Independence Health Group Coverage for Rehab

Parent company of Independence Blue Cross (IBX), Independence Health Group provides healthcare to over eight million Americans, including coverage for addiction treatment.

IBX is a licensee of the Blue Cross Blue Shield Association and based in Philadelphia, Pennsylvania. For many, health insurance is used to make treatments like addiction rehab more accessible and affordable.

You may be exposed to a lot of information when seeking drug and alcohol addiction treatment, including the cost of rehab. Keep reading to learn everything there is to know about substance abuse treatment and your Independence Health Group coverage.

Answer: Yes, Independence Health Group does cover alcohol and drug addiction treatment, but there are some caveats to these insurance benefits.

All marketplace plans, like those provided by IBX, are required to cover addiction treatment at least partially under the Affordable Care Act (ACA), which lists substance abuse treatment as one of the 10 essential health benefits.

The coverage you receive through your Independence Health Group insurance plan will depend on several factors, which you will find detailed further down.

Answer: You will find that there is a wide variety of addiction treatment options covered by IBX insurance plans.

Some people seek a particular treatment type when they receive addiction treatment, while others receive a combination of several treatment approaches.

Read on to learn about the most common treatment methods, what you can expect from them, and IBX coverage information for each service.

Medical Detox

Many Independence Health Group insurance plans cover medical detox at least partially. You may have to pay a copay, depending on your plan.

Medical detoxification is a service offered in both inpatient and outpatient care, typically at the start of a treatment program. This service helps your body get rid of any addictive substances.

Detoxing can be a challenging and dangerous process, which is why medical detox is so important. Medical detoxification involves monitoring your vitals, administering medications, and managing withdrawal symptoms.

Medication-Assisted Treatment

IBX health insurance plans cover medication-assisted treatment (MAT), though the amount of coverage will depend on your plan’s terms.

MAT is an evidence-based treatment option that is particularly effective in people with opioid addiction. This service uses specific medications to treat addiction. The medication works by reducing cravings and withdrawal symptoms as well as reducing the risk of relapse over time.

Inpatient Rehab

Inpatient rehab is another addiction treatment service that Independence Health Group will help you cover, at least in part. Your deductible will likely apply here.

Considered to be the highest level of care in addiction treatment, inpatient treatment is an addiction rehab service that is very highly structured, making it great for people with more severe addictions.

Inpatient rehab offers round-the-clock care, and thus, requires participants to live in the care facility throughout the length of their treatment program.

Dual Diagnosis Treatment

Dual diagnosis treatment is also a covered service under most IBX plans. Depending on the setting in which you receive care (inpatient or outpatient), you may have to pay a copay or coinsurance, and your deductible will most likely apply.

It is very common for people with substance use disorder (SUD) to also have a mental health disorder. This is referred to as a co-occurring disorder.

Dual diagnosis treatment is a service that addresses mental health issues in conjunction with addiction. This often includes therapy or counseling. Some common co-occurring disorders include post-traumatic stress disorder (PTSD), anxiety, and depression.

Outpatient Treatment Programs

Most Independence Health Group plans cover outpatient addiction treatment as long as it is received from an appropriately licensed healthcare provider. You may have a copay for each day of treatment, and your deductible may not apply.

Outpatient rehab is often the next step people take after completing an inpatient program. In other cases, people may seek outpatient care from the start if they have a less severe addiction or are unable to live outside of their home temporarily.

While you will not be required to live in a treatment center when receiving outpatient care, you can expect to travel to a facility several times a week for a set number of hours for your addiction treatment.

There are also variations of outpatient treatment you may encounter like intensive outpatient programs (IOPs) or partial hospitalization programs (PHPs).

Counseling & Behavioral Therapy

Services offered through psychologists and addiction counselors are covered by most IBX health insurance plans. Again, your coverage will depend on the setting in which you receive this service. You may have a copay or be responsible for a percentage of the overall cost.

