Carefirst Coverage for Alcohol and Drug Rehabilitation

One of the top reasons why people can’t get proper healthcare, is the expenses. Is rehabilitation more expensive than continuing the addiction? Short-term answer, yes. Rehabilitation can cost around $10,000 and can go as high as $50,000, but there’s something else to consider: your health.

Health is Wealth, and the long-term answer is no. The amount someone spends on their addiction will chip their pockets and their health. By the time they’ve spent as much as rehab costs, it might already be too late. If rehab is so expensive, how can people get the help they need?

Following the Affordable Care Act, Carefirst’s plans cover alcohol and drug rehabilitation. The amount they cover depends on the patient’s plan, but it’s still better than paying the full amount.

Visit your trusted rehab center in your area for more information.

What Rehabilitation Treatments Does Carefirst Cover?

Treatments are classified into two: inpatient and outpatient care. Inpatient care is more expensive but is more effective against debilitating addiction. Outpatient care is more fit for the busy individual who needs to both manage their life and addiction.

Carefirst covers the following inpatient programs.

• Inpatient Detoxification Programs

• Rehabilitation Services from Acute Hospitals

• Residential Inpatient Programs

• All related medical and non-medical expenses

Depending on the facilities around your area, you can avail luxury rehab centers. The coverage will still depend on your plan, so check your manual, or contact Carefirst’s support hotline for information.

For outpatient programs, Carefirst covers the following:

• Partial Hospitalization Program
• Diagnosis and Medication for Substance Abuse Therapy
• Physician and specialist visits and consultation
• Methadone Treatment
• Therapy for Behavioral and Emotional Disorders.

How do I start?

If you’re already a member, the first thing you do is see a doctor. If you don’t know where to find a proper one, Carefirst as a directory of providers to help. They will pinpoint a specialist that can give you a proper diagnosis and recommend a treatment. Once you have your recommendation, refer to Carefirst’s plans and see how much they cover.

Duration of Coverage

Most common rehabilitation programs last 30 to 90 days. Extensions are made depending on your physician’s advice. If you’ll need an extension, you’ll need Carefirst to pre-approve it first.

Coverage Levels

Carefirst has “metal levels” for its coverage. Your level will differ from your plan and tenure and the amount the company covers is dependent on the level.

The general amount they cover are as follows:

• Platinum: Carefirst covers 90% of the costs with 10% copay. (Washington D.C. only)
• Gold: Carefirst covers 80% of the costs with 20% copay
• Silver: Carefirst covers 70% of the costs with 30% copay
• Bronze: Carefirst covers 60% of the costs with 40% copay

Now that insurance companies can finance rehabilitation, it’s not anymore an excuse not to get help. If you know someone who needs rehabilitation, don’t hesitate to call their insurance. Healthcare providers can arrange interventions for them, so make sure you show your support. Health is wealth. Your health will serve you far longer than your wealth can so take it upon yourself to get insured.

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Dr. Vikram Tarugu MD

Dr. Vikram Tarugu, M.D, is the CEO of Detox of South Florida, Inc and medical professional focused on addiction. A veteran in the medical field with over 25 years of professional experience. He is a consultant for many South Florida Rehab centers. Patients travel from allover the US to seek his help with addiction and Hepatitis C treatment.