Does Health Plan of Nevada Pay for Rehab? - Solutions Recovery

Does Health Plan of Nevada Pay for Rehab?

Health Plan of Nevada offers drug rehab insurance coverage.2 This coverage is under the umbrella of behavioral health services and provided by Behavioral Healthcare Options (BHO).2 You may be wondering Health Plan of Nevada covers. Some of the main services you can expect include: 3

  • Substance use services.
  • Inpatient detox services.
  • Outpatient rehab services.
  • Therapy services.
  • Mental health services.
  • Educational resources.
  • Crisis intervention services.
  • Stabilization services for those in crisis.

In addition to these services, Health Plan of Nevada works in coordination with employers to offer Employee Assistance Programs (EAP).3 These programs connect employees with online resources for minor issues involving mental health, stress, and coping.4

How to Use Your Health Plan of Nevada Benefits

Health Plan of Nevada rehab insurance coverage handles all aspects of substance addiction, but you may need prior authorization. Let’s review which services need authorization for in-network or out-of-network addiction treatment:5(pg 16&18)

  • In-network and out-of-network inpatient admissions require prior authorization.
  • Outpatient services require prior authorization for some services. Examples of behavioral health services that may require prior approval include electroconvulsive therapy (ECT), intensive outpatient program treatment, partial hospitalization treatment, transcranial magnetic stimulation therapy (TMS), and psychological testing.

As always, it’s best to consult with your insurance provider about the specific details of your plan’s coverage.

Once you obtain authorization for drug rehab treatment, the out-of-pocket cost will consist of your calendar year deductible (CYD) and your office copay. An estimate of what your copays might be is as follows (keep in mind, this is only an estimate—you should talk to your healthcare provider for the exact amount):6

  • Outpatient services for substance use disorder are $15 per visit.
  • Inpatient services for substance use disorder are 30% of the amount for services after the deductible is met.

If you fail to get pre-authorization, you could be responsible for the entire amount.

As a Health Plan of Nevada member, you can access your plan’s benefits to get the substance abuse treatment you need. Be sure to work with a provider that accepts Health Plan of Nevada, such as American Addiction Centers, Desert Hope Treatment Center in Nevada.

How Do I Check My Health Plan of Nevada Rehab Coverage?

If you want to check your specific health plan benefits and manage your account online, you will first need to create an online account by following these steps:

  1. Access the main website here.
  2. Select the option on the far top right that reads “Create an Account.”
  3. On this screen, you will need to have your insurance member ID ready. Also, you’ll fill out your name, date of birth, zip code, email address, and phone number.

Once you’re registered, you can select “Sign in” at the main website and proceed to the database of information. You’ll be able to access member information as well as tap into resources for members only.

In addition, you can get the MyHPN or MySHL apps in the app store so that you’ll have all the information you need at your fingertips.7

Types of Health Plan of Nevada Insurance Plans

When you sign up for the Health Plan of Nevada, you will have either a Health Maintenance Organization (HMO) plan or a Point-of-Service (POS) plan.8 Health Plan of Nevada does not offer Preferred Provider Organization (PPO) plans. However, the plans they offer will provide all you need in the way of healthcare solutions.

A Health Maintenance Organization (HMO) plan operates with contracted doctors, hospitals, and clinics to deliver service at an affordable rate for all involved.7 The way it works is that the insurance company contracts with the providers and receives a reduced rate.9 As a result, the members must select from within the network of providers and medical facilities that are contracted with Health Plan of Nevada.8

A Point of Service (POS) plan also works with the contracted doctors, hospitals, and healthcare facilities, but you will need to get a referral from your primary care physician to see a specialist.10 A Health Plan of Nevada POS plan has three tiers:11

  • Tier I HMO Benefit Option: This level of service gives you the most coverage for the least out-of-pocket cost, but you still need to get prior authorization for specialty care such as drug rehab.
  • Tier II Expanded Plan Provider Benefit Option: This tier offers a broader range of providers, so if you feel you may need more options for doctors and facilities, this option may work best.
  • Tier III Non Plan Provider Benefit Option: This tier allows you to go to any health care provider or hospital you want. However, you are responsible for paying the costs for care at the time of service. You then file your claim for reimbursement and meet the deductible. You will pay a higher coinsurance with this tier.

You can read more about your plan in this Member Guide or login to your account to see specific details.

American Addiction Centers Accepts Health Plan of Nevada

Struggling with a drug or alcohol addiction can be overwhelming, and you may have put off seeking addiction treatment. Take comfort in knowing that American Addiction Centers (AAC) accepts Health Plan of Nevada, making the process easier for you. We have a convenient location in Nevada for clients who need a reputable substance abuse treatment center. AAC’s Desert Hope facility works with many large insurance providers, such as Health Plan of Nevada, to ensure patients can begin the path to sobriety. You can verify your insurance now safely and securely.

At Desert Hope, you can count on our qualified team to use evidence-based therapies and programs to deliver top-quality service. Additionally, we have a high staff-to-patient ratio, ensuring you get personalized care. We work with board-certified therapists, clinicians, and other professionals, such as physicians and psychiatrists.

Our mission is to make sure you get the help you need to heal. Our programs will aid you in the entire addiction treatment journey—from detox to aftercare and relapse prevention. There is hope for you today. Reach out to one of our helpline representatives and start the process today. Call .

Verify Your Insurance Coverage at American Addiction Centers


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