Does AvMed cover Inpatient Alcohol and Drug Rehab or Detox Centers?

Choosing to break free from substance use is a powerful, courageous choice. You know you need the right substance use treatment to achieve long-term recovery, but how can you pay for it?

If you have AvMed insurance coverage, your insurance plan can pay some or all of the rehab costs. The Affordable Care Act (ACA) requires all long-term insurance plans to cover 10 essential health benefits, which include substance use and mental health treatment.^{1, fifth bullet}

AvMed is one of Florida’s oldest and largest non-profit health plans, providing coverage in 52 of Florida’s 67 counties.^{2, second paragraph} They offer a variety of plans, including individual and family plans, Medicare Advantage, and insurance through employers.^{2, second paragraph}

AveMed is celebrating more than 50 years of offering high-quality, cost-effective insurance plans for members in Florida, with excellent customer service and a focus on member health.^{2, first paragraph}

Different AvMed medical insurance plans will have different coverage levels and requirements, so make sure you know the details before you choose a rehab. You can call the phone number on the back of your insurance card, or you can contact American Addiction Centers (AAC) using online chat, by phone, or by filling out the form below. We’re here to help you get the care you need.

What will AvMed cover?

No treatment plan works for everyone, so you’ll need to work with your doctor to create a plan specific to your needs. AvMed coverage will focus on paying for the medically-necessary care your doctor recommends.

It’s important to be honest with your doctor about your substance use, how long you’ve been using, your home environment, and more. It’s an essential part of getting the recommendations you need to get the care you need to create a life you love.

Some of the most common types of treatment for substance use include:³

• Inpatient rehab. Inpatient treatment is an excellent way to focus on your recovery without the distractions of everyday life. You’ll receive around-the-clock care and get the opportunity to begin the process of creating new habits to create a life free of substance use. You receive a combination of group and individual therapy to address the underlying causes of substance use.
• Outpatient rehab. Outpatient care is typically less intensive than inpatient treatment, meaning you can continue to work or attend school while receiving treatment. Outpatient sessions focus on drug abuse education, individual and group counseling, and teaching participants how to cope without their substance use.
• Intensive outpatient programs (IOP). IOP programs meet for a few hours a day, several days a week. The program is more intensive than normal outpatient care and includes counseling, educational programs, and medication management if required. IOPs are structured programs that follow a schedule and routine, which can help you build the habits you need to live life without substance use. They also offer courses to address the issues that cause addiction, such as trauma, emotional regulation, self-discovery, and more.
• Partial hospitalization programs (PHP). In a PHP, you get a similar treatment intensity and daily structure to that of inpatient/residential programs, but with the added benefit of being able to return home in the evenings and on weekends. PHPs offer a variety of services, such as one-on-one therapy, group therapy, family meetings, medical services, and treatment of co-occurring mental health disorders.

No matter what types of treatment your doctor recommends, what’s most important is that you follow through completely. It’s tempting to stop treatment as you start to feel better, but if you haven’t finished your program, you risk relapse. Instead, finish your treatment process entirely. That will give you the best chance of long-term recovery.

Does AvMed Cover Mental Health Care Treatment Facilities?

Having a mental health diagnosis alongside substance use issues can feel frustrating and make you feel alone. However, you aren’t alone—in fact, 50% of those who struggle with substance use also have a mental health diagnosis, which is known as a co-occurring disorder.^{4, second paragraph}

Common mental health concerns that co-occur with substance use include anxiety, depression, PTSD, ADHD, bipolar disorder, and more.^{4, second paragraph} The good news is that you can get treatment for both mental health and substance use at the same time. In fact, this kind of integrated treatment has a much better success rate than only treating one or the other.^{5, first paragraph}

Do AvMed insurance benefits include treatment for mental health as well as substance use? They do because the ACA includes both mental health and substance use treatment in the 10 essential health benefits all long-term plans must cover.^{1, fifth bullet} You can rely on your AvMed mental health coverage to pay at least some of the costs of in-network mental health care.

How Long Does AvMed Cover Inpatient drug Rehab centers?

How long is rehab? We often hear this question, but no answer applies to everyone. Studies show that people generally need at least 90 days to make a substantial change in their substance use, including quitting.^{6, fifth point} As a result, most treatment programs are at least 3 months long.

Your specific treatment process may be longer, however, and might include multiple treatment options, such as inpatient treatment followed by outpatient care. What’s important is not how long rehab is, but that you follow the treatment program completely all the way through. That’s the way to give yourself the best chance at long-term recovery.

Of course, different AvMed coverage plans have different coverage levels and requirements, so be sure you verify your insurance before you commit to treatment. You can call AvMed directly, or you can contact AAC anytime, 24/7. Our admissions navigators can review your insurance in just a few minutes while chatting with you, and answer your questions about rehab as well.

What if my AvMed policy does not cover Inpatient drug rehab center?

What if you find out that your AvMed rehab insurance only covers part of the cost of treatment, and you have to pay the rest yourself? Or if you discover your target treatment program isn’t part of the AvMed network coverage, so you have to pay the full cost yourself?

Don’t let these financial situations keep you from getting the care you need. There are many options when it comes to paying for rehab, and your insurance isn’t the final word. For example, some treatment programs offer scholarships for your portion of the cost, or you might be able to set up a payment plan.

You might also be able to borrow money to cover the cost of rehab. One thing is certain; when you are substance-free and living the life you truly want, you’ll be much more capable of managing your financial obligations.

The main thing is to not let financial concerns cause you to put off treatment. There’s no perfect time to go to rehab, and substance use has serious long-term legal and health ramifications. You want to break free before it’s too late.

AvMed In Network vs. Out of Network alcohol and drug Rehab Centers

As you review your treatment options, you might notice that some treatment centers are listed as AvMed in-network providers, while others are out-of-network. What does that mean?

Every insurance plan has a group of doctors, hospitals, and centers that agree to treat plan members at a lower cost.^{7, p. 1 What’s a Provider Network} This group is known as the plan’s network of providers.^{7, p. 1 What’s a Provider Network}

When you use a provider inside the network, you’ll maximize your insurance coverage and pay less out of your own pocket.^{7, p. 2, Why do some plans…} However, most plans don’t offer any coverage outside the network, so you’ll have to pay the full cost yourself.^{7, p. 2, Why do some plans…}

To make the most of your AvMed rehabilitation coverage, you’ll want to find an in-network treatment facility if possible. If it’s not possible, though, don’t panic. As we mentioned earlier, there are many ways to pay for rehab. The key is to get the treatment you need as soon as possible.

How to find out AvMed Covered alcohol and drug Addiction Treatment programs?

How do you know if a treatment program is part of your insurance network? Let us help. You can contact AAC anytime by online chat, over the phone, or by filling out the form on this page. Our admissions navigators can verify your coverage in just a few minutes. We can also answer questions about rehab and help you take the first steps toward freedom.

You deserve a happier, healthier life free of substance use. It’s time to take the first steps toward a life you truly want. Contact us today.