Regence Insurance Coverage for Rehab

Insuring 3.1 million Americans, Regence Insurance is a popular insurance company in the U.S., available to Washington, Idaho, Oregon, and Utah residents. Many Regence policyholders use their healthcare insurance to access drug and alcohol addiction treatment.

Navigating your recovery journey can be an immense task, and for many that starts with finding a treatment facility and understanding their rehab coverage.

If your or your loved one’s insurance provider is Regence, keep reading to learn about addiction treatment with Regence.

Answer: Yes, Regence does cover alcohol and drug addiction treatment due to the Affordable Care Act (ACA).

Under the ACA, substance use disorder (SUD) treatment is listed as one of 10 essential health benefits, requiring all plans in the marketplace to offer at least some coverage for it.

There are some factors that affect coverage with your Regence healthcare plan, like where you live and the plan you hold.

Answer: Regence health insurance covers a vast array of addiction treatment options, all with varying levels of coverage.

To learn more about coverage for each treatment service and what you can expect from each, scroll on.

Medical Detox

Many Regence insurance plans offer some coverage for medical detox services, inpatient and outpatient. You may need to receive a diagnosis prior to receiving detox services and may be responsible for a portion of the cost or a copay.

Medical detoxification is often offered at the beginning of your treatment plan. It helps you safely detox from addictive substances by getting them out of the body.

Detoxing on your own can be dangerous and difficult, which is why many people seek out medical detox services. During treatment, you’ll be administered medications, have your vitals monitored, and receive help with managing withdrawal symptoms.

Medication-Assisted Treatment

Medication-assisted treatment (MAT) is covered for many Regence policyholders through Boulder Care, which offers telehealth MAT. Inpatient and outpatient settings may be subject to copays or coinsurance depending on your plan.

MAT is an evidence-based treatment approach used primarily in opioid addiction, but it can be used for other types of substance addiction. MAT uses FDA-approved medications to treat addiction by reducing the risk of relapse, cravings, and withdrawal symptoms.

You may receive MAT for an extended period of time, even after you complete your treatment program.

Inpatient Rehab

Many Regence insurance plans offer coverage for inpatient treatment, though you may need a diagnosis from your healthcare provider to receive coverage.

Inpatient rehab offers 24-hour care in a dedicated facility and is considered to be the highest level of care for addiction treatment. During inpatient treatment, you’ll live in the rehab facility and stick to a very regimented schedule.

Dual Diagnosis Treatment

Dual diagnosis treatment is also covered by many Regence plans and is offered through Boulder Care.

When it comes to substance abuse, many people find the root of their addiction to be mental health disorders. These are referred to as co-occurring disorders.

In dual diagnosis treatment, you can expect to receive care for your mental health alongside care for your physical health. Some commonly treated mental health conditions that co-occur with addiction include depression, anxiety, and bipolar disorder.

Outpatient Treatment Programs

Outpatient treatment is covered by many Regence plans for people who have completed inpatient treatment or do not need rigorous care. You may need to pay a copay for your outpatient visits.

Outpatient rehab is very effective but less intense than inpatient treatment. You’ll be expected to travel to a treatment center multiple days of the week for several hours rather than living in the rehab facility.

You may also have the option to receive other variations of outpatient treatment such as a partial hospitalization program (PHP) or intensive outpatient program (IOP).

Counseling & Behavioral Therapy

Most Regence policyholders can get counseling and behavioral therapy services covered in part by their plan. Be sure to select an in-network provider, though.

Counseling is a service that focuses on the discussion of your emotions, thoughts, goals, and fears surrounding your treatment. It may be a one-on-one service or in a group setting.

Behavioral therapy is a type of psychotherapy that focuses on improving your behavioral health. By adjusting your behavioral patterns and thought patterns, you may be able to reframe your mindset in a way that helps to treat your addiction and improves overall wellness.

Dialectical behavioral therapy (DBT) and cognitive behavioral therapy (CBT) are some commonly used behavioral therapy types.

Continuing Care

Regence may cover continuing care services through many insurance plans, but this will differ much more than coverage for other services.

Aftercare, or continuing care, is treatment services you continue to receive after you finish a treatment program. This can look different for everyone, so coverage will look different depending on the service.

Some people continue to receive group therapy, individual counseling, MAT, or live in a sober house after completing treatment.

Keep in mind that there are many factors that can affect your Regence health insurance coverage. You may find your coverage is different from that of another policyholder with Regence.

Some factors that can affect your coverage include:

• The type of plan you have: Most insurance companies have a wide range of plan options, Regence included. Different plans offer different coverage levels for each type of treatment.
• Where you live: The state you live in can also affect your coverage. This may be due to specific laws and regulations concerning addiction treatment and the cost of living in that state.
• Treatment type: You may need a particular kind of addiction treatment or a combination of several treatment options. They all carry different costs and coverage levels. For example, you may receive more coverage for inpatient versus outpatient care.

If you find that you still need financial assistance after insurance coverage, you may be abel to work with the care provider to set up a payment plan or other financing options.

Answer: Sometimes Regence will cover out-of-network rehab programs. Depending on your plan type, you may receive a low level of coverage or be partially reimbursed for out-of-network care.

However, your out-of-pocket cost will likely be much higher and you may be expected to pay the full cost of your treatment.

As best practice, stick to in-network rehab facilities. This way, you can keep your out-of-pocket costs as low as possible. You may still need to pay copays or coinsurance, but you will not be responsible for every part of the cost.

Regence offers several different health insurance plans depending on your location and your employer, if you receive healthcare through your job.

You’ll find that Regence offers individual and family plans as well as some Medicare plans.

Some Regence plans you may be able to choose from include:

Individual and family plans:

• Cascade bronze plan
• Cascade silver plan
• Cascade gold plan
• Essential bronze plan
• Health savings account (HSA) bronze plan
• HSA silver plan
• Traditional bronze plan
• Traditional silver plan
• Traditional gold plan

Medicare plans

• Regence Valiance (No Rx)
• MedAdvantage + Rx Core
• MedAdvantage + Rx Primary
• MedAdvantage + Rx Classic
• MedAdvantage + Rx Enhanced

When choosing between plans, it can be helpful to compare variables like deductibles, copays, coinsurance, health savings accounts (HSA), and pre-authorization requirements.

While there are factors that affect your coverage, Regence doesn’t determine coverage levels based on the type of addiction you’re getting treated for. Virtually any substance addiction is covered.

Common addictions Regence covers treatment for can include:

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

Other addictions less commonly treated can also be covered such as nicotine or marijuana addictions. You’ll need to double check that your plan covers this treatment, however.

Now that you’ve learned about Regence insurance coverage and addiction treatment, you’ll need to start looking for a treatment center. This can be overwhelming for some people, so here are a few tips.

Tips for finding a rehab facility that accepts Regence:

1. Talk to your doctor. Ask your doctor for some referrals, they should be able to give you a list of treatment centers in your network.
2. Call Regence. Talk to a representative from Regence or use their “Find a doctor” function on their website to ensure a treatment facility is in-network.
3. Use the Substance Abuse and Mental Health Services Administration’s (SAMHSA) treatment locator. This is a confidential search engine designed to help you find treatment centers in a particular location.
4. Check out our state-specific treatment center lists. Each list offers insurance information for some of the top reliable facilities in your state, many of which are accredited.

Many people rely on Regence to access more affordable addiction treatment, but it’s important to understand what your plan has to offer in the way of coverage.

If you’re ready to start your recovery journey or find yourself with more questions, don’t hesitate to call our helpline today.