Those seeking substance abuse treatment may have concerns about cost, and what coverage, if any, their insurance plans will provide. There are several health plans in the United States, each with different variations in their coverage for drug and alcohol treatment. Bright HealthCare is one of many insurance companies that can provide coverage for substance abuse treatment. Depending on your policy details and what rehab facility you choose, Bright HealthCare insurance may cover all or some of the cost of substance abuse detox. Understanding what benefits Bright HealthCare offers its plan participants can help you take full advantage of your plan when you check into a rehab facility.

Does Bright Health Cover Detox or Rehab?

Insurance coverage and out-of-pocket costs are major concerns for many seeking detox and addiction treatment. Bright HealthCare insurance plans can cover a wide array of detox and addiction treatment services, though individual coverage may vary.

Bright HealthCare is bound by the provision of the Affordable Care Act (ACA) that requires health insurance providers to deliver essential benefits to customers.² Essential benefits, as defined by the ACA, include treatment for “mental health and substance use disorders.” ²Bright HealthCare insurance plans may also provide coverage outpatient therapy.²

The extent of coverage you have with Bright HealthCare insurance depends on the exact policy or plan you have. Some policies or tier levels may have higher co-pays, deductibles, or other out-of-pocket expenses. It’s important to identify which plan you have and discuss your benefits with a Bright Health representative before attending detox treatment.³

Types of Addiction Treatment Covered by Bright Health Insurance

As you prepare to seek substance abuse treatment, it’s helpful to understand the different levels of addiction treatment. As mentioned in the example above, there are out-of-pocket costs associated with the type of treatment you obtain. It’s necessary to consult with an admissions navigator and medical professional before jumping into one particular treatment program. They will assist you in creating a treatment plan that targets your substance use issues. Here are some common rehab programs that Bright HealthCare may cover:

Medical detox: When you detox from any substance, the body is getting rid of the drugs that were present. This type of program can cause significant withdrawal, so it is done under medical supervision.⁵
Inpatient treatment: An inpatient treatment program is also referred to as a residential program because you will stay in a residential setting and receive 24-hour care.⁴ Long term residential rehab can last from 6 to 12 months, depending on the situation.⁴
Intensive outpatient programs (IOP): For someone who has already completed a detox or inpatient program, attending intensive outpatient therapy might be the next best step. It involves much more therapy time than regular outpatient programs.⁴
Partial hospitalization programs (PHP): When patients need an intense treatment approach but cannot stay overnight for an inpatient program, PHP may work for them.⁶
Outpatient therapy and treatment programs: You will attend therapy sessions on a regular basis.⁷

How to Use Your Bright Health Insurance for Addiction Treatment

Now that you know Bright HealthCare insurance plans work with addiction treatment programs, let’s review the necessary steps to begin your journey:

Determine what type of treatment program you require by speaking to an admissions navigator at a rehab facility.
Find a rehab center that accepts Bright Health insurance.
Check to see if your Bright Health plan and tier level will cover that treatment program.
Determine if you need to get pre-authorization first and doing so if needed.
Find out what your total out-of-pocket costs will be.
Check with the rehab facility for payment plan options if your specific policy doesn’t cover all the costs.

By using the Bright HealthCare provider tool, you can find in-network rehab facilities in your area. Bright HealthCare advises that you stay in-network to keep the cost of your service down.¹³If you’re looking for rehab treatment, it’s best to reach out to your Bright HealthCare representative to determine your coverage, or to check your coverage online.

Finding Detox Centers That Take Bright Health Insurance

You can take the first step to recovery by finding a detox center that takes Bright HealthCare insurance. There are online resources that can assist you with finding the ideal rehab facility that accepts your insurance. A rehab treatment directory found here will do a search for you and let you know what rehab centers take Bright HealthCare insurance.

American Addiction Centers (AAC) provides top-quality rehab treatment programs for substance abuse. They accept a wide range of insurance plans, including Bright HealthCare. Recovery First and River Oaks are two of AAC’s Florida treatment facilities that offer both inpatient and outpatient rehab programs.

Bright Health Insurance Types

Bright HealthCare offers both HMOs and PPOs with a Medicare contract.⁸They also offer several tier levels, ensuring you get just the right plan to fit your health needs.⁹

HMO: This stands for Health Maintenance Organization.¹⁰ This type of insurance plan usually requires you to select care from doctors and rehabs who have a contract with the HMO.¹⁰ In most cases, it won’t cover out-of-network care except in an emergency.¹⁰

PPO: This stands for Preferred Provider Organization.¹¹ It also has a network of providers you can select from, but you can use out-of-network facilities too—you’ll just have to pay an additional cost.¹¹

There are also different levels to Bright HealthCare insurance plans that can affect the extent of one’s coverage. These levels are as follows:⁹

Gold: This level is designed for those who need to use their insurance often. The costs are more predictable since it is mostly co-pays.
Silver: If you want a lower deductible and don’t think you will use your plan that much, the Silver level might work best. It still offers more benefits than the Bronze plan.
Bronze: If you don’t go to the doctor’s much, then you can reduce your monthly out-of-pocket premium costs but will have a higher deductible for costly health issues.
Catastrophic: For younger people who want a low premium and don’t plan on visiting a doctor often, this will provide you with three primary care visits a year. Afterward, no other benefits are covered until the maximum out-of-pocket is reached.

Bright Health Medicare Advantage

A Medicare Advantage plan is Part C of Medicare, which bundles the benefits you get from Medicare’s Part A and Part B.¹² Some of these things include: ¹²

Inpatient care.
Hospital care.
Doctors’ visits.
Outpatient services.

By accessing your Medicare Advantage plan through Bright HealthCare insurance, you can take advantage of substance abuse treatment programs. Whether it’s inpatient care or outpatient therapy, the Bright HealthCare Medicare Advantage will assist with coverage.

Sources:

Bright HealthCare. (2021). Feel good with Bright HealthCare.
Bright HealthCare. (2021). Family-friendly benefits, pediatric practices, hospitals, and more.
Bright HealthCare. (n.d.). Summary of benefits and coverage.
NIDA. (2020). Types of treatment programs.
FindTreatment.gov. (2019). Treatment options.
National Library of Medicine. (n.d.) The National Association of Private Psychiatric Hospitals and the American Association for Partial Hospitalization. (1990). The Psychiatric hospital, 21(2), 89–90.
NIDA. (2019). Treatment approaches for drug addiction DrugFacts.
Bright HealthCare. (2021). Medicare advantage.
Bright HealthCare. (2021). Individual and family.
HealthCare.gov. (n.d.) Health maintenance organization.
HealthCare.gov. (n.d.) Preferred provider organization.
Bright HealthCare. (2021). Get to know the Medicare basics from terminology to eligibility.
Bright HealthCare. (2021). Use your network & save money.

Using Bright Health Insurance for Drug and Alcohol Treatment