Does Insurance Cover Rehab? All Your
Questions Answered in One Place

At Newport Academy, we know that treatment financing can make all the difference in receiving quality treatment. In addition, advisors and insurance companies sometimes push families towards low-cost, poor-quality treatment options. As a result, this sets young people up for exposure to negative and even traumatic treatment experiences. Short-term thinking costs more in the long run, as families dedicate energy, time, and money to ameliorating symptoms without addressing underlying concerns. To support families in their efforts to access quality young adult and adolescent treatment, Newport Academy accepts a wide range of rehab insurance plans and provides financing options.

Here are the primary ways that teens, young adults and families pay for treatment at Newport Academy:

Rehab Insurance Coverage

Does insurance cover rehab? Insurance often covers a majority of treatment costs, and up to 100% of the treatment and therapeutic modalities that Newport Academy offers.

Private Pay

Some young adults or families choose a private pay option, which means that they cover all treatment costs without using rehab insurance. Private pay is a viable option for those who feel comfortable using their own resources. In the event that you don’t have rehab insurance, or your balance after insurance benefits adds up to something you can’t afford, we will work with you and your insurance provider. Connecting you to the help you need, when you need it, is our top priority. Treatment is a worthwhile endeavor that provides the foundation for a new life—and ultimately, it saves time, money, and energy, and promotes quality of life and peace of mind.

Does insurance cover the costs of mental health treatment?

When you are considering whether a loved one or family member will enter treatment, remember that you will be making a lifetime investment in positive transformation and wellness. Addiction and untreated mental health issues are challenging—and they’re not going to go away by themselves. For an adolescent who has not yet developed the tools and infrastructure to face head-on the complexities of day-to-day life, untreated mental health issues can become overwhelming. Your commitment to lifelong recovery will yield invaluable results and ultimately become fundamentally life changing.

Here are some of the things that influence treatment costs:

  • The individual’s clinical diagnosis
  • The recommended length of stay in treatment
  • Whether the situation requires specialized services
  • The individual’s mental health insurance coverage or preferred payment options

What can I expect when I call?

We’re here 24 hours a day, 7 days a week. Your call is always confidential, and there’s no pressure to commit to treatment until you’re ready. Our fundamental priority is to help your family get the treatment you require and deserve—even if it’s not at Newport Academy.

844-496-4451

Does insurance cover the costs of mental health treatment?

When you are considering whether a loved one or family member will enter treatment, remember that you will be making a lifetime investment in positive transformation and wellness. Addiction and untreated mental health issues are challenging—and they’re not going to go away by themselves. For an adolescent who has not yet developed the tools and infrastructure to face head-on the complexities of day-to-day life, untreated mental health issues can become overwhelming. Your commitment to lifelong recovery will yield invaluable results and ultimately become fundamentally life changing.

Here are some of the things that influence treatment costs:

  • The individual’s clinical diagnosis
  • The recommended length of stay in treatment
  • Whether the situation requires specialized services
  • The individual’s mental health insurance coverage or preferred payment options

We Accept All Major Insurance, and 100% of Our Services are Covered

We’re adding more carriers to our in-network insurance lists all the time. The selection below represents some of our most popular rehab insurance provider plans.

Anthem Blue Cross Blue Shield of Colorado
Anthem Blue Cross Blue Shield of Connecticut
Anthem Blue Cross Blue Shield of Georgia
Anthem Blue Cross Blue Shield of Missouri
Anthem Blue Cross Blue Shield of Nevada
Anthem Blue Cross Blue Shield of Ohio
Anthem Blue Cross Blue Shield of Pennsylvania
Anthem Blue Cross of California
Blue Cross Blue Shield Federal Employee Program (FEP)
Blue Cross Blue Shield of Florida
Blue Cross Blue Shield of Illinois
Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Minnesota
Blue Cross Blue Shield of North Carolina
Blue Cross Blue Shield of Rhode Island
Blue Cross Blue Shield of South Carolina
Blue Cross Blue Shield of Tennessee
Blue Cross Blue Shield of Texas

Blue Cross Blue Shield of Western New York
Blue Shield of California
Capital Blue Cross of Pennsylvania
CareFirst Blue Cross Blue Shield of Maryland
Empire Blue Cross Blue Shield of New York
Excellus Blue Cross Blue Shield of New York
Group Health Incorporated
Hawaii Medical Service Association (HMSA)
Highmark Blue Cross Blue Shield of Delaware
Highmark Blue Cross Blue Shield of Pennsylvania
Horizon Blue Cross Blue Shield of New Jersey
Independence Blue Cross of Pennsylvania
Managed Health Network (MHN)
Premera Blue Cross of Washington
Regence Blue Cross Blue Shield of Oregon
Regence Blue Shield of Idaho
Regence Blue Shield of Washington
Wellmark Blue Cross Blue Shield of Iowa and South Dakota

Insurance Terms

Insurance Verification

If you’re interested in exploring the possibility of treatment at Newport Academy for your teen’s mental health, behavioral health, or substance abuse issues, we can begin the insurance verification process immediately. Furthermore, we are happy to obtain your rehab insurance policy information and seek verification on your behalf. You can also expedite this process by completing the insurance verification form. There is no obligation to either Newport Academy or to your insurance provider. We will generally get back to you with verification results and a comprehensive assessment of your insurance benefits coverage within 24 hours.

