Does AllWays Health Partners Pay for Rehab?

AllWays Health Partners

Now that you are ready to make the commitment to overcome your addiction with treatment, being able to afford the cost may be on your mind. One of the most popular medical insurance carriers is AllWays Health Partners. Here is an overview of AllWays and the types of coverage that may be available to you. Please verify your coverage through your insurance provider.

About AllWays Health Partners

With more than three decades of experience in insurance coverage for individuals and families, AllWays Health Partners is a solid network of providers that is always growing to meet the needs of their members. The organization is a member of Partners HealthCare, a system in the United States that is both established and respected.

AllWays Health Partners Insurance Plans

Like most insurance carriers, AllWays Health Partners offers several ways to obtain insurance.

Employer plans: AllWays Health Partners offers employer-based plans for companies that want to offer this benefit to their employees. The plans include medical, health and wellness options. If you have employer-based insurance coverage through AllWays Health Partners, your employer may have cost-sharing in place. You sign up through your employer, and your portion of the premiums is taken out of each paycheck.

Types of Network Providers Through AllWays Health Partners

AllWays Health Partners offers HMO and PPO insurance plans. The type of plan that you have may determine how you can access addiction treatment services.

PPO plans: PPO plans through AllWays Health Partners offer coverage for providers that are in-network and out-of-network, although the coverage levels may vary. You may have higher out-of-pocket costs with out-of-network providers. Premiums for these types of plans tend to be higher. AllWays Health Partners recommends that you receive a referral through your primary care provider, but it is not required. Therefore, these types of plans offer the greatest flexibility for coverage.

Individual and Family Insurance Plan Levels for AllWays Health Partners

In addition to the individual types of insurance plans that are offered through AllWays Health Partners, the company also offers four levels of coverage for the individual and family plans offered through the Affordable Care Act.

Silver plans: Silver plans through AllWays Health Partners offer low premiums and more affordable out-of-pocket costs. Preventive care does not involve any out-of-pocket costs.
Platinum plans: Availability for Platinum plans through AllWays Health Partners is limited as each state determines which plans best suit the needs of their residents. The premiums are higher, and you have little to no deductible.

Addiction Treatment Coverage Through AllWays Health Partners

Addiction treatment coverage through AllWays Health Partners varies by policy type and coverage level. You should have this information available to determine if your addiction treatment is included in your plan. Currently, AllWays Health Partners offers eight different options for complete coverage.

• Complete HMO 1000: Outpatient substance use services have a copayment for each visit. For inpatient addiction treatment, the plan requires that you meet the deductible and then pay a copayment for each admission to pay your portion of the facility cost. Professional fees are subject to the deductible and do not require any additional copayments.
• Complete HMO 2000 30/60 II: Outpatient substance use services require a copayment per visit. For inpatient detox or rehab, you are required to pay the deductible and then pay a copayment for the facility with each admission.
• Complete HMO 2000 30%: Outpatient addiction treatment services require a copayment per visit. Inpatient addiction treatment requires a deductible and coinsurance for the facility fees and professional fees.
• Complete PPO Plus 2000 30/60: As a PPO plan, the Complete PPO Plus 2000 30/60 plan offers levels of coverage for in-network and out-of-network providers. If you use an in-network provider for your outpatient addiction treatment, you only pay a copayment. For out-of-network providers, you pay the deductible and then coinsurance. For inpatient addiction treatment, using an in-network provider means that you pay your deductible and then a copayment for each admission. Professional fees after you meet your deductible do not require a copayment. If you use an out-of-network provider for inpatient addiction treatment, you pay the deductible and a coinsurance amount for both the facility and professional fees.

When you are choosing a provider for your addiction treatment and have insurance through AllWays Health Partners, it is best to stay in-network. You should verify your coverage beforehand.

AllWays Health Partners ConnectorCare Plans

AllWays Health Partners offers subsidized health care plans for families and individuals. These plans include coverage for outpatient addiction treatment, inpatient addiction treatment and detox. The out-of-pocket costs are very affordable for low-income families and individuals.

• Complete ConnectorCare 10/18: With the Complete ConnectorCare 10/18 plan through AllWays Health Partners, you only pay a copayment for each outpatient addiction treatment visit and a copayment for each inpatient addiction treatment admission for the facility only. There is no cost-sharing required for the professional fees associated with your inpatient addiction treatment or detox.
• Copayments: Copayments are amounts that you pay with each visit or admission for addiction treatment. The amount is defined in your policy Deductibles: You may be required to meet a deductible before AllWays Health Partners helps with the cost of your addiction treatment. The way that a deductible works is that the facility sends the billing information to AllWays Health Partners for processing. The allowable costs are already defined in the contracts between the facilities and insurance carrier. AllWays Health Partners reviews the claim and then determines the allowable costs. You must pay the allowable costs until you meet the amount of your deductible. At that point, you may have to pay coinsurance.
• Detox: Detox is typically the first step for addiction treatment. This is the time when the drugs are removed from your body under medical supervision. This step is necessary to help you focus on the next steps in your recovery. (Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.)
• Outpatient addiction treatment: Outpatient addiction treatment helps you transition from inpatient addiction treatment back into your own life. This may involve individual or group counseling sessions and other types of support that keep you on the path of recovery.

How to Check Your Benefits for Addiction Treatment

You can check your addiction treatment coverage through AllWays Health Partners by calling the phone number on the back of your insurance card. The customer service representative will ask for some basic information to verify your identity and policy terms. You can also visit their website and create an account to access information about your specific policy. The information that you receive will explain your level of coverage, out-of-pocket expenses and any limitations to coverage.