Rehab Centers That Accept APS HealthCare Insurance

Professional drug and alcohol rehab can be expensive, especially without insurance, but is often considered essential for many people struggling with addiction. Fortunately, most insurance plans provide at least some level of coverage for substance abuse treatment, with APS HealthCare making it one of the pillars of their care.

If you are located in one of the 35 states that are covered by APS HealthCare and carry this type of policy, it is essential that you know how to verify your coverage if you decide to attend a professional addiction treatment program.

For help in understanding your benefits and rehab insurance options, as well as the costs associated with APS HealthCare addiction treatment, please do not hesitate to reach out to us at RehabNet.

APS HealthCare Insurance does cover drug rehab programs, and does so through Medicare, Medicaid, and private insurance options.

APS HealthCare specializes in providing coverage for mental health services and makes this one of the foundations of their service. As part of their mental health and behavioral health services, substance abuse treatment is covered and considered part of their comprehensive care.

The MHPAEA influenced rehab coverage by ensuring that the benefits provided for mental health and substance abuse services were not more limited when compared to the benefits provided for medical and surgical services.

It also expanded coverage in some instances for people in need of MAT for opioid use disorders who had previously been denied coverage for these medications.

APS HealthCare drug rehab coverage provides for multiple levels of care, including inpatient treatment, outpatient treatment, and detox programs. The level of care that a person seeks out will depend on the severity of their addiction, the type of substance they are addicted to, and how much supervision or flexibility they require.

It is always a good idea to verify your APS HealthCare mental health benefits before starting your rehab program, and this can be done in a few ways. You can contact APS HealthCare customer service using the number on the back of your insurance card, ask the rehab facility itself, or use online directory tools.

Addiction treatment includes several different levels of care, depending on what each individual needs and what is covered by their specific APS HealthCare insurance plan.

Detoxification programs can exist as standalone programs but are often incorporated as part of residential treatment.

These programs exist to get people through what is often considered the most difficult part of overcoming addiction by managing withdrawal symptoms and providing supervision.

Inpatient rehab with APS HealthCare is the most intensive type of addiction treatment available and typically consists of programs that last between 30 and 90 days.

During residential treatment, patients live onsite in the facility and participate in therapy and support groups along with other patients in the program.

APS HealthCare outpatient addiction treatment can come in several levels, all of which are generally covered.

Levels of outpatient treatment include:

• Partial hospitalization programs (PHPs) meet almost every day for several hours each time, offering several treatment options and a high amount of structure. Patients are still able to return home at night and on weekends.
• Intensive outpatient programs (IOPs) are similar to PHPs but less intensive, meeting several days a week for a few hours each time.
• Standard outpatient programs offer the utmost flexibility and affordability, and often consist of therapy, support groups, and MAT when needed.

MAT can be included as part of an outpatient program along with therapy, an inpatient program, or continuing care after a program is complete.

This type of treatment uses medications such as buprenorphine and Suboxone to help people taper off opioids or alcohol slowly and safely.

Therapy and counseling are an integral component of any addiction treatment program, and often include different forms of behavioral health therapy.

These can include cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), both of which are effective in treating mental health disorders as well as substance use disorders.

Aftercare and relapse prevention are also an important part of drug and alcohol treatment, and usually take place as part of an ongoing outpatient program. More intensive forms of aftercare, such as sober living homes or transitional housing, are generally not covered by insurance and are paid for by the individual.

The total amount that you end up paying as a carrier of APS HealthCare for your rehab treatment will depend on a variety of factors.

APS HealthCare is available in 35 states, as well as Puerto Rico, though not all states provide the same plans and policies.

One significant way that they can differ is in available options through the federal insurance marketplace. Another way that they can differ is in the availability and type of plans that utilize Medicaid expansion.

The specific type of plan that you have through APS HealthCare will also affect the benefits that you can access as well as referral requirements.

Health insurance plan types include:

• Health Maintenance Organization (HMO): typically only covers services that are in-network and also usually requires referrals or preauthorization for rehab and other services.
• Preferred Provider Organization (PPO): is often more expensive but usually provides for both in-network and out-of-network care, though out-of-network care may be covered only partially.
• Exclusive Provider Organization (EPO): similar to an HMO in that it provides only for in-work care, but does not have the same referral and preauthorization requirements.

Preauthorization or a referral is not usually required for rehab services unless you have an HMO or POS form of insurance plan. In these instances, a referral or preauthorization may be required to prove that the services you are seeking are medically necessary.

You may have a preference for a specific treatment facility that you want to attend, even if this specific facility is not considered in-network with your APS insurance plan.

If this is the case, and you’ve exhausted all possibilities for trying to get this out-of-network treatment covered, make sure that you are financially prepared to pay full price for your addiction treatment, or consider choosing a different facility.

While every plan with APS is required to offer some level of substance abuse treatment, the costs associated with each plan can vary significantly.

Any time that you are reviewing your APS insurance policy, make sure that you have a good understanding of any deductibles or copays that you are responsible for. This can help you determine what your total out-of-pocket APS Healthcare rehab costs will be as well.

While APS, as a rule, is a network-based insurance provider, you may still be able to utilize out-of-network treatment in certain circumstances.

In-network providers are those that have agreements with your insurance provider to offer their services at a lower, pre-negotiated rate. This typically means much lower costs overall.

