Does GEHA insurance cover Alcohol and Drug Rehab or Detox Centers?

Choosing to break free from substance use is courageous, and you need the right support to have long-term success. Fortunately, there are treatment centers available that can teach you new habits and help you embrace life without substance use.

How can you pay for treatment, though? The good news is that if you have GEHA healthcare coverage, your insurance plan can pay for some or all of the cost of treatment. The Affordable Care Act (ACA) requires all long-term health insurance plans to cover 10 essential health benefits, which include substance use and mental health treatment.

Every plan is different, however, so it’s important to understand the details of your GEHA insurance coverage before you commit to a treatment program. You can call the number on your insurance card or contact American Addiction Centers (AAC) by online chat, over the phone, or by filling out the form on this page.

We’re here to help you understand how you can use GEHA coverage to get the care you need.

What is GEHA?

Government Employees Health Association (GEHA) is a medical plan provider for federal employees, federal retirees, military retirees, and their families.^{2, Exclusively for…} GEHA was founded in 1937 by a group of postal clerks, and today is one of the largest medical and dental plan providers in the U.S. that exclusively serves federal employees.^{2, Our history}

GEHA health plans are designed specifically with federal employees in mind, with a network of providers that spans the country.^{2, Large network} You can also take advantage of telehealth options anytime and anywhere.^{2, Large network} In addition to health coverage, GEHA plans include rewards for healthy habits, prescription coverage, and other benefits.^{2, Benefit plans…} They offer a variety of individual and family plans, as well as Medicare Advantage plans.^{3, Five medical…}

What are GEHA Coverage Levels and Plans?

GEHA has 5 primary plans:^{3, Five medical…}

• The Elevate plan focuses on offering a low monthly premium, although it may cost you more out-of-pocket to get care.^{3, Five medical…}
• The high-deductible plan helps you save money by charging a lower monthly premium and allowing you to set aside money for your deductible, which you pay before insurance coverage kicks in.^{3, Five medical…}
• The Standard plan focuses on offering balanced coverage for a variety of life’s needs.^{3, Five medical…}
• The Elevate Plus plan has a low deductible and generous rewards programs while having a higher overall monthly premium.^{3, Five medical…}
• The High plan offers the most comprehensive coverage with low out-of-pocket costs, but you pay a higher monthly premium in return.^{3, Five medical…} Some plans also offer additional benefits, including gym discounts, vision coverage, and other perks.^{3, Rewards and savings}

Which States Do GEHA Operate In?

As a provider of plans for federal employees, GEHA operates throughout the country.^{2, large network} Federal employees live in every state, and GEHA is available to provide coverage for their needs.^{2, large network}

What will GEHA insurance cover?

Substance use treatment will be different for every person, so it’s important to work closely with your doctor to determine the best treatment for your needs. Your doctor will ask about your substance use, history, home environment, and more. It’s vital to be honest, so you get the care you need.

Some common types of treatment include:^{4, 5, p. 30}

• Inpatient rehab. During inpatient care, you receive around-the-clock care and support while you work on developing new habits to help you live without substance use. The therapists at inpatient care facilities are trained to identify the root issue and develop a treatment plan that addresses your unique needs.
• Outpatient rehab. Outpatient sessions focus on drug abuse education, individual and group counseling, and teaching participants how to cope without their substance use. This type of treatment can be a starting point for treatment or a follow-up after you graduate from inpatient treatment. During outpatient treatment, you can often work or attend school normally.
• Intensive outpatient programs (IOP). Intensive outpatient treatment is a type of treatment where you go to therapy several hours a week, but not full-time. Treatment includes counseling, educational programs, and medication management if required. The care is more focused than normal outpatient care, and IOPs are structured programs that follow a schedule and routine. The program helps you build the skills you need to live life without substance use.
• Partial hospitalization programs (PHP). PHP programs provide daylong treatment for individuals who do not require round-the-clock supervision, but who can benefit from a highly structured treatment setting. You receive treatment during the day and can then put your treatment skills to use at home in the evenings and on weekends. PHP programs have significant amounts of individual and group therapy where you learn better ways to deal with your stress instead of turning to alcohol and drug abuse.

