Centene Corporation Insurance Coverage for Addiction Treatment
Learn if Centene insurance covers drug rehab, mental health, and addiction treatment. Find out about coverage for detox, therapy, and medication-assisted treatment options.
Centene Corporation Insurance Coverage for Addiction Treatment
Learn if Centene insurance covers drug rehab, mental health, and addiction treatment. Find out about coverage for detox, therapy, and medication-assisted treatment options.
Centene Corporation was founded in 1984 and originally sold Medicaid plans in Wisconsin. The origin of the company is heartwarming — it was started by a hospital’s bookkeeper to help lower income folks get the healthcare they need. The bookkeeper, Betty Brinn, had grown up in a children’s home, so she knew firsthand the challenges lower income families face. Today, this company offers multiple insurance plans that cover 1 in 15 Americans.
Does Centene Corporation Cover Addiction Treatment?
It’s common to wonder if your insurance plan will cover drug rehab. The good news is that there was a law passed in 2010 called the Affordable Care Act (ACA). This law says most long term insurance plans have to cover specific health benefits. Both mental health and addiction treatment are on the list. That means most Centene plans will help pay at least some of the cost of drug rehab. However, there are exceptions to the law, so be sure to verify your coverage.
There are multiple types of addiction treatment. Your doctor will create a treatment plan showing the path you should follow. After you finish treatment, there are a lot of aftercare resources that can help you stay on the right track long term.
Before you start treatment, though, it’s important to understand the details of your insurance. Different plans have different coverage. The insurance company can help you find treatment centers in the plan’s network, for example. That maximizes your insurance benefits while helping you pay lower out of pocket costs.
Medication-Assisted Treatment: Does Centene Cover Suboxone & Methadone?
Medication-assisted treatment (MAT) is a form of treatment available for alcohol and opioid addictions. With this form of treatment, FDA-approved medications are combined with other therapies to treat substance use disorders. Centene plans may cover expenses for any prescription medications that are required for your addiction treatment, such as Suboxone or methadone. The specific plan determines how much you’ll have to pay out-of-pocket.
MAT programs generally include counseling and individual and group therapy, and this aspect of the program is also covered by most Centene plans. Keep in mind you may need a referral to a MAT program to get insurance coverage, and your doctor might need to preauthorize the care with the insurance company before you begin.
Does Centene Corporation Cover Other Mental Healthcare?
Behavioral health encompasses both mental health and substance use treatment. Most Centene plans offer resources to support members who are experiencing stress, anxiety, depression, and other mental and behavioral health concerns.
Depending on your plan and medical needs, you might be able to get coverage for both inpatient and outpatient services. These services include crisis support, individual and group therapy, medication to manage mental health, and more.
One thing that’s important to keep in mind is that many people have both a mental health diagnosis and substance use concerns, which is known as co-occurring disorders. In this case, getting integrated treatment for mental health and addiction together is essential to achieving long term recovery.
Common types of therapy that may be covered by your insurance plan include Cognitive behavioral therapy (CBT), Dialectical behavior therapy (DBT), Motivational interviewing, and trauma-based therapy.
What Kinds of Insurance Does Centene Offer?
Centene has a clear focus: they offer Medicaid plans, Medicare Advantage options, and individual and family plans through the Health Insurance Marketplace in multiple states. In fact, they are the nation’s largest Medicaid managed care organization. That makes sense since they started off as a Medicaid provider.
Medicare Advantage plans are options for older Americans and others who qualify for Medicare. These plans can help you get benefits that aren’t normally part of Medicare, like dental or vision coverage. However, they also have more limited provider networks.
Families and individuals can get Centene plans on their state’s insurance marketplace. The insurance marketplace was created by the ACA. It helps Americans get affordable insurance coverage by providing lower premiums for those with lower incomes. You can sign up or change your insurance in the marketplace during certain times of year.
It’s important to understand that every insurance plan is unique. Your plan will have a specific provider network and out of pocket costs for every type of care, including drug rehab. To set yourself up for success, be sure to get the details before you start treatment.
What Inpatient Rehab Does Centene Corporation Cover?
Most Centene plans cover both inpatient and outpatient addiction treatment. However the amount of coverage varies by plan and state.
Depending on the individual policy Centene insurance may cover inpatient rehab services such as medical detox and residential treatment. It is extremely important that individuals check with their insurance provider to determine coverage and out of pocket expenses. You’ll also want to know if prior authorization is required and if you need to stick with in network providers.
In-patient medical detox allows for individuals to receive medical supervision while going through the withdrawal process. This can take anywhere from a few days to a couple of weeks. Healthcare providers will provide medication and other treatment to help manage withdrawal symptoms in an environment where clients have 24/7 support. Medical detox can take place in a dedicated inpatient detox facility, hospital or residential setting.
Residential treatment allows you to focus fully on treatment without any outside distractions. You may have individual and group therapy. Many treatment centers also offer holistic treatment like yoga and meditation along with art therapy and other options. You’ll live full time at the facility for the duration of the program which is between 30 and 90 days.
What Types of Outpatient Addiction Treatment Does Centene Corporation Cover?
Outpatient rehab and detox is covered by most Centene plans. Depending on the individual policy, Centene may cover outpatient rehab services such as partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs). They likely also cover general outpatient care and medication assisted treat (MAT).
MAT uses FDA approved drugs to support the recovery process for weeks or months and in some cases years. Studies show that MAT greatly decreases relapse rates and allows you to focus on recovery rather than cravings.
PHPs are full day programs where you receive treatment similar to a residential program but you go home at night. An IOP offers around nine hours of treatment a week and often has evening or morning sessions so you can accommodate work or school. These intensive programs are helpful after you finish residential treatment.
After the intensive programs you step down to general outpatient care which offers 1 or 2 hours of counseling a week. You can also get aftercare support and connections to peer support groups.
How to Verify Your Centene Corporation Coverage
Centene has a variety of ways for their members to verify their insurance coverage. One way to do this is by calling the toll free number on the back of the member card. Centene also has a website where participants can look up benefits and find in network medical providers or find educational health information.
Finally if you have a specific treatment center in mind they may be able to help with verifying your insurance. They can also let you know if you need your doctor to call for preauthorization before you begin treatment.
Calls to any general helpline will be answered or returned by one of the treatment providers listed, each of which is a paid advertiser.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
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