Drug & Alcohol Rehab Covered by Health Plan of Nevada

Health Plan of Nevada (HPN) provides rehab coverage for many members residing in Nevada. Here’s a brief overview on how the insurance company handles addiction treatment.

Does Health Plan of Nevada Cover Substance Abuse Treatment?

Yes. In fact, most insurance plans are required by law to provide coverage for substance use and mental health treatment. Furthermore, when coverage is provided for treatment of these conditions, it must be equitable to the coverage provided for medical and surgical services.1

The Affordable Care Act (ACA) also mandated that pre-existing conditions be covered. This means that if you have struggled with addiction or other mental health disorders prior to beginning your health insurance plan, you will still receive coverage for mental and behavioral health services.2

The exact amount of coverage you have for these services will vary according to your plan.

Health Plan of Nevada Policies

HPN offers several different plans, each providing some level of coverage for mental health and substance use disorder (SUD) treatment. These plans fall under 3 main categories:3

  • Health maintenance organization (HMO) plans.
  • Exclusive Provider Organization (EPO) plans.
  • Health Savings Account Exclusive Provider Organization (HSA EPO) plans.

HMO plans provide a specific network of providers for the policyholder to use. The network of providers has already agreed to provide coverage at lower costs than are typical for the services being rendered.3

An EPO is similar to an HMO, in that coverage is usually restricted to providers within the HPN network. One key difference is that an EPO plan allows the policyholder to make their own appointments with specialists (without a referral). This means EPO plans are usually more expensive than HMOs.3

An HSA EPO plan is an EPO plan that allows the policyholder to put aside money on a pre-tax basis that can be used for qualified medical expenses.3,4

Each category of plan has 3 tiers—bronze, silver, and gold—that affect the amount of coverage provided for services.3

How to Pay for Rehab with Health Plan of Nevada Insurance

The first step in using insurance to pay for rehab is to check whether the facility in question is within the insurance company’s network. The level of coverage is based on the specific policy.

Within minutes, you can see if your policy covers treatment at Desert Hope by using the online benefits verification tool below or by calling an admissions navigator at . An admissions navigator will guide you through the process and help you obtain prior authorization for treatment.

Out-of-pocket costs vary depending on your specific plan. Choosing a facility that is within the HPN network will help you keep your costs down. If you don’t have insurance or are having trouble covering out-of-pocket costs, there are a few methods that may help you handle the cost of rehab, including payment plans, healthcare credit cards, and loans.

Types of Addiction Treatment Covered by Health Plan of Nevada

Health insurance plans usually place addiction treatment in 2 categories: inpatient drug rehab and outpatient rehab treatment. However, there are several levels of addiction treatment that fall within these categories. At Desert Hope, your plan may cover:

  • Medical detox. This allows patients to safely withdraw from substances under the supervision of medical professionals.
  • Inpatient/residential rehabilitation. Patients stay at the facility 24/7 until treatment is completed and are provided intensive support and structure.
  • Partial hospitalization. Partial hospitalization—or day treatment—requires patients to visit the facility 5 days per week or more for 6 hours at a time to undergo treatment.
  • Intensive outpatient care. This option involves the patient visiting the facility at least 3 times a week for 3 hours.
  • Outpatient treatment. Regular outpatient care is the least intensive and most flexible option and will be customized to fit each patient’s needs.

Coverage and the way it is applied will vary based on the specific policy and level of treatment. For example, patients may be charged a copayment each time they visit the facility for outpatient treatment, while patients opting for inpatient treatment will usually be charged a co-insurance percentage of the overall cost of treatment.

Benefits of Using Health Plan of NV for Rehab

Health Plan of NV provides coverage for addiction treatment in Nevada and nearby regions. Unfortunately, addiction and related problems in the Battle Born state are severe:5-7

  • In 2020, the state of Nevada was placed on “red alert” after a 50% rise in opioid overdoses between the 1st and 2nd quarter of the year.
  • 372 people died of an opioid overdose in Nevada in 2018.
  • In 2019, 83.2% of people in Nevada met the criteria for binge drinking.

If you’re one of the many Nevada residents who are struggling, you can come to us for help. Don’t wait to begin your journey; addiction is treatable and is not a life sentence. You can start over today.

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