HealthPartners Health Insurance Coverage for Drug Rehab

HealthPartners is a non profit healthcare organization based in Minnesota. They were founded in 1957 as a cooperative and are now the largest consumer governed nonprofit healthcare organization.

They have over 26,000 employees serving over 1.8 million members, and they participate in over 400 research studies each year. The company’s mission is to improve health and wellbeing making it more affordable by building relationships throughout the community.

In addition to insurance, the organization also has a network of clinics, hospitals, and healthcare providers. HealthPartners is known for its commitment to community health, patient centered care, and integrating care delivery with health insurance.

In 2019, they received the Health Equity Award from the Centers for Medicare and Medicaid Services for helping to increase access to healthcare.

Does HealthPartners Cover Addiction Treatment & Drug Rehab?

Yes, most HealthPartners plans provide coverage for drug addiction treatment to meet the requirements of the 2010 Affordable Care Act and the 2008 Mental Health Parity and Addiction Equity Act.

While these two federal laws require health insurance providers to cover mental health conditions and substance use disorders, there are exceptions to the law. For this reason, you must verify your insurance coverage before beginning treatment.

Your policy may include benefits for a variety of addiction services. However, each policy varies depending on your insurance plan, geographical location, and coverage level.

HealthPartners Coverage Areas for Addiction Treatment

HealthPartners provides coverage in several states in the Midwest. Their main focus is Minnesota but they also offer select plans in Wisconsin, North Dakota, and South Dakota.

In Minnesota they offer individual and family plans along with employer plans, Medicare, and Medicaid. In Wisconsin HealthPartners has individual and family plans in some areas along with Medicare options. In North and South Dakota Medicare plans are available.

What Are HealthPartners Plans?

HealthPartners offers individual and family plans in the marketplace that meet the Affordable Care Act regulations. There are four coverage levels with a range of premiums and out of pocket expenses: bronze, silver, gold, and platinum plans. The bronze plans have the lowest premium but the highest out of pocket costs while the platinum plans have the highest premiums and the lowest out of pocket costs.

Medicaid is a state and federal program covering lower income individuals and families that meet the eligibility criteria. HealthPartners offers Medicaid plans in Minnesota for individuals and families, including pregnant women and children. You may qualify for Medicaid, MinnesotaCare, or Minnesota Senior Health Options.

They also offer Medicare plans. If you have Original Medicare, you can get Part D prescription plans and Medicare Supplement plans from HealthPartners. Medicare Supplement plans cover costs Original Medicare does not cover, such as deductibles and copayments.

You can also replace Original Medicare with a Medicare Advantage plan, which generally includes Part A, Part B, and Part D. Advantage plans often offer additional benefits such as vision and dental coverage. However, if you have an Advantage plan you will likely need to use in network providers and you may need preauthorization before you start addiction treatment or other significant care.

HealthPartners offers employer sponsored plans tailored for small businesses and larger employers to provide a range of coverage options that meet the health needs of their employees. Larger employers have access to wellness programs, preventive care, and more.

Finally, HealthPartners offers short term plans designed for temporary coverage when you transition between jobs or are waiting for another insurance policy to begin. They also offer specialty plans to help cover dental and vision care, and wellness and prevention plans.

How to Verify Coverage With HealthPartners

It’s crucial to verify your insurance coverage before you receive care for addiction. Your policy may limit the types of therapy you receive, the number of times you receive it, or where you receive it. You may also need a referral or preauthorization before you begin.

You can access this information in the documentation that arrived after purchasing your insurance plan or by calling HealthPartner’s member services number. You can also log in to your HealthPartners online account to see your coverage details and find in network providers.

Another option is to work directly with an addiction treatment center. They can verify your insurance coverage and answer questions about your treatment plan. They can even begin the admission process if you’re ready.

What Inpatient Addiction Treatment Does HealthPartners Cover?