Counseling and behavioral therapy are incredibly important treatment services many people receive during their treatment plan.

Counseling may be offered in individual or group settings and typically involves the discussion of your thoughts, emotions, goals, and worries related to your addiction recovery. Family therapy is another counseling option you may encounter.

Behavioral therapy is a type of talk therapy that is often used for people with mental health illnesses. Some kinds of behavioral therapy you may have heard of include cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).

During behavioral therapy, your care provider will help you improve your behavioral health and patterns that may be exacerbating your addiction and negatively affecting your well-being.

Continuing Care

Some continuing care services may be covered by Independence Health Group health insurance plans. Some may require a copay, some may be subject to your deductible, and some may not qualify for any coverage.

Continuing care services, sometimes referred to as aftercare, are services you continue to receive after completing a treatment program.

You and your care team will determine which services may be beneficial for you to continue. This may look like counseling, support groups, sober housing, or MAT.

There are many factors that can affect your coverage levels when using your IBX health insurance plan.

Factors that may affect your coverage include:

• Your plan: The most influential factor in determining your coverage level will be the insurance plan you have. Even plans with the same insurance company will have different levels of coverage. One plan may cover more for a certain service than another.
• The treatment you’re seeking: Put plainly, some addiction treatment services have a higher price tag than others. If you are in need of a specific type of treatment, whether it’s per your doctor’s advice or personal preference, you may expect higher or lower coverage levels.
• Your location: Where you live is also an important variable. Your state may have more affordable treatments than other states or your insurance may provide better coverage than in other states.

You can expect your insurance provider to consider all of these factors and more when it comes to determining your coverage.

Answer: Yes, Independence Health Group will cover out-of-network rehab programs, but as a disclaimer, coverage is only offered after you meet your out-of-network deductible, which will likely be much higher than your in-network deductible.

If you’re absolutely set on receiving addiction treatment from an out-of-network provider, it’s possible to get some of your treatment covered, but your out-of-pocket cost will be higher.

It’s always best to try to stay in-network, if possible.

Independence Health Group offers a diverse set of insurance plans, including some Medicare plans.

Some plans you may be able to enroll in include:

• Individual and family plans:
  • Keystone HMO Proactive plans
  • Keystone HMO plans
  • Personal Choice PPO plans
  • Personal Choice EPO plans
  • Personal Choice EPO Reserve plans
  • Personal Choice EPO Catastrophic plan
• Medicare plans:
  • Keystone 65 HMO
  • Personal Choice 65 PPO

Plan options will differ based on your location and employer (if you receive health insurance through your job). Choose the plan that is best for you, and be open to comparing variables like premiums, deductibles, copays, coinsurance, and health savings account (HSA) options.

All common substance addictions are covered at least partially by Independence Health Group. This is because insurance coverage isn’t determined based on the type of addiction you have.

Some common addictions covered by IBX insurance plans include:

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

Because different addictions may require different treatment approaches, coverage may vary between addiction types.

Finding a rehab facility that accepts your IBX insurance plan can be half of the journey. Luckily, there are several fantastic resources to do just that. Be sure to look for accreditations and certifications as well.

Some great resources include:

• Ask your doctor for referrals. If there’s a provider you’ve been seeing for your addiction, you can always ask them for a list of treatment facilities in your network.
• Call Independence Health Group. Give IBX a call if you’re unsure whether a rehab center takes your insurance. You can also call the center itself.
• Use the Substance Abuse and Mental Health Services Administration’s (SAMHSA) treatment locator. Here, you can find treatment facilities in your area.
• Check out our list of treatment centers in each state. You’ll find information about reputable facilities and insurance information.

Independence Health Group is a popular health insurance provider offering coverage for a wide array of treatment services and addiction types. Based on the plan you have with IBX, you may be able to get a significant portion of your addiction treatment covered.

If you or your loved one is ready to take the first step in the journey toward recovery, give our helpline a call today.