Does Tufts Health cover Inpatient Alcohol and Drug Rehab Centers?

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Seeking help for your addiction is a courageous step that can feel intimidating at first, but it is worth it in the long run. Substance use disorder is a debilitating disease that affects millions of American families daily. Over 21 million people in the United States struggle with addiction to drugs or alcohol.1 intro In New England alone, almost 4,000 people died from drug overdoses in 2020, and this number continues to rise yearly.2 Massachusetts, Rhode Island, Connecticut, New Hampshire, Vermont, Maine

Many put off getting help for different reasons, like fear of judgment, guilt, or financial burden. Overcoming the worries and stigma that may hold you back from getting help opens the doors to countless options for support and assistance throughout your recovery journey.

Tufts Health Plan offers different levels of coverage for various substance use disorders and mental health treatments in Massachusetts, Rhode Island, Connecticut, and New Hampshire.3 They cover many addiction services, such as medical detox, residential rehab, and outpatient programs, while providing a wide range of tools and resources for members to take full advantage of their benefits.3

Different factors specific to your situation, like your location, the type of services you need, the facility you choose, and the duration of your treatment, determine your level of Tufts Health coverage.

You may wonder what level of coverage you’ll receive under your specific Tufts Health plan. Rehab centers can check your coverage based on the information you provide. You can also call the number on the back of your insurance card or reach out to American Addiction Centers (AAC) for assistance verifying your insurance.

What will Tufts Health cover?

There are several treatment options for substance use disorder, and some work better than others, depending on your unique needs. Often a combination of different methods like medical detox, behavioral therapy, and pharmacotherapy is used to fight addiction. Your Tufts Health Plan will cover various services depending on your specific plan. Some common addiction treatments that may be partially or fully covered under Tufts Health include:4 What are treatments for drug addiction?

  • Inpatient or residential rehab: If your addiction is severe, treatment in inpatient or residential rehab, where you’ll receive continuous monitoring and care, could be a good option. Most standard inpatient programs last about 30 days and offer a supportive, safe space to live during recovery. Sometimes separating yourself from your environment can be beneficial to take a break from the stress and distractions of daily responsibilities and focus solely on getting better. You’ll develop coping skills to handle your addiction triggers in a healthy way, promoting long-term recovery.
  • Outpatient rehab and therapy: Outpatient rehab may be a good place to start for people with mild or moderate addiction. You may still want to tend to your daily responsibilities, like work and family while seeking treatment. With outpatient rehab, you can still live at home while visiting a treatment center as often as you’d like. You’ll have opportunities to receive similar treatments to inpatient rehabs, like medical detox, behavioral therapies, peer support, and addiction aftercare, while building new skills and setting yourself up for long-term sobriety.
  • Intensive outpatient programs (IOP): IOPs are more rigid, community-based outpatient programs where you continue living at home while in treatment but are required to visit your treatment center multiple times a week, based on your schedule.
  • Partial hospitalization programs (PHP): Also called day programs, PHPs are similar to inpatient rehab, but they allow you to remain living at home. You’re required to visit a treatment facility weekly for about 20 hours, at least 5 days a week.

Does Tufts Health Cover Mental Health Care Treatment Facilities?

As one of the essential health benefits, mental health treatment is considered a necessity for well-being.5 Mental health care is often necessary to effectively treat substance use disorders that coincide with mental health illnesses or co-occurring disorders.1 intro Co-occurring disorders, or “dual diagnoses,” are extremely common. About half of those suffering from substance use disorder also struggle with at least 1 mental health illness like depression, PTSD, anxiety, bipolar disorder, or ADHD.1 intro

It’s unclear exactly how co-occurring disorders arise, but mental health professionals recommend treating co-occurring disorders in tandem for the most effective results.4 Points to Remember Some people develop mental health disorders from extensive drug or alcohol use over a long period of time, while others form an addiction trying to alleviate the symptoms of their mental health illness with substances.1 does one cause the other?

Targeting both disorders simultaneously heightens the chances of long-term recovery by treating the issue as a whole.1 what should I do? Under the Affordable Care Act, insurance providers are required to offer at least some coverage for mental health care and treatment.5 This means that coverage for co-occurring disorders and stand-alone heroin rehab will always be covered under your Tufts Health insurance.

How Long Does Tufts Health Cover Inpatient Drug Rehab Centers?

Everyone is unique, and one treatment won’t work for all. But it’s agreed among mental health professionals that staying in treatment as long as possible significantly heightens your chances for long-term recovery and remaining sober.4 Points to Remember Taking the time you need for treatment throughout your recovery and even after allows you to focus on any underlying issues that may be contributing to your addiction and understand how to fight addiction triggers.

Addiction aftercare is also very important for a successful recovery and is often recommended for at least a year after treatment. 4 Points to Remember

If you want to know how long your Tufts Health plan will cover your treatment, call the number on the back of your insurance card or contact the rehab that you’re interested in attending. Several factors besides your specific plan can affect your level of coverage, like where you live, the services you need, and the facility you choose. Since there are so many types of policies and tiers of coverage, you should verify your insurance benefits to know exactly what’s covered under your plan. AAC can also assist you in verifying your health insurance.

What if my Tufts Health policy does not cover Inpatient Alcohol and Drug Rehab Centers?

