Asuris Northwest Health Insurance Coverage for Rehab

Asuris Northwest Health is an insurance provider that provides over 50,000 Americans in the eastern Washington state area with healthcare. Many of these policyholders use their insurance plan to access addiction treatment.

If you or your loved one is an Asuris Northwest Health member, learn about substance abuse treatment coverage below, including common treatment services, plan types, and more.

Answer: Yes, Asuris Northwest Health does cover alcohol and drug addiction rehab. However, there are exclusions to this coverage.

Asuris Northwest Health is required to cover drug and alcohol addiction treatment under the Affordable Care Act (ACA), which lists substance abuse treatment as one of the 10 essential health benefits.

Along with all of the other health insurance plans on the marketplace, Asuris Northwest Health must cover treatment for substance use disorder (SUD) at least partially.

Answer: There is a wide range of addiction treatment services you may receive coverage for through your Asuris Northwest Health plan. You may find that your healthcare provider recommends a particular type of treatment or a combination of several.

Asuris Northwest Health only covers addiction treatment that is considered medically necessary. That being said, you’ll need to receive preauthorization.

Scroll on to learn about some common treatment options including what to expect during each service and projected coverage levels.

Medical Detox

Medical detoxification is covered by most Asuris Northwest Health insurance plans. You may be responsible for coinsurance for this service.

A service typically provided at the start of a treatment program, medical detox is used to help rid the body of addictive substances. Detoxing on your own can be very dangerous, which is why medical detox services are a great place to start your recovery journey.

During detox, your care team will monitor your vitals, help manage withdrawal symptoms and cravings, and administer any necessary medications or supplemental treatments.

Medication-Assisted Treatment

Often referred to as MAT, medication-assisted treatment is another covered service for many Asuris Northwest Health policyholders. You may be responsible for coinsurance for each visit related to MAT.

MAT is an evidence-based treatment service that typically treats opioid addiction using U.S. Food and Drug Administration (FDA)-approved medications.

These medications are designed to help manage withdrawal symptoms and cravings as well as reduce the risk of relapse as you complete your comprehensive treatment program.

Inpatient Rehab

Most Asuris Northwest Health insurance plans cover inpatient treatment as well. You will likely be responsible for coinsurance for the treatment program.

Inpatient rehab is a popular starting point for many people in their recovery journey. This kind of treatment offers a high level of care as it is quite structured and scheduled.

Individuals live in the treatment facility through the course of their inpatient program to receive round-the-clock care.

Inpatient treatment offers a comprehensive approach as participants receive various treatment services throughout their program.

Dual Diagnosis Treatment

Dual diagnosis treatment is another treatment service you may encounter that qualifies for coverage under many Asuris Northwest Health insurance plans.

If you receive dual diagnosis treatment in an inpatient setting you will likely be responsible for coinsurance, on the other hand, you will likely have a copay for each visit to an outpatient office.

Many people with addiction also have mental health disorders, known as co-occurring disorders. Common co-occurring disorders include anxiety, depression, bipolar disorder, eating disorders, and post-traumatic stress disorder (PTSD).

Dual diagnosis services treat mental illnesses in conjunction with substance addiction. For many people, these mental health issues worsen or cause their addiction. Treatment involves mental health services alongside physical health services.

Outpatient Treatment Programs

When it comes to outpatient treatment programs, many Asuris Northwest Health policyholders may find that they are responsible for a copay per office visit.

Outpatient rehab is another common treatment method that is often considered a step down from inpatient treatment. Individuals can remain living at home, but must travel to a treatment center several days a week for several hours of rehab.

Sometimes, people opt for variations of outpatient services such as partial hospitalization programs (PHPs) or intensive outpatient programs (IOPs).

Counseling & Behavioral Therapy

Counseling and behavioral therapy are covered by many Asuris Northwest Health insurance plans. If you’re receiving these services in an inpatient setting you may be responsible for coinsurance whereas outpatient settings will likely result in a copay per visit.

Counseling is a common part of a comprehensive treatment plan and is offered in individual as well as group settings. It allows people to share any thoughts, worries, or emotions surrounding addiction and recovery.

Behavioral therapy is a type of talk therapy that focuses on behavioral health. It is often used for people who have co-occurring disorders to help them change behavioral patterns and thought processes that exacerbate addiction.

Continuing Care

Asuris Northwest Health insurance plans cover many continuing care services, but not all. This is because continuing care looks different for every person.

Often also called aftercare, continuing care is the treatment services one uses after completing a treatment program to encourage long lasting recovery.

Some services like group therapy, behavioral therapy, or MAT are eligible for coverage while others like sober living may not be.

Asuris Northwest Health coverage for rehab is dependent on several factors:

• Type of treatment: Each type of treatment may have a different level of coverage.You may receive more or less coverage depending on your plan.
• Your plan: The type of plan you have will heavily factor into your coverage levels. Some plans offer higher coverage levels with higher deductibles or premiums whereas some are differentiated by their copay or cost sharing policies.
• Your location: That’s right, even where you live can affect your coverage. This is because you’ll have access to a unique set of insurance plans based on your location. Additionally, your state may have local laws or regulations that affect coverage levels.

Answer: No, Asuris Northwest Health does not cover out-of-network providers. That being said, it’s important to choose a provider within your network to ensure you can receive coverage and minimize out-of-pocket expenses.

This is because in-network providers are contracted with Asuris Northwest Health to provide care at negotiated rates, which allows you to have lower out-of-pocket costs.

Speaking with a representative at Asuris Northwest Health or using your member portal is always a great way to double check that a provider is in your network. You can also ask about reimbursement policies.

Asuris Northwest Health offers a range of individual and family plans as well as some Medicare plans.

Plan types include:

• Bronze Essential 8500
• Bronze Health Savings Account (HSA) 7000
• Bronze Essential 8500 / Dental, Vision
• Bronze HSA 7000 / Dental, Vision
• Silver 4500
• Silver 4500 / Dental, Vision
• Gold 2500
• Gold 2500 / Dental, Vision
• Medicare Prescription Drug Plans (PDP)
• Asuris Medicare Supplement (Medigap)

You may have access to different plans based on your location, but these are a few generally offered plans. Be sure to check out the details of each plan to determine which is best for you.

There is a wide range of addictions covered by Asuris Northwest Health. Coverage is not contingent on the type of addiction you have.

Common addictions covered by Asuris Northwest Health:

• Cocaine
• Meth
• Alcohol
• Heroin
• Opioids
• Prescription drugs
• Benzodiazepines

The only substance addiction explicitly not covered by Asuris Northwest Health is tobacco addiction. If you’re unsure if your addiction is covered, call a representative for reassurance.

Finding a rehab center can be an overwhelming task, especially when it comes to finding one that accepts your insurance. Luckily, there are several easy ways to find a treatment facility that accepts your Asuris Northwest Health plan.

If you have a primary care provider, you can always ask for a list of referrals. They should be able to find rehab centers in your network.

You can also use the “find a doctor” program on Asuris Northwest Health’s website, or call their helpline.

Lastly, we recommend checking out our list of rehab facilities by state. Each list contains the top accredited and reliable treatment centers in your state. You’ll also find insurance information for each facility.

Through your Asuris Northwest Health insurance plan, you may be able to receive addiction treatment at an affordable cost.

If you or your family member needs additional guidance in substance abuse treatment coverage and Asuris Northwest Health, give our helpline a call today.