Your HealthPartners insurance coverage may provide benefits for inpatient addiction treatment. However your policy typically requires care to be medically necessary. This may require documentation or even prior authorization before treatment can begin. Your doctor can help provide a treatment plan that documents the medical necessity for inpatient care.

Medical detoxification is a program where you have medical supervision to manage withdrawal symptoms during detox. This often includes the use of FDA approved drugs to reduce the symptoms and help prevent side effects that can occur during withdrawal from some drugs. Medical detox programs psychological support throughout the withdrawal process.

From there you may transition to an inpatient or residential care program where you receive evidence based treatments such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT). They may also use motivational interviewing. Some residential facilities also include holistic approaches that address your mental and emotional needs along with physical and spiritual aspects of recovery. A holistic approach provides many benefits and supports your long term recovery.

What Outpatient Rehab Does HealthPartners Cover?

HealthPartners insurance policies typically offer some coverage for outpatient drug and alcohol rehabilitation. Again your policy usually requires care to be medically necessary. Outpatient programs can include partial hospitalization programs, intensive outpatient programs, and general outpatient treatment.

Partial hospitalization programs offer an intensive and highly structured environment that mimics inpatient care with the added benefit of being able to go home in the evening. They usually offer care five days per week for six to eight hours a day.

An intensive outpatient program provides less intensive and structured outpatient drug and alcohol addiction therapy. Typical programs offer treatment over several days each week for several hours each day. Some treatment centers offer care during morning or evening hours to accommodate your schedule and family, work or school obligations.

A general outpatient treatment program may provide therapy or counseling one or two days each week providing a smooth transition from a more intensive program to an aftercare program. Aftercare is a critical component of the recovery process because it helps support your new lifestyle. You might participate in community support groups and live in a sober living house.

Does HealthPartners Cover Methadone & Suboxone (MAT)?

Medication assisted treatment can be used for both medical detoxification and ongoing treatment of opioid and alcohol use disorders. Medication assisted treatments use FDA approved prescription drugs to reduce the effects of withdrawal and can be used for ongoing treatments to reduce cravings and help prevent relapse and overdose deaths.

Two common medications used for opioid disorders are methadone and Suboxone. Methadone is long acting opioid agonist that helps reduce your cravings and withdrawal symptoms by acting on the same brain receptors as opioid drugs but without the euphoric effect.

There are other medications that block the euphoric feeling that can come with drinking alcohol or even makes you sick if you drink. These approaches can help you stay focused on your recovery and avoid relapse.

Does HealthPartners Cover Other Mental Healthcare?

The Affordable Care Act and Mental Health Parity and Addiction Equity Act ensure that most insurance plans provide treatment for mental health and substance abuse with benefits that at least meet the level of benefits they offer for medical and surgical care. However there are exceptions so it’s important to check your coverage before starting treatment.

Co occurring mental health conditions are common with substance abuse or substance use disorders. This condition is called dual diagnosis and requires more complex and integrated care to achieve successful and sustainable recovery. Insurance plans that cover treatment for substance use disorders and mental health conditions will typically cover treatment for co occurring disorders and dual diagnosis. This sets you up for long term success.

Other common mental health conditions that require therapy and crisis support may include depression issues and anxiety disorders along with eating disorders. You can also get help for bipolar disorder and borderline personality disorders. Each of these can also be a co occurring mental health condition alongside a substance use disorder.

Can I Travel Out of State For Treatment With HealthPartners?

Many times HealthPartners uses medical networks that are focused on specific regions of the country. This means you likely cannot receive in network coverage when you travel out of state for treatment. Your plan may offer coverage with in network benefits if you must receive emergency care while traveling out of the state.

Your plan may also have an out of network coverage option that you can use to see an out of state provider. However it’s important to know that if you choose to see an out of state provider who is not in the network that your out of pocket costs will be significantly more than if you choose an in network provider. That means your deductible and copayments could be quite expensive.

If possible it’s best to stay in network so you can maximize your insurance coverage while receiving high quality care.