value-options-rehab-coverage

Value Options Insurance Coverage for Drug & Alcohol Rehab 

 

NOTICE: Step One Rehab works hard to make sure our information is accurate. Due to constant changes in insurance company policies, we suggest you contact your insurance company with your member ID for any policy questions. This FAQ is only intended as a guide to point you in the right direction.

Value Options Drug and Alcohol Rehab Coverage – FAQ

Note: Value Options is now Beacon Health Options.

Where does Value Options Operate?

Value Options, now Beacon Health Options (Beacon), combined Beacon Health Strategies and Value Options. They serve more than 50 million people across all 50 states and in the United Kingdom.

Value Options / Beacon Health is Headquartered in Boston, MA.

Does Value Options Cover Rehab?

Value Options often will cover drug rehab. They base coverage on a number of factors which vary based on your plan. Value Options offers a host of plans for health insurance.

Their coverage ranges from partial to full. You are responsible for whatever they do not cover. If your plan has a deductible, you have to pay the deductible amount before your insurance coverage takes over.

Most Value Options plans have coverage for the following:

  • Detoxification
  • Inpatient/residential treatment
  • Partial hospitalization
  • Intensive outpatient programs (IOP)
  • After-care programs
  • Various mental health and behavioral health programs

To manage your Value Options plan, or learn more about it, you can visit Value Option’s Member Connect. They also have a mobile app.

How Long will Value Options Cover Addiction Treatment?

Value Options coverage length varies. It can be only a few day, or up to several months.

Are out of network providers allowed with Value Options?

Out-of-Network providers are allowed with their PPO plans. They are not allowed with an HMO plan, or will incur additional costs. If you have anHMO or POS plan, you must choose a Primary Care Physician (PCP) to ensure coverage. PPO plans do not require a PCP or referrals for specialty care.

Contact Value Options to confirm your level of coverage, if any, for out-of-network providers.


Does Value Options Allow for Treatment at Luxury Rehab Facilities?

Yes, though not for all plans. Luxury (private) drug rehabs are often where wealthy people and celebrities will go for addiction help. They are often as nice as any hotel or resort you may use for a vacation spot. They usually have massages, acupuncture, hot-tubs, pools, and quality dining, in addition to other exclusive privileges.

 

 
Premier Settings

Premier Settings

Private Gyms

Private Gyms

Massage Therapy

Massage Therapy

Yoga

Yoga

Inpatient Addiction Treatment vs. Outpatient Treatment

This is one of the biggest and most important choices that a patient or their family will make when looking for addiction help. Where you go, and what you do from here on matters and can determine your level of success.

Both options are better than not seeking treatment and could save your life. They each have their own strengths and weaknesses.

An outpatient facility is usually a local option. They give you the chance to meet with Value Options professionals like doctors, alcohol and drug counselors, or therapists, attend group sessions, and go to recovery meetings while being able to head home afterwards. Co-pays may be required for each visit.

Inpatient facilities, also called residential programs, are most often 28 day programs. They provide structure and are typically remote destinations where you stay in the facility for the duration of the program.

Do I need Insurance to go to Rehab?

You are not required to have insurance to get addiction treatment. However, without insurance, the cost of drug rehab facilities is usually very expensive and impractical for most people. You would need to pay out of pocket. You can certainly pay with a credit or debit card, work out a payment plan, or use other methods that each facility accepts.

Typical inpatient rehabs may cost anywhere from $6,000-$20,000 for a 28 day program.

Outpatient Rehab can range from $4,000-$10,000 for 90 days. The cost of outpatient rehab will vary and is mostly based on how many visits are made.

 How does Value Options Decide my Claim?

The majority of Value Option’s health plans have been awarded NCQA Accreditation and URAC Accreditation.

Value Options makes decisions about their coverage based on your health plan. Each claim decision is reviewed on a case by case basis and varies by state. In general, Value Options will look at services you use. They then follow national guidelines and other policies to determine if you’re covered. Services that may be covered can include drug addiction rehab, blood-tests, surgeries, or hospital stays.

For drug treatment, you many need a doctor’s evaluation and recommendation, and you may need prior approval from Value Options.

If your claim is denied, Value Options will notify you. You DO have the right to appeal.  To start an appeal with Value Options, call their Member Services number on your Value Options ID card. You do have a time-limit to file for an appeal. It starts from the date of the initial payment (or denial notice). This deadline varies by state, so you will need to ask about your specific process.  

All Value Options appeals are responded to compliance with state, federal and NCQA guidelines. It is possible to get appeals expedited.

Follow this link to see more about Value Option’s Appeal Process, or see their Members Rights & Responsibilities Page

What Else does Value Options Provide?

Value Options has a host of health, wellness options, and discounts

A network of over 50,000 providers.

24/7 Support

A variety of plans and the ability to manage and adjust your plan.

Per HIPAA laws, anything that you say is kept confidential. You don’t have to worry about anyone knowing you may have trouble with alcohol or drugs.

They have an Alcohol Screening Tool you may want to use if you are not sure you need help.

Get an Approved Value Options Drug and Alcohol Rehab

Verifying what insurance will cover can be a time-consuming process. This hassle usually involves lots of waiting and multi phone calls back and forth. Our knowledgeable staff can verify your coverage for you and take the stress and annoyance out of this already difficult time. You have enough to worry about already. Verifying insurance coverage for rehab shouldn’t be an additional burden.

Instead, give us a call now and let us handle this step, at no cost to you! We are totally confidential. Our number is 877-348-7494