Pre-Certification

The majority of insurance providers require pre-certification, or authorization, prior to entering the program and continuously throughout treatment. We will guide you through this process as well. Consequently, if your policy has this stipulation, we will provide you with support and direction on how best to proceed. If you don’t see your rehab insurance provider in the list above, that does not mean that we cannot work with them—it might simply mean that we haven’t worked with them previously.

Clinical Review and Insurance Substantiation

At Newport Academy, we take great pride in the fact that we have a full-time, in-house team dedicated to supporting our families through the rehab insurance coverage and financing process. In order to secure sufficient rehab insurance coverage, we will most likely need to conduct a series of clinical reviews and any requested doctor-to-doctor calls with the insurance company. These reviews take place every two to 14 days, depending on the individual’s specific case and insurance company. We will also file appeals for any denials and bill the insurance company directly. Our team of rehab insurance review experts assists families with this process on a daily basis. While other facilities charge for this service, we feel it is our responsibility to help you and your family receive the highest-quality treatment.

Deductible

Your deductible is an annual amount that you must pay before insurance will begin to cover your expenses. Typically, once the deductible has been satisfied for the year, your rehab insurance policy will start to cover a percentage of the total treatment costs, called the coverage amount.

Coinsurance

Coinsurance is the percentage of treatment costs, after the deductible, that your rehab insurance policy will not cover. You are responsible for this amount.

Maximum Out of Pocket (MOOP)

The MOOP is a limit on your policy set by your insurance company. Once the total amount of coinsurance paid equals the MOOP, the insurance policy typically covers 100 percent of the “allowed amount.” Sometimes, the deductible applies toward the MOOP, which can help you meet that limit faster.

Allowed Amount

The allowed amount is the daily rate that the insurance company feels is appropriate for the services rendered. The allowed amount may be exactly what you are invoiced for services, or it may be less. It is important to note that, for out-of-network services, the rehab insurance coverage amount percentage applies to the allowed amount, and is not necessarily reflective of invoiced amounts or cost of services rendered.

Balance Billing

Balance billing is a practice in which an out-of-network treatment provider invoices the person who will be receiving treatment for the difference between what the insurance company paid and the actual cost of treatment. Newport Academy does not balance bill. What this effectively means is that we work to ensure maximum coverage by in- and out-of-network insurance providers, and once we collectively understand the rehab insurance coverage options, our Admissions Specialists will work hand in hand with the family or individual to affirm the final cost of treatment. With some treatment centers, you’ll receive an invoice for a balance due after treatment, but Newport Academy does not support this practice. There will be no surprises.

Copay

A copay is a regular fixed cost that you pay for certain services. For example, many people pay a small copay each time they visit a doctor. This contributes to your overall plan and is part of your cost agreement with the insurance company. Some insurance plans do not require copays.

Primary Insurance Subscriber

This is the person whose name is on the insurance card. Many young adults in treatment qualify for coverage under their family’s insurance plan.

Premium

A premium is the amount that people pay at regular intervals to their insurance companies for their coverage. This is the individual’s contribution to their policy, and in some cases, employers may also contribute to the premium. Premiums are determined by what kind of coverage a person has, such as an HMO or PPO plan.

Out-of-Pocket Expenses

Your out-of-pocket cost is the amount of money you must pay each time you visit a doctor or receive inpatient, outpatient, or other therapeutic treatments. These costs are usually due at the time treatment begins, but you may also be able to pay them a little at a time with payment plans. Out-of-pocket expenses include deductibles, copays, and co-insurance.

Policy Effective Date

This is the date your rehab insurance company begins to help pay for your healthcare costs. You must enroll in a health insurance plan either during the open enrollment period, usually offered for a set amount of time once a year, or during a “special enrollment period.” Special enrollment periods begin after a qualifying event, such as marriage, the start of a new job, the birth of a baby, or the loss of healthcare coverage, and usually last for about 90 days. Your policy effective date is determined after you’ve enrolled, and usually falls a few weeks or months after your initial enrollment date.

Managed Care

This blanket term is used to describe the primary system through which healthcare services are provided in the United States. An insurance company directs—i.e., manages—the way you receive treatment, from regular checkups to accidents to major illnesses. Managed Care Organizations (MCOs) include the doctors, hospitals, laboratories, and clinics that make up your network.

Insurance Plan Types

Newport Academy covers an array of mental and drug rehab insurance plans, and the important thing to remember is that we have successfully worked with them all. Plan types break down into two categories: those with out-of-network benefits and those without out-of-network benefits. Plan types that typically offer out-of-network benefits are Preferred Provider Organization (PPO) and Point-of-Service (POS) plans. Plan types that typically don’t offer out-of-network benefits are Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. The bottom line: We pride ourselves on being able to work with them all, to help teens and young adults receive the best treatment possible, as soon as possible.

Single-Case Agreement

A Single-Case Agreement is when a provider, such as Newport Academy, works out a special contract so that out-of-network providers can work with your insurance company on an in-network basis. Approximately 25 percent of those who receive treatment from Newport Academy do so within a Single Case Agreement, so we have extensive experience working with insurance companies to create Single Case Agreements for teens and young adults with emotional, behavioral, or substance abuse disorders. Our goal is to ensure that your rehab insurance provider makes it possible for your teen or young adult to receive the most comprehensive and high-quality treatment available.

Coverage Amount

The coverage amount is the percentage of treatment costs, after the deductible, that your rehab insurance policy will cover.

Insurance Verification Form

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or if dialing from outside the US, +1-714-798-9320

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Upon receipt of your insurance verification, our admissions specialists will verify specific information from you by phone prior to submitting your form for verification.