization will only cover the costs accrued from an in-network provider. You will also have to pay co-pays (the fee-specific plan holders must clear before the company starts covering their treatment costs).

Outpatient rehab or therapy: The treatment varies in intensity and can occur at varying frequencies, but typically, outpatient therapy is less intensive than intensive outpatient programs. Outpatient therapy is provided chiefly after inpatient treatment to avoid relapses. Beacon Health will typically cover in-network doctors and hospitals, but you must pay co-pays and meet deductibles before the company covers some or all of your rehab treatment costs.

Partial hospitalization programs: With partial hospitalization programs, you typically attend care at a rehab facility for four to eight hours per day which is why the program is referred to as a day program. The treatment can extend for a few days, but no overnight stay is necessary.

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How Beacon Health Options Drug and Alcohol Rehab Coverage Works

Beacon Health

Beacon Health Options covers many addiction treatment services.

Rolling Hills Recovery Center accepts a variety of Beacon insurance coverage.

Medically Reviewed:

Dr. Carl Williams Ph.D., LCADC

Rolling Hills Recovery Center

Executive Director

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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Beacon Health insurance coverage works the same as any other health insurance plan, meaning you must confirm that there is a medical need for treatment, file a claim with Beacon Health Options, and confirm your cost and coverage.

Among the first steps of getting rehab coverage for substance abuse disorder is confirming that treatment is a medical requirement. Beacon Health allows you to check what your policy and plan need for the confirmation process. Typically, you will have to get a referral from a primary care doctor, a behavioral health doctor, or pre-authorization for treatment.

Once you show that drug and alcohol treatment is medially required, the next step is to file a claim with the organization. In most cases, your doctor or hospital will take care of the claim process, which includes all the paperwork and any necessary calls to Beacon Health. After Beacon Health processes your claim and applies for rehab coverage, you will receive a digital explanation of the benefits in the mail. The information often includes:

Beacon Health’s billed cost of treatment.
The services the organization is covering.
Services that are not eligible for coverage.
The amount you should clear if Beacon Health covers partial costs.
Your financial responsibility is the difference between your coverage and the billed cost of treatment.

Estimating the Costs of Out-of-Network Services

HMO and EPO Plans: If you are covered by an EPO or HMO plan, then your plan does not allow or cover out-of-network benefits except during emergencies. If you want to receive treatment from an out-of-network provider, you can use Beacon Health Fair Health Calculator to get an estimate of the UCR rate for services from an out-of-network facility.

PPO and POS Plans: If you are covered under a POS or PPO insurance plan, the plan can provide benefits for most services received from an out-of-network provider. However, the terms and conditions of such coverage will vary depending on the specific plan you are enrolled in. Beacon Health Options offers clients tools to estimate how much the organization will pay and the amount that will come out of their pocket.

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Deductibles, Co-Pays, and Out-of-Pocket Payments

Beacon Health Options insurance levels are divided into four metals: bronze, silver, gold, and platinum, based on actual metal value. Typically, the bronze insurance plan covers 60% of medical costs and offers you maximum out-of-pocket expenses that are less than the remaining 40%.

Silver insurance plans start at 70%, gold plans are set at 80%, and platinum's most valuable metal is set at 90%. You should pick an insurance plan based on your healthcare needs and the amount you are willing to pay out-of-pocket.

Deductible, co-payments, and out-of-pocket costs related to using and maintaining your Beacon Health Options insurance plan.

Premium is the amount of money paid to the insurance company every month. The premium is locked for one year, meaning Beacon Health cannot charge you a higher interest for that year.
Deductible is a yearly payment you must pay your insurance provider before paying for your medical services. Preventative care is mainly excluded from deductibles.
Out-of-pocket costs are the annual maximum amount you can spend on medicine and health care services without the help of an insurance provider.

It is important to note that the organization's allowance will not reflect any applicable cost-sharing, that is, co-payments, deductibles, and co-insurance, which you must clear and also lowers the amount of assistance payable to the organization. The actual payment will depend on several factors, including the services you receive, the amount billed to your healthcare provider, and your eligibility for benefits when you receive the service.

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As one of the largest providers of mental health and substance use disorder treatment plans, Beacon Health Options is accepted in most rehab centers, including Rolling Hills Recovery Center. Our primary vision is to rescue and transform through innovation by utilizing a comprehensive array of approaches that provide the best evidence-based practices for treating and managing addictive disorders.