Drug And Alcohol Rehabs That Accept Prominence Health Plan

Medically reviewed by

Jennifer Cousineau, MSCP, LPCI, NCC

April 12, 2019

Making the decision to get help for a drug or alcohol addiction is monumental. Unfortunately, the cost of treatment is one of the major factors that keep people out of rehab programs. Luckily, insurance companies like Prominence Health Plan offer coverage for a number of different addiction treatment options.

Prominence Health Plan provides Medicare Advantage health plans to those who qualify. This company also offers small-group insurance plans for employers. Through these plans, Prominence offers varying levels of coverage for addiction treatment and services.

As you begin to plan your path to recovery, becoming familiar with your plan and the amount of coverage you can expect to receive is an important step.

Does Prominence Health Plan Cover Addiction Treatment?

Prominence Health Plan provides coverage for a number of mental health, alcohol, and chemical dependency services. They contract with a wide variety of providers and facilities to offer varying levels of care.

Prominence offers several different plans to its clients. For example, the company’s triple gold choice plan offers the highest level of coverage for behavioral health and addiction services. However, thanks to the Mental Health Parity and Addiction Equity Act of 2008, all Prominence plans provide some level of coverage for drug and alcohol addiction treatment.

Drug And Alcohol Addiction Treatment Services Covered By Prominence Health Plan

The plan you have with Prominence Health Plan will determine which addiction services are covered. Your plan will also determine the exact level of coverage you are eligible to receive.

Most Prominence insurance plans require patients to receive prior authorization for all services except for outpatient programs. However, prior authorization requirements may vary from plan to plan.

Common drug and alcohol addiction services covered under Prominence Health Plan include:

• detox programs
• family, group, and individual therapy
• drug tests
• intervention programs
• psychological testing
• medication management
• treatment for dual diagnosis and mental health conditions

Prominence Health Plan also may cover additional and more intensive addiction services. These may include medication-assisted treatment (MAT), inpatient rehab programs, and outpatient services.

Inpatient Treatment

Inpatient addiction treatment provides a much more intensive program when compared to outpatient treatment. Inpatient programs require patients to stay at the facility for several days or weeks to receive 24-hour monitoring.

This type of drug and alcohol addiction treatment consists of daily therapy as well as a number of different treatment services. These services may include a variety of therapies, counseling, and medication-assisted treatment (MAT).

Prominence typically provides some form of coverage for inpatient treatment. For example, with the Prominence Health triple choice gold plan, inpatient treatment is covered up to 50 percent once a person has met his or her yearly deductible. Inpatient substance abuse treatment coverage from Prominence requires prior authorization.

Outpatient Addiction Treatment

Outpatient treatment is typically the first type of treatment recommended for someone struggling with alcohol or drug addiction. Outpatient programs take place in a variety of settings, including doctors’ offices, rehab facilities, and hospitals.

There are several different options when it comes to outpatient treatment. Standard outpatient programs are the least intensive and require patients to attend treatment once or twice a week. Intensive outpatient programs (IOP) are more structured and intensive and consist of therapy several times a week. Partial hospitalization programs (PHP) are the most intensive form of outpatient treatment. They require patients to attend the program five days a week for several hours each day.

Most Prominence Health Plan insurance plans provide coverage for outpatient treatment. Prior authorization is typically not required for this type of addiction program.

Questions To Ask Before Using Your Prominence Health Plan Insurance For Addiction Treatment

Choosing to pursue treatment for a drug or alcohol addiction is the best decision you can make regarding your health and overall well-being. To ensure that your treatment is as stress-free as possible, there are several things to consider, especially in relation to cost.

Knowing which questions to ask your Prominence representative can help you better understand your plan and what it has to offer. Knowing what is covered and what isn’t will prevent surprise fees and out-of-pocket expenses.

Questions to consider before seeking treatment include:

• What forms of treatment are covered by my Prominence insurance plan?
• Is a medically supervised detox program covered? What about any medications that may be administered?
• Is inpatient treatment covered by my plan? If so, what length of time is covered?
• Which treatment services require prior authorization before coverage is provided?
• What is my deductible and copay for treatment services?
• What out-of-pocket costs should I expect?
• Is there any paperwork that needs to be submitted before treatment will be covered by Prominence?

Using Your Prominence Health Plan Insurance To Cover Drug And Alcohol Addiction Treatment

Becoming familiar with your Prominence insurance plan is a key factor in determining what type of treatment you will pursue. It’s also important to make sure that the facility you plan to attend accepts Prominence.

Speaking with a Prominence representative can help answer all of your questions regarding your coverage and treatment options. Additionally, speaking with a treatment specialist can help you decide which specific treatment programs are right for you.

While it may feel overwhelming, understanding your insurance plan and the treatment options available can help ease any stress you may be experiencing. Contact a treatment specialist today to get more information on your coverage and the treatment facilities that accept your plan.