Freedom Health Insurance Coverage for Drug Rehab

Freedom Health is a managed care organization (HMO) that offers Medicare Advantage insurance plans in Florida. Plans are available to people who are eligible for Original Medicare due to their age or disability.

Freedom Health also offers chronic special needs plans (C-SNPs) and dual special needs plans (D-SNPs) that are available to people who have both Medicare and Medicaid.

Freedom Health’s headquarters are in Tampa, Florida. The company was founded in 2005 and currently has more than 62,000 members throughout 24 Florida counties. As an HMO, Freedom Health utilizes its own network of doctors and specialists to provide services to members.

Freedom Health’s provider network consists of primary care doctors, specialist providers, and pharmacies. Freedom Health has a Medicare rating of 4.5 stars (out of 5) for its Medicare Advantage plans.

Does Freedom Health Cover Drug Rehab & Addiction Treatment?

Freedom Health Medicare Advantage plans do cover mental health and substance abuse treatment in addition to medical treatments. Substance abuse treatment options will differ depending on the policy chosen. Copays or coinsurance may apply. Some policies may also have limitations on certain services.

Freedom Health plans may require you to use doctors and centers in the plan’s network to get coverage, so be sure to check out your plan’s specific details before you commit to treatment. For those plans that have out of network coverage, you’ll pay quite a bit more in out of pocket costs if you use a non network provider, so keep that in mind.

What Types of Inpatient Rehab is Covered By Freedom Health?

Drug rehab treatment options that may be available through Freedom Health’s Medicare Advantage insurance policies include a range of inpatient services.

Detoxification to remove drugs from the body, as part of alcohol or opioid addiction treatment, may be covered through some Freedom Health insurance plans. During detox, typically one of three FDA-approved medication-assisted treatment (MAT) medications–methadone, naltrexone, or buprenorphine–are used. Detox treatment is often administered as part of inpatient hospitalization.

Inpatient drug rehab in a clinic or a hospital may be covered by Freedom Health, just as it is available through Original Medicare Part A. Inpatient care must be verified as medically necessary by a physician.

Inpatient mental health treatment is also part of Freedom Health plans, but it also must be verified as medically necessary and you’ll need to choose a clinic that is approved by Medicare and accepts your specific insurance plan.

What Types of Outpatient Rehab are Covered By Freedom Health?

When you’ve completed inpatient treatment, or if your doctor recommends that you start with outpatient care, there are a variety of programs that may be available to you.

Partial hospitalization programs (PHPs), which are also called day programs, are delivered as outpatient treatment in community mental health hospitals or community mental health centers. In PHP programs patients attend sessions during the daytime and return to their homes at night.

PHPs following Medicare guidelines must be directly supervised by a physician. Treatments must be outlined in an individualized care plan ordered by the doctor. Most PHP sessions last 4-8 hours a day and take place over three to five days a week.

A total of at least 20 hours of treatment per week for 3-4 weeks are typical. However, treatment can last up to two months or more, if the treatment plan specifies it. PHP treatment includes individual, group, and family counseling, along with addiction and relapse prevention education; it may also include mental health medication when it is needed.

Intensive outpatient programs (IOPs) often include 9-20 hours of treatment per week, with these hours spread across 3-5 days. A recommendation of 90 days of treatment is typical for IOPs.

IOP programs include individual, group, and family counseling sessions, plus addiction and relapse prevention education. 12-step programming may be offered. Some intensive outpatient programs are structured as opioid treatment programs, which have been covered by Medicare since 2020.

General outpatient care meets once or twice a week and can help you maintain and reinforce everything you’ve learned in previous levels of addiction and mental health treatment.

Medicare Part B covers telehealth services by phone or internet when these services are provided by a physician or a mental health counselor who is contracted with Medicare as a provider. For services that treat addiction, mental health, or both, you don’t have to be in a specific area; instead, you can receive telehealth treatment from home.

Because Medicare Advantage plans must cover at least as much as Original Medicare, your Freedom Health plan will also include these telehealth options.

Are There Additional Benefits Available With Freedom Health?

Many Medicare Advantage plans offer additional benefits that Original Medicare doesn’t have. Freedom Health is one of the company that offers a variety of extra benefits and coverage.

For example, they have premium reimbursement for some Medicare Part B fees, which is returned to you in your Social Security check. Freedom Health plans also provide free wellness checks and screenings, 24/7 access to a nurse advice line, and a Free Silver Sneakers® fitness program membership.

You may also get a monthly pharmacy allowance of up to $125 for over the counter drugs and transportation to provider visits. Members of the special needs program (SNP) plans have access to caseworkers who can help you manage finances, keep your home safe, access the medication you need, and connect you to other resources.

What Are Freedom Health Plan and Care Levels?

Freedom Health offers 3 types of Medicare Advantage plans. They are Health Maintenance Organization (HMO), Special Needs Plan (SNP), and Point of Service (POS) plans.

Their HMO plan offers participants the ability to choose their own primary care provider from a list of participating health professionals. Should a patient require the services of a specialist the PCP is able to send a referral to that provider for coverage. Some of these plans have no monthly premium costs and have low copayment requirements.

The SNP plan is for individuals who qualify for Medicaid or Medicare due to a chronic illness regardless of age. This plan helps individuals to offset the out of pocket cost of their medical treatment and prescription costs. Some of these plans have no monthly premium costs and have no copayment requirements.

Freedom Health’s POS plan offers the participants the option of seeing both in network and out of network providers and hospitals. The amount of coverage is greater when individuals see in network providers. For out of network care there is a higher out of pocket cost. Referrals to specialists may be required from the patient’s primary care provider.