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NYSHIP Health Insurance Coverage for Alcohol and Drug Rehab

New York State Health Insurance Program (NYSHIP), also known as the Empire Plan, offers quality coverage for substance use to its members who are struggling with addiction. 

If you or a loved one are living with a substance use disorder and have NYSHIP insurance, you have access to a large number of alcohol and drug rehab facilities.

NYSHIP is facilitated by United Healthcare and Blue Cross Blue Shield, which gives you access to even more resources and providers to help throughout the entire treatment process, from detox to aftercare. 

Overview of NYSHIP Health Insurance

NYSHIP is a health insurance program offered to eligible employees and retirees in the State of New York and their dependents. 

Here are some key features:

  • Eligibility: available to state employees and retirees, as well as their eligible dependents, including spouses and children
  • Health plans: offers a choice of several health plans, including Empire Plan, which is the primary plan and several HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations) that offer more limited networks of providers
  • Benefits: provides a wide range of benefits, including doctor visits, hospitalization, prescription drugs, mental health services and addiction treatment coverage
  • Cost-sharing: requires members to pay a portion of the cost of their services, including copays, deductibles and coinsurance
  • Out-of-network coverage: plans generally provide some coverage for out-of-network services, but the amount of coverage and the out-of-pocket costs can vary significantly depending on the plan
  • Wellness programs: to help members maintain their health and prevent illness

NYSHIP Coverage for Drug and Alcohol Treatment

If you have a NYSHIP insurance plan, you will be able to receive some level of coverage for rehab. How much coverage you have will of course depend on your specific plan and the type of treatment program. To find out, you should first review your plan documents or contact NYSHIP directly. 

You can also seek help from a treatment center such as Luxe Recovery who accept NYSHIP drug and alcohol rehab coverage. The team is happy to verify insurance benefits for you and assist with your admission. 

A variety of drug addiction and alcohol treatment services are covered by NYSHIP, including:

  • Detoxification: medically supervised detox helps to safely and comfortably withdraw from substances such as alcohol, opioids and prescription medications
  • Inpatient treatment: 24-hour care with a wide range of services within a therapeutic environment to help you overcome addiction
  • Outpatient rehab: attending various therapies and sessions on a regular basis is less intensive than inpatient and allows you to live at home and continue with your daily activities
  • Cognitive-behavioral therapy (CBT): focuses on identifying and changing negative patterns of thought and behaviors that are contributing to your addiction
  • Group therapy: involves participating in therapy sessions with others who are going through similar struggles. Group therapy is very effective and provides a sense of community and support.
  • 12-step programs: a type of group therapy designed to help people overcome addiction such as Alcoholics Anonymous and Narcotics Anonymous
  • Medication-assisted treatment (MAT): medication to help manage withdrawal symptoms and reduce cravings is often used in combination with other types of therapy
  • Holistic approaches: focus on healing the whole person, including their physical, emotional and spiritual needs and include yoga, meditation and acupuncture

It’s important to note that not every health insurance plan will cover every type of treatment. Some may have restrictions on the length of treatment you are able to receive or the type of rehab services you can access.

What Addictions are Covered by Your Health Insurance Plan?

  1. Substance: drug and alcohol are most common types of addiction
  2. Behavioral: gambling, gaming, shopping, internet and exercise
  3. Food: addiction to high-sugar or high-fat foods
  4. Nicotine: cigarettes, cigars, chewing tobacco and vapes
  5. Prescription drugs: painkillers, sedatives and stimulants
  6. Work addiction: when you feel compelled to work excessively and other areas of your life are neglected
  7. Sex: pornography, masturbation, sex with multiple partners and online dating
  8. Shopping: a lot of time is spent shopping resulting in financial problems

Addiction is a complex condition that involves multiple factors, including genetics, environment and individual behavior. Seeking professional help at an accredited alcohol and drug rehab center is crucial for people struggling with addiction.

How to Use NYSHIP Insurance at a Drug and Alcohol Rehab Program?

  • Check your coverage: The first step is to check your plan to see what type of coverage you have for substance abuse treatment. You can do this by calling the customer service number on the back of your insurance card or by visiting their website.
  • Find a provider: The provider you chose will also be able to help you check benefits and get things started for admission. 
  • Obtain pre-authorization: Before you start treatment, you will need to obtain pre-authorization from your insurance provider. NYSHIP must approve your treatment plan before you can start receiving services. 
  • Pay your share of the cost: Depending on your plan, you may be responsible for paying a portion of the cost of rehab through copays, coinsurance or deductibles. Make sure you understand what your costs will be before starting treatment.
  • Follow up with NYSHIP: After you complete treatment, be sure to follow up to ensure the claims have been processed and paid correctly. 

Advantages of Using NYSHIP Insurance at Alcohol and Drug Rehab

Here are some of the advantages of using NYSHIP for drug and alcohol addiction treatment:

  • Comprehensive coverage: treatment coverage includes a wide range of services, including inpatient, outpatient, detox and counseling at drug and alcohol rehab centers
  • Affordable: plans are designed to be affordable for state employees, which means that the premiums and deductibles are often lower 
  • Access to high-quality care: a large network of providers to ensure members have access to high-quality care from experienced professionals who are accredited
  • Confidentiality: NYSHIP protects the confidentiality of their members’ medical records so you don’t need to worry about your privacy being compromised
  • Continued support: provides long-term aftercare support to members who complete inpatient treatment to help maintain sobriety and avoid relapse

US Substance Abuse Stats

Addiction is a widespread issue across the US, affecting millions of people each year. Here are some statistics that illustrate just how devastating the current drug crisis is:

  • In 2020, an estimated 21.6 million people over the age of 12 had a substance use disorder (SUD) in the past year. This represents 7.9% of the population.
  • Alcohol use disorder (AUD) is the most common SUD in the US, affecting more than 14.5 million people in 2020.
  • Drug overdose deaths continue to rise. In 2020, there were an estimated 93,331 drug overdose deaths, up from 70,630 in 2019.
  • Opioid addiction is a particularly concerning issue. In 2020, an estimated 1.6 million people had an opioid use disorder and there were 69,710 opioid overdose deaths reported.
  • Addiction does not discriminate based on race, ethnicity or socioeconomic status, but certain populations are more vulnerable. For example, American Indian/Alaska Native and White populations have higher rates of SUDs than other racial and ethnic groups.
  • Addiction has a significant impact on health, relationships and finances. It can also lead to criminal activity, job loss and homelessness.
  • Treatment for addiction can be effective, but many people don’t receive the care they need. In 2020, an estimated 18.2 million people needed substance use treatment, but only 2.5 million received it.
  • Prevention and early intervention can be key in addressing addiction. This includes education on the risks and consequences of substance use, as well as access to mental health resources and support services.

Luxe Recovery Will Accept NYSHIP Insurance

Luxe Recovery does accept NYSHIP insurance.

If you are struggling with drug or alcohol addiction and have NYSHIP insurance, it’s important to seek help as soon as possible. Luxe Recovery will support you on your journey to recovery, every step of the way.

As a first step, the professional team will verify your insurance and check your benefits. They will communicate with NYSHIP for pre-authorization and provide any required documentation. The goal is to maximize benefits to get you the most treatment possible.

Luxe Recovery offers high quality treatment options for mental health and substance abuse and works hard to ensure your program is designed to address your unique needs and goals. So whether you need alcohol detox or a robust aftercare plan, Luxe Recovery can help.

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