Does Health Net insurance cover Alcohol and Drug Rehab?

Californians who may have a Health Net insurance plan and are also struggling with addiction may be wondering if they can use their plan to cover alcohol and drug rehab costs. The true answer to this question will be dependent upon many factors, including what type of health plan, including Medi-Cal, Medicare, and individual and family plans, you may have through Health Net, as well as the type of care you need and where you seek care.^{1 para 1}

The best way to find out whether your Health Net plan provides this type of coverage is to verify your benefits. You can do this by calling the number on the back of your insurance card and speaking to a Health Net insurance representative who can help you learn more about your plan and coverage details. You can also work with the rehab center directly to find out whether your plan is accepted at the facility and what your coverage includes.

What is Health Net Insurance?

Health Net insurance is a subsidiary of Centene Corporation, a healthcare company that works with local companies to provide quality, affordable coverage to people across the country.^{1 para 4} Centene Corporation specifically covers nearly 1 in 15 people nationwide. ^{1 para 4}

In the state of California, Centene operates through Health Net.^{1 para 1} Health Net was founded in California more than 40 years ago and today serves 3 million members and offers a 90,000 network of providers.^{1 para 1} The Health Net insurance market provides a variety of different plans through different markets.

Health Net Plans

Health Net insurance plans are available through a variety of different markets. Specifically, Health Net provides plans including Medi-Cal, Medicare, and individual and family plans.^{1 para 1} Health Net also offers group insurance plans to employers, where employees can get coverage through their job.² Health Net is recognized by the National Committee for Quality Assurance (NCQA) for the following health plans:

• Marketplace Exchanges – Health Net IFP HMO, HSP, SBG HMO, IFP EPO and SBG PPO
• Commercial & Medicare Health Net – Health Net Life HMO/POS, PPO, EPO
  • Medicare HMO
• Medi-Cal – Health Net HMO
• Health Net Commercial, Marketplace, Medicare, and Medi-Cal

To find out what type of plan you have, you can look on your insurance card. You can also call the number on the back of your plan to speak with a representative to learn more about your plan.

What will Health Net insurance cover?

Health Net insurance covers a variety of healthcare services, which may include mental health services. As such, you may be wondering what specifically is covered under your health plan. However, because there are so many different plans available through Health Net, it’s impossible to say what is exactly covered by your plan. The only surefire way to find out what is or is not covered by your Health Net plan is to call the number on the back of your card and speak with a plan representative.

Whether your plan covers all addiction treatment types or just some, it’s important to know what addiction treatment may be recommended for you. Here are 4 common types of addiction treatment that may be recommended for you:

• Inpatient or residential rehab. If you attend an inpatient program, you’ll receive care at the facility and live there 24/7 throughout the duration of your care. You will receive around-the-clock medical care and supervision, and you may be able to undergo detox in this facility prior to attending inpatient treatment.^{3, Pg 8, “What types of treatment programs are available?” Para 2,}
• Outpatient rehab or therapy. Outpatient rehab involves traveling to a facility 1 to 2 times per week for treatment. You will continue living at home during this time and will travel to the outpatient rehab facility as needed.^{3, Pg 10, Para 2}
• Intensive outpatient programs (IOPs). If you’re a patient in an IOP, you’ll generally be required to attend a minimum number of hours of treatment each week, and you are not required to stay overnight in this treatment program.^{3, Pg 10, Para 3}
• Partial hospitalization programs (PHPs). In a PHP, you’ll be required to attend 4–8 hours of care or treatment per day, multiple days each week, but will return home in the evening.^{3, Pg 10, Para 1}

Even though the treatments are listed here, they may not be recommended for you. Nor is it guaranteed that your Health Net plan will cover these addiction treatment methods. To verify your benefits and coverage, be sure to call the number on the back of your insurance card. Whenever possible, it’s recommended that you check your benefits and coverage before seeking care.

Does Health Net Insurance Cover Inpatient Mental Health Treatment Facilities?

