Emblem Health Insurance

Emblem Health is one of the largest nonprofit health plans in the United States with over 3 million members in New York and the tristate area. Emblem offers individual and family plans, employer plans, and Medicare. With affordable health plans, Emblem has several insurance options that include coverage for addiction services and rehab facilities. Drug and alcohol rehab treatment and coverage for substance abuse will vary based on your individual insurance plan. If you are struggling with addiction and worried about how to pay for rehab, learn more about Emblem Health insurance and coverage for Innovative Health’s treatment programs. 

Does EmblemHealth Insurance Cover Rehab?

EmblemHealth has a network of thousands of physicians and clinicians that provide affordable, quality health care to its members. Depending on your plan, EmblemHealth insurance coverage is for part or all of treatment for substance use disorders and other mental and behavioral health services. All insurance plans must include at least some coverage for behavioral health such as residential treatment, counseling, mental health inpatient services, and outpatient treatment for substance use disorders. 

Addiction treatment services include inpatient and outpatient rehab, partial hospitalization (PHP), detoxification, individual and group therapy services, and continuing care. Depending on your insurance plan with Emblem, alcohol and drug rehab may be covered partially or fully. Your treatment coverage could be from 28 to 45 days. Specific coverage for treatment and services is based on your plan’s benefits. You can check your eligibility and enrollment online or call EmblemHealth directly to speak with a representative. 

How much of rehab is covered by Emblem? 

When you are looking for treatment, the biggest question is usually how much is the out-of-pocket expenses for rehab? Your coverage is largely dependent on your insurance EmblemHealth plan and the level of care you require. The passing of the Affordable Care Act made coverage for essential health services, including substance abuse treatment and mental health services, more accessible. 

Innovative Health alcohol and drug rehab center that offers intensive outpatient rehab for substance use disorders. We treat alcohol and drug addiction and other mental health disorders. We are a leader in comprehensive alcohol and substance use treatment with evidence-based individualized treatment in New York state. At Innovative Health, you have several options for treatment, including telehealth services. We offer medication-assisted treatment, behavioral and mental counseling, and evaluations. 

If you have not met your plan’s deductible, you may be required to pay more out of pocket. Your out-of-pocket maximum is the most you will have to pay for covered services per year. If you are concerned that your insurance will not pay for rehab services or cover the entire cost of substance abuse treatment, payment options are available. Health insurance coverage is processed with your insurance provider. Once your claim is processed, your remaining balance will be available, and we have payment plans available to take the financial burden out of rehab. At Innovative Health, we believe everyone deserves access to addiction treatment.

Emblem Insurance Rehab Coverage for Medication-Assisted Treatment

Medication-Assisted Treatment, or MAT, is the use of medications in combination with detox and addiction therapy to treat substance use disorders. MAT is an effective treatment that helps with withdrawal symptoms from certain substances. Medication-assisted treatment is primarily used to treat addiction to opioids and prevent an opioid overdose. 

For opioid use disorder, we provide monthly injections of Suboxone, Buprenorphine, or Sublocade. To treat alcohol use disorder, Naltrexone or Vivitrol monthly injections are available. These medications are typically covered by insurance. 

If you require MAT, it is typically an ongoing, long-term treatment plan. Generally, MAT also requires mental and behavioral health services. You may be wondering if your insurance policy covers MAT treatment and additional treatment. Insurance for MAT works the same as coverage for any other treatment services. When you are referred for MAT treatment, your coverage will be verified. Your insurance company will be able to confirm your plan’s coverage. Health insurance that covers substance abuse typically pays for any MAT services that are considered medically necessary. Most insurance plans offer at least partial coverage for addiction treatment, including MAT. 

Does Innovative Health Accept EmblemHealth Insurance?

EmblemHealth plans are in-network at Innovative Health. We accept all Emblem insurance plans. The cost of in-network providers is lower than out-of-network because in-network providers have an agreement with Emblem Health. The coverage for your treatment will depend on your specific plan as well as your treatment program. While you still may be required to pay a copay, your insurance with in-network providers pays significantly more. 

How to Verify Your Coverage with Emblem?

If you need a rehab center for substance use disorder treatment, Innovative Health is here to help you understand your options. You can verify your insurance through Emblem by reviewing your benefits online or calling your provider. Innovative Health can assist you with verifying your coverage. Give us a call at 914-683-8050 for assistance with your Emblem insurance plan.