Can Medica Cover Addiction Treatment?

When considering your options for treatment, you will eventually reach the point where you have to take your payment options into account. Typically, most insurance plans will have a few different coverage plans and tiers within that plan will determine the level of addiction treatment coverage that will be offered. An individual in Norman, OK covered by Medica will likely be covered by the Harmony or Quest plans. Here are some things to know about those plans:

  • Harmony by Medica
    • Does not provide coverage statewide
    • Low monthly premium
    • Three tiers of coverage: Gold, Silver, and Bronze
    • Co-pays and deductibles may apply and vary by tier
  • Medica Quest
    • Coverage throughout most of Oklahoma
    • High monthly premium
    • Three tiers of coverage: Gold, Silver, and Bronze
    • Co-pays and deductibles may apply and vary by tier.

The next thing you will want to know is whether you are covered by an HMO or PPO plan. These plans are important because they can determine where you will be able to receive treatment from, and have that treatment covered. The first plan, HMO’s or Health Maintenance Organization plans are the more cost-effective options. HMO’s slightly limit where you can receive treatment because they require a PCP (Primary Care Physician). The PCP must write a referral before the individual can receive additional services. The individual will only be referred to in-network provider’s and will not receive coverage at out-of-network provider’s except for in emergency cases.

The PPO or Preferred Provider Organization plan, on the other hand, is costlier. However, the PPO plan allows the individual more options for treatment. PPO plans do not require the individual to see a PPO, and the individual can receive coverage at out-of-network providers, although they may have to file a claim to receive coverage.

Understanding Your Coverage Options

Once you are aware of the differences in HMO and PPO plans, and know the ins and outs of your plan, you may still have additional questions. Having questions is understandable considering all of the term’s and condition’s one must understand with insurance. Please call us at 405-583-4319 with any questions you have pertaining to your insurance coverage. We want to make it so that you receive the best care possible with your coverage.

Additionally, you will want to visit your coverage provider’s website. Your provider’s website will provide the information on its addiction coverage under its behavioral and mental health sections. If you are curious about a particular facility, the website should have information on which facilities are covered. The website is a great resource if you are just beginning to look for treatment centers as you will be able to find facilities that accept your coverage if you were not sure where to start.

Medica is not the only provider available. If you come to find that you need another coverage choice, you have options. Medicare may be difficult to navigate as it does not specify the type of addiction treatment coverage it offers. Medicare of Oklahoma will cover treatment when the addiction is both severe and treatment is deemed necessary. Both in-patient residential services and outpatient care can be covered under Medicare.

Medicaid can also cover addiction treatment. Treatment for both alcohol and drug dependency can be covered under Medicaid of Oklahoma. More so, an individual with Medicaid can receive coverage for both in-patient and outpatient services. Lastly, if none of these options fit your needs, there are a variety of facilities in Oklahoma that offer payment assistance. Payment assistance can be in the form of payment plans or services provided on a sliding fee scale.

Stop Your Addiction, No Matter What

Keep in mind, with Medica, you can likely receive addiction coverage under both the Harmony and Quest plans. PPO plans allow you to be flexible with your treatment options, while HMO plans are more cost effective. Your provider’s website should have plenty of information on your treatment options, but you can call us if there is something you cannot find. Remember that many facilities accept both Medicare and Medicaid. Facilities also provide additional payment assistance for those who need it. You may find that all of this information is a lot to take in, please call us at 405-583-4319 and let us break all of the information down for you.

You can find treatment in Norman, OK or even beyond. When dealing with treatment it is essential that you are aware of all of the options available to you that can receive coverage for. Knowing all of your options allows you to receive the best treatment, and have it covered in the way you need. Don’t let all of the tricky insurance jargon stop you from getting treatment or hit you with unnecessary medical bills. Our experts are standing by to assist you with any questions you have concerning coverage. We can match you with a facility no matter your coverage needs.