Health Net Insurance benefits may be vast and may include coverage for inpatient mental health treatment facilities and treatment rendered at such facilities. This is because the Affordable Care Act (ACA), a federal healthcare reform law, mandates almost all U.S. health plans to provide coverage for certain health benefits, including mental health care.⁴

Specifically, almost all U.S. health plans, potentially including Health Net insurance plans, are required to provide coverage in some capacity for inpatient mental and behavioral health services, behavioral health services, and substance use disorder treatment.⁴

This means that those who need coverage for services like stand-alone heroin rehab or treatment for co-occurring disorder treatment will have it. A co-occurring disorder is what it is known as when someone has both a mental illness and substance use disorder at the same time.⁵

Having one does not cause the other, but if you have a mental illness or substance use disorder, you’re twice as likely to develop the other during your lifetime.⁵ Because of the connection between the 2 conditions, it’s recommended that patients receive treatment for each condition while they’re in rehab.^{4 “What should I do?”}

To learn more about co-occurring disorder treatment, how it may be covered under your plan, and whether inpatient mental health treatment facilities are covered under your plan, call the number on the back of your insurance card.

How Long Does Health Net Insurance Cover Rehab?

You may be wondering if there’s a certain length of time of rehab that your Health Net insurance plan will cover. What’s covered under your plan and the length of time it will extend that coverage depends on the plan you have, the treatment you receive, and where you seek care. Additionally, there may be varying out-of-pocket costs for which you’re responsible when it comes to coverage, including copays, deductibles, and coinsurance. To learn more about what is covered under your plan, call the number on the back of your insurance card.

Please keep in mind that the extent of your Health Net coverage may not align with the length of treatment prescribed by your mental healthcare provider. If this happens to you, you’ll need to prioritize listening to the advice of your provider. Remaining in treatment for the appropriate length of time is essential to the success of your treatment.

Although every person is unique and different, experts recommend staying in treatment for at least 90 days to improve the overall outcomes of your situation.^{6, bullet 5} Some patients may need to remain in treatment for a longer or shorter period than the recommended 90 days. You can work directly with your mental healthcare provider to determine the best course of treatment for you.

What if my Health Net policy does not cover rehab?

It is possible that your Health Net policy may not cover the cost of rehab, whether in full or partial. If this happens to you, and you’re wondering how you can pay for rehab, there may be options available. Depending on the rehab center you choose to attend, the center may offer scholarship options or financing. Be sure to ask facility staff whether this is an available option if you find that your Health Net policy doesn’t cover rehab. Getting the treatment you need today is critical rather than pushing it down the road.

Check Health Net Insurance Coverage for Addiction Treatment

If you’re ready to get the care you need for your addiction treatment and want to use your Health Net insurance to cover some or all of those associated costs, we’re here to help. Call the American Addiction Centers helpline today to speak with a world-class addiction treatment staff member. Our trained staff is here to help you learn more about your coverage and benefits, as well as your addiction treatment options.

By giving us some basic information about your insurance plan, we can help you determine what your addiction treatment coverage entails, as well as locate nearby covered facilities. We can also check whether your insurance plan is accepted at any of our industry-leading treatment facilities across the country.

If you’d prefer to check your benefits on your own, enter your information in the form below.

Health Net In Network vs. Out of Network Rehab Centers

The terms “in-network” and “out-of-network” are common in the healthcare world, but for many consumers, understanding what they mean can be difficult. A network is a group of providers and facilities that work with your insurance company to provide healthcare services, often at a lower cost to members.⁷

Every plan has differing requirements for coverage, including whether you must see an in-network provider. Additionally, plans may or may not cover care received at out-of-network facilities, unless it’s a true emergency.

To find out your plan’s network requirements, be sure to call the number on the back of your insurance card. You can also ask the plan representative for help in locating a covered provider near you. Or, you can log in to your online platform and use a tool to locate a covered facility nearby.