Beacon Health Options Insurance Coverage for Drug and Alcohol Rehab 

More than 23 million Americans are currently suffering from addiction, which is categorized as a chronic disease affecting the brain just like other mental health disorders.

Prolonged use of drugs or alcohol affects the brain’s reward center and leads to dependence, both physically and psychologically. 

The National Institute on Drug Abuse estimates that $700 billion is spent on addiction each year. The current drug crisis is impacting all levels of our society – individuals, families, businesses.

For people struggling with substance abuse issues, a quality treatment program – detox, inpatient or outpatient – will be needed in order to help you reach recovery.

Recovery and sobriety are life-long commitments and to prevent the cycle of relapse, a professional team will need to help you gain the skills and tools you need to live your life to full potential. 

The Affordable Care Act requires that all health insurance providers offer coverage for drug and alcohol addiction treatment. Providers are no longer permitted to raise rates after getting treatment.

Overview of Beacon Health Options Insurance

Beacon Health Options provide comprehensive mental health and substance use disorder management services and solutions to individuals, organizations, government agencies and health plans. 

Beacon offers a wide range of services, including:

  1. Care management: provides care management services that help individuals access the right level of care at the right time. This includes care coordination, case management and utilization management.
  2. Provider network: has a nationwide network of mental health and substance use disorder providers. The company works with providers to ensure they are delivering high-quality care and following evidence-based treatment protocols.
  3. Data analytics: uses data analytics to identify patterns and trends in behavioral health care which helps them to develop more effective interventions and improve outcomes for individuals.
  4. Crisis management: provides crisis management services for individuals experiencing a behavioral health crisis. This includes a 24/7 hotline and mobile crisis teams that respond to emergencies.

Along with their insurance plans, Beacon manages a large network of health facilities and providers who offer a wide range of addiction and mental health treatment options.

Beacon’s focus is on helping provide individuals with behavioral health solutions as well as working with companies, government agencies, military, public sector workers as well as solutions for Medicaid. 

Beacon Insurance Rehab Coverage for Addiction Treatment

Beacon will typically provide coverage for your inpatient or outpatient treatment for substance use, addictions and mental health. Their coverage amounts tend to be higher as they specialize in behavioral health and addiction treatment solutions. 

Many people access Beacon coverage through a workplace Employee Assistance Program (EAP) meaning that the coverage is offered through the employer not your personal plan. If you check your policy the details and what is covered will be there.  

Beacon works with a network of more than 100,000 behavioral health providers including a large number of the 30,000+ rehabs and treatment centers in the US. 

  • Assessment and Evaluation – this will be needed to qualify for treatment (prior authorization).
  • Detox – medical detox provides supervision to ensure there are fewer risks, side effects and lower risk of relapse. 
  • Medication-Assisted Treatment (MAT) – commonly used MAT are the drugs used for opioid detox including suboxone and naltrexone.  
  • Inpatient Treatment – once deductibles and co-pays are met, Beacon covers most of the cost of inpatient. 
  • Partial Hospitalization Programs (PHPs) – Beacon provides good coverage for PHPs.
  • Outpatient Programs – co-insurance with Beacon for outpatient is about 5%

The coverage amounts will of course depend on your specific plan. Check the back of your insurance card or contact your employer if offered through an EAP.

Beacon has more than 22 different plans and services as well as custom solutions per organization they work with so it’s important to check your coverage in advance.

Also worth noting that Beacon will not cover any form of treatment offered outside an official office or healthcare setting. They will only cover evidence-based and FDA-approved treatments.

Does Beacon Insurance Cover Drug and Alcohol Rehab?

Formerly known as ValueOptions, Beacon Health Options has more than 30 years of experience in managed care. They specialize in behavioral healthcare so it comes as no surprise that their plans include benefits for substance abuse, addiction treatment and mental health services.

As a top provider, Beacon Health Options is in-network with more than 100,000 treatment centers and behavioral health providers across the US. Coverage amounts for services will vary from state to state and depend on what plan you have.

Beacon strives to provide long-term addiction treatment coverage that focuses on the continuity of care and aftercare programs.