No matter what program your doctor recommends, it’s important to follow the entire treatment process through until the end. It’s common to want to quit when you start to feel better, but the best way to achieve long-term recovery is to practice your new skills in a safe environment for as long as possible.

Does GEHA Insurance Cover Mental Health Treatment Facilities?

Struggling with both mental health and substance abuse is common. In fact, about 50% of those who deal with substance use also have a mental health diagnosis, which is known as a co-occurring disorder.^{6, second paragraph} What’s important is to treat mental health and substance use issues together — research shows that integrated treatment has the best chance of long-term success.^{7, first paragraph} Fortunately, many treatment programs are equipped to help you with both your mental health and substance use.

Does GEHA medical insurance include coverage for mental health treatment, as well as substance use? It does because the ACA includes mental health treatment among the 10 essential health benefits plans are required to cover.^{1, fifth bullet} Each GEHA plan will have its own requirements and limits to coverage, so it’s important to know the details before you start treatment.

To find out that information, you can call the insurance company directly or connect with AAC anytime, 24/7. Our admissions navigators can verify your insurance in just a few minutes while they chat with you and answer any questions you have about rehab.

We know you deserve a life of freedom where you can chase your dreams, and we’re here to help you take those first steps.

How Long Does GEHA Insurance Cover Rehab?

One of the most common questions we hear is, “How long is rehab?” That answer is different for everyone, but research shows that it takes most people at least 90 days to make a major change in their substance use, including stopping.^{8, fifth point} That’s why many treatment programs are 3 months long.

Your treatment process may be longer, though, especially if it includes multiple treatment options. For example, you may spend a few months in inpatient treatment and then attend an outpatient program afterward.

What’s most important is that you complete your entire treatment process. The best way to achieve long-term recovery is to participate fully in treatment every step of the way.

Different GEHA plans may have requirements or limits to the insurance coverage for rehab, so that’s why it’s important to review your coverage before you commit to a program.

What if my GEHA policy does not cover rehab?

When you review your treatment options, you might find that your GEHA insurance coverage covers only part of the cost of rehab, and you have to pay the rest. Or, you might have found a program you want to attend, but it’s not covered by GEHA insurance benefits, so you have to pay the full cost.

Don’t let these financial situations cause you to panic or give up on getting treatment. There are many ways to pay for rehab, and your insurance is only part of the solution. For example, some programs offer scholarships for your portion of the cost, or you might be able to set up a payment plan. Some people borrow money from friends and family to get the care they need.

The 1 thing that’s certain is that it’s essential to get treatment now. There’s no perfect time for rehab, and substance use has serious health and legal consequences. Getting the care, you need now can help you break free before it’s too late.

Check GEHA Insurance Coverage for Rehab

A life without substance use allows you the freedom to chase your dreams and create a life you love.

To get started, you’ll want to understand the details of your GEHA rehabilitation coverage so you can choose a rehab program that meets your needs and accepts your insurance. We can help. Simply reach out to AAC by online chat, over the phone, or by using the form below.

You deserve freedom. To take the first steps, contact us today.

GEHA In Network vs. Out of Network Rehab Centers

As you look at different treatment centers, you’ll notice that some of them are considered “in-network” with your GEHA rehab coverage, while others are “out-of-network.”

What does that mean? Every insurance plan has a group of facilities, hospitals, and doctors that agree to treat plan members for a lower price.^{9, p. 1 What’s a Provider Network} That group is the plan’s provider network.^{9, p. 1 What’s a Provider Network}

Using a treatment program in the network will allow you to maximize your GEHA insurance for addiction treatment and keep your own costs low.^{9, p. 2, Why do some plans…} However, there may be no coverage for a rehab outside the network.^{9, p. 2, Why do some plans…}

The best option is to find a substance use treatment program that’s part of the GEHA network. If that’s not possible, don’t panic—as we mentioned earlier, there are many ways to pay for rehab.