Out-of-network providers, on the other hand, do not have agreements with your insurance provider and set their rates. This often means paying full price for services, unless you have a specific health plan that allows for out-of-network coverage.

Depending on the type of plan that you have, APS Healthcare may cover part of your out-of-network rehab, but at a lower percentage than they would for in-network rehab.

In addition, APS Healthcare may also require individuals to meet a certain deductible before it covers any out-of-network costs.

It is important to remember that you do have options available if your preferred rehab facility is out-of-network with your APS HealthCare plan.

Steps you can take include:

1. Review your insurance policy to make sure you understand your benefits and potential costs.
2. Work with your doctor to provide documentation that the service you are seeking is medically necessary.
3. Working with a billing specialist who may be able to negotiate coverage for you.
4. Consider a Gap Exception or Continuity of Care Waiver if there are no suitable providers in your area that are in-network.
5. File an appeal if your coverage is denied.

When out-of-network rehab is still used but not covered by insurance, you generally have a few other payment options available.

This can include paying with cash or using financial assistance options like scholarships or payment plans, as well as finding a facility that offers a sliding fee scale based on income.

In addition to the different types of health plans that insurance companies offer, APS also offers different types of plans depending on income, location, and preference.

In many circumstances, you may have your choice of insurance plan through APS HealthCare. In other instances, you may be placed in one based on your income and family size, or what is specifically offered by your employer.

Types of insurance found through APS HealthCare include:

• Medicaid-based plans: APS works with both Medicaid and Medicare to provide state-funded insurance plans to people below a certain income threshold, above a certain age, who are blind or disabled, parents and caregivers to minors under 18, and more.
• Employer-sponsored health plans: APS offers an Employee Assistance Program (EAP) called APS OptiMind that strives to promote mental health assistance, including direct clinical services, workshops, and more, in the workplace. It may also include APS HealthCare employer-sponsored addiction treatment, depending on the specific location.
• Managed care and behavioral health plans: Managed care plans are those commercial health plans that can be classified into HMOs, PPOs, EPOs, and POSs.

Each type of plan will have its own benefits and offerings regarding mental health and substance use treatment, but all provide some level of coverage.

Certain plans, such as those with an EAP, may have more limited offerings. Additionally, there are significant differences in premiums across different APS HealthCare plans. Generally, Medicaid and Medicare plans tend to have lower out-of-pocket costs compared to private plans.

Most rehab centers work to treat several different types of addiction, with many of the most common substance use disorders covered by APS HealthCare.

As one of the most common types of substance addiction, alcohol addiction and the accompanying withdrawal symptoms can be life-threatening.

Professional treatment can make a huge difference for people trying to overcome an alcohol addiction, as the legalities and availability of this substance can make it difficult to avoid.

Opioid addiction continues to grow as a problem throughout the United States and rest of the world, and is becoming one of the more common disorders found at treatment centers.

Opioids are considered to be the most addictive drug in the world, and this includes both prescription opioids and illicit opiates like heroin.

Any type of stimulant addiction can be very dangerous, as the side effects of these drugs can lead to overdose when used heavily, especially for people who have existing cardiovascular issues.

Stimulant addiction can include an addiction to prescription stimulants, such as Adderall for ADHD, or illicit stimulants such as cocaine or crystal meth.

Benzodiazepines, which include Xanax and Valium, are often prescribed to people for anxiety or sleep disorders. Their euphoric and sedating effects can make them very addictive.

Benzodiazepine withdrawal can cause life-threatening seizures and other dangerous symptoms, so it is always recommended to detox from these types of drugs with medical supervision.

While a marijuana addiction is not necessarily one of the more life-threatening forms of addiction, it is one of the most commonly abused drugs.

Treatment options for marijuana addiction often include therapy and support groups, and may also include detox or inpatient treatment for more severe cases.

Prescription drug abuse can be particularly complicated because it often involves an addiction that started with a legitimate prescription. Prescription drugs that are commonly abused include painkillers, such as opioids, or anti-anxiety medications, such as benzodiazepines.

If you are seeking rehab centers that accept APS HealthCare, it is important to know how to find them and how to locate centers that are of high quality.

APS HealthCare offers beneficiaries the opportunity to search for mental health providers and other types of doctors through their online search directory.

People also have the opportunity to request appointments through their online portal by stating their personal information, specific health plan, and reason for the appointment.

You also have the option of calling rehab centers directly to confirm with them whether they accept APS health insurance. This can oftentimes be the best way to get up-to-date information, as rehab facilities may change their accepted providers regularly.

RehabNet can also help individuals to find in-network addiction treatment services for APS HealthCare coverage, or for whichever type of coverage you carry.

We offer multiple ways for prospective patients to search for rehab facilities near them, as well as a helpline where you can access assistance from any of our skilled representatives.

The following are questions that are frequently asked about APS HealthCare insurance coverage.

If you or a loved one needs professional and evidence-based treatments for any type of substance abuse, please trust RehabNet addiction help as a resource in finding the best rehab with APS HealthCare.

We can help you find the best alcohol and drug addiction treatment facility in your area, as well as help you verify your insurance benefits and estimate your out-of-pocket costs for rehab treatment.

RehabNet insurance verification is always free and essential before beginning any type of rehab program.

It is never too late to begin your journey to recovery. To get started today, you can call us at any time on our free and confidential helpline, or you can fill out our contact form.