If the treatment center you’re interested in isn’t covered under your Tufts Health policy, don’t be discouraged. There are still many options for financial assistance, such as grants, scholarships, and loans. Federal, state, and local organizations assist with many different addiction treatment services, like medical detox, inpatient or residential rehab, outpatient rehab, and mental health treatment. Some, or all, of the cost of addiction treatment could be covered depending on your circumstances. Some common options for financial assistance include:

  • The Affordable Care Act (ACA): The ACA offers coverage for different addiction treatment programs for people with low or no income.5
  • Government-funded programs: The Substance Abuse and Mental Health Services Administration (SAMHSA) provides financial assistance for high-risk and at-risk populations through block grants. Anyone struggling with addiction, especially IV drug users, mothers, and expecting mothers, is encouraged to apply.6 What is a Block Grant?
  • State-funded rehabs and local assistance: Many state and local treatment facilities and community organizations provide partial or full coverage for the costs of addiction treatment programs and medical detox through scholarships.
  • S. Department of Veterans Affairs (VA): The VA offers access to different services, like medical detox, outpatient programs, and mental health treatment for Veterans struggling with addiction.7 What services does VA provide for Veterans with substance use problems?
  • Loans and financing: You can finance your recovery journey by taking a loan from a bank or private lender.

Getting the best treatment as soon as possible is most important. Instead of pushing it off for another day, learn more about ways to finance your recovery journey.

Tufts Health In Network vs. Out of Network Inpatient Drug Rehab Centers

The best way to guarantee Tufts health coverage for at least some part of your treatment is to choose a provider in your network. Provider networks include rehab facilities, specialists, detox programs, and recovery programs contracted to offer quality healthcare services through your Tufts Health insurance.

With an in-network provider, you’ll receive at least some coverage for treatment, but you might still pay other fees like deductibles and copays. When choosing a provider outside your network, you’ll likely have to pay high out-of-pocket costs.

If you can’t find the coverage you need in your network, Tufts can help you find the best available coverage and access the care you need. To figure out whether a provider is in your network, contact your Tufts insurance provider or reach out directly to the rehab center you’re interested in for more information.

How to Find Tufts Health Covered Inpatient Alcohol and Drug Rehab Centers?

Many common addiction treatments are covered to some extent if you have Tufts health insurance. Tufts Health Plan offers a variety of coverage levels and plans that provide high-quality substance use and mental health treatment at affordable rates, available in Massachusetts and Rhode Island. Some of the most popular plans include:8 Employer-Sponsored Plans,9,10

  • Health Maintenance Organizations (HMOs): With HMOs, your primary care physician will coordinate care. HMO plans are cheaper and only offer coverage for in-network providers.
  • Preferred Provider Organization plans (PPOs): PPOs offer the freedom of seeking care from any doctor in or outside of your network without a referral from your PCP. Because of this, they have higher monthly premiums. You’ll still have to pay out-of-pocket costs for services from providers outside of your network.
  • Advantage HMO and PPO plans: These plans have lower monthly premiums and higher deductibles that have to be met before your insurance offers coverage.
  • Medicaid: Individuals and families with lower incomes may qualify for Medicaid coverage through Rhode Island Medicaid or MassHealth. With Tufts Medicaid, you’ll receive full state Medicaid coverage benefits.
  • Medicare Advantage: Tufts Medicare Advantage Plan is an all-inclusive alternative to original Medicare for seniors in Massachusetts. It provides HMO-style coverage and additional benefits that aren’t included with standard Medicare. Coverage only applies to in-network providers.

AAC is here to assist you with verifying your Tufts Health insurance coverage. If you contact our helpline, you can speak directly with one of our representatives, who can check your benefits right while you’re on the phone. You can also fill out our SSVOB form to instantly determine which providers are in your network or reach out through online chat and speak with an agent for assistance.

Our top-notch facilities at AAC offer high-quality care and evidence-based treatment from well-renowned mental health professionals across the nation. A healthcare professional can design an individualized treatment plan to best fit your needs and meet you where you are in your addiction journey. Many of our centers offer specialized treatment programs and addiction care, such as medical detox, behavioral therapy, inpatient or residential rehab, outpatient programs, and addiction aftercare.

AdCare Treatment Centers are a group of top-tier treatment facilities and hospitals in New England, covered under Tufts Health insurance. With 2 inpatient facilities and 7 outpatient programs throughout Rhode Island and Massachusetts, AdCare provides a wide array of high-quality treatment options to best accommodate everyone’s unique needs. AdCare has been serving New England residents for over 45 years, providing access to treatment like day programs, co-occurring disorder treatment, medical detox, and telehealth. Each AdCare facility is a supportive environment for treatment and compassionate care from well-trained professionals.

Accepting your addiction and getting help is the first step to welcoming health and happiness back into your life. If you’re ready to start your recovery journey, AAC can help you along the way.

What Rehab Centers Take Tufts Health Plan Insurance? 

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Tufts Health insurance plan, the following AAC facilities accept Tufts Health Insurance for drug and alcohol addiction rehab.

  • AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and tele-health.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need.

Will my insurance pay for treatment?
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  • You may receive treatment at one of our facilities at a reduced rate.
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