They encourage members to engage in long-term treatment including sober living arrangements. Their EAP also focuses on long-term care. 

Beacon covers:

  • Dual-diagnosis treatment and support
  • Physical and mental healthcare
  • Physician coverage and prescription medications
  • Mental healthcare, counseling and therapy

Remember, substance abuse treatment will require prior authorization. To get started you can contact Luxe Recovery treatment center, we can help you to check your coverage for rehab. You can also contact Beacon directly by calling the number on the back of your card.

Beacon Specifically Covers Mental Health 

Beacon provides a significant amount of mental health coverage and supports psychiatric evaluations, individual therapy, group therapy, family therapy, neurobehavioral testing, inpatient mental health treatment and emergency treatment for suicidal behaviors and eating disorders.

Again, most of these treatments will still require prior authorization. Beacon health insurance is likely to cover these services minus the cost of copays or coinsurance.

How to Check Your Health Insurance Coverage?

As with any insurance plan, alcohol and drug rehab coverage varies from plan to plan and each plan has different limitations.

To check what coverage your plan offers you can talk to the treatment center you want to go to and they can help check your eligibility and coverage or you can get in touch with Beacon directly so they can go over your policy details and help you understand your coverage and what you may have to pay for. 

As with most insurance plans, Beacon has deductibles, copays, coinsurance and or a combination of these.

  • A deductible is the amount you are responsible to pay for services before the insurance provider will pay any expenses. 
  • A co-pay is a set amount that you have to pay for a service before and after the deductible is met. 
  • Coinsurance is the percentage you must pay for a service before and after the deductible is met.

Finding a Compatible Substance Abuse Treatment Center

Finding a compatible Beacon drug and alcohol treatment center that offers the type of treatment you need can be a challenging and daunting task, but there are several things you can do to make the process easier. Here are some steps you can take:

  • Research: Do thorough research on addiction rehab facilities in your area and ones you are willing to travel to. Look at their website, read reviews and check out their accreditation and certification.
  • Check their approach: Determine what kind of approach the addiction rehab center takes, whether it’s a 12-step program, holistic, or evidence-based treatment.
  • Evaluate the facilities: Look at the facilities and assess whether they have the necessary amenities and resources for your recovery, such as comfortable living quarters, outdoor space, and access to medical care.
  • Check the staff: Look into the staff members’ qualifications, experience, and credentials. It’s essential to have experienced and trained staff who can provide quality care.
  • Check the cost: Determine the cost of the rehab program and whether they accept insurance. If you are uninsured, look for facilities that offer financing options or scholarships.
  • Seek recommendations: Ask for recommendations from your healthcare provider, therapist, or support group. They may know of reputable addiction rehab centers that fit your needs.
  • Visit the facility: If possible, visit the addiction rehab center and meet with the staff. It can help you get a better sense of the center’s atmosphere and determine whether it’s a good fit for you.

Beacon PPO: Out-of-Network Providers

Beacon provides coverage to more than 100,000 behavioral health and wellness centers across the US. However, if you want to go to a treatment center that is not covered under their network, you may not be able to get compensation. It’s important to check with Beacon, your employers EAP health insurance coverage or contact the treatment center to help you. 

You will normally only get out of network coverage for emergency situations where you have to be taken by ambulance or are placed by a judge.

Otherwise you may be responsible for paying in-network fees and deductibles and if you choose to go to a center that is not covered, you will have to pay all the costs out of pocket.

Luxe Recovery Accepts Beacon Insurance Benefits

The team at Luxe Recovery will help you to determine what your Beacon plan will cover and what deductibles and copays may have to be paid.

They will assist you in getting prior-authorization and stay connected with Beacon throughout treatment to ensure they have the necessary reports to continue to approve treatment.

Luxe Recovery offers individualized treatment for people struggling with various forms of substance abuse as well as mental health issues.

Their professional and caring team will provide you with the support you need to achieve sobriety from the first call to after discharge.

The admissions staff at Luxe Recovery are on hand to take you call and help you get started. 

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