Does Insurance Cover Mental Healthcare? All Your
Questions Answered in One Place

At Newport Academy, we know that treatment financing can make all the difference in receiving quality treatment. To support families in their efforts to access the most effective and compassionate adolescent mental healthcare, Newport Academy works with leading providers of healthcare insurance to provide financing options.

Here are the primary ways that families pay for treatment at Newport Academy:

Insurance for Mental Healthcare

Does insurance cover mental healthcare programs? Yes, insurance often covers a majority of treatment costs. Newport Academy is In-Network with most major insurance companies, and we also have extensive experience working with out-of-network payers to negotiate Single Case Agreements that provide coverage for teens in our care. 

Private Pay

Some families choose a private pay option, which means that they cover all treatment costs without using insurance. Private pay is a viable option for those who feel comfortable using their own resources. 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. Our results-driven treatment is proven to be successful in providing sustainable healing for teens and families.

What factors determine the cost of mental health treatment?

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

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. Untreated mental health issues and co-occurring disorders 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.

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

What factors determine the cost of mental health treatment?

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

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.

We Work with Most Major Insurance Companies to Optimize Access to Care for Families

We’re adding more carriers to our In-Network insurance lists all the time. The selection below represents some of our most popular providers of behavioral healthcare insurance.

Aetna
Anthem Blue Cross Blue Shield of California
Anthem Blue Cross Blue Shield of Connecticut
Anthem Blue Cross Blue Shield of Maine
Anthem Blue Cross Blue Shield of New Hampshire
Blue Cross Blue Shield of Georgia
Blue Cross Blue Shield of Illinois
Blue Cross Blue Shield of Indiana
Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Minnesota
Blue Cross Blue Shield of Rhode Island
Blue Cross Blue Shield of Texas
Blue Cross Blue Shield of Virginia
Beacon Health Options
Blue Shield of California

CareFirst Blue Cross Blue Shield of Maryland
CIGNA
ComPsych
Empire Blue Cross Blue Shield of New York
First Choice Health Network
First Health
HealthNet/Managed Health Network
HighMark Blue Cross Blue Shield
Independence Blue Cross of Pennsylvania
Kaiser Mid Atlantic
Kaiser Northern California
Kaiser of Washington
Magellan
Premera Blue Cross Blue Shield
Regence Blue Cross Blue Shield of Utah
Regence Blue Shield of Washington
United Behavioral Health/Optum

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 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 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 process of obtaining insurance coverage for mental healthcare. In order to secure sufficient 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 insurance review experts assists families with this process on an ongoing 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 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 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 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 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 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 has successfully worked with behavioral healthcare insurance plans both In-Network and out of network. 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 their families receive the best treatment possible, as quickly as possible.

Single-Case Agreement

A Single Case Agreement is when a provider, such as Newport Academy, negotiates a special contract so that out-of-network providers can work with your insurance company on an In-Network basis. Many of the teens and families who receive treatment from Newport Academy do so utilizing a Single Case Agreement, so we have extensive experience working with insurance companies to create Single Case Agreements for teens with mental health and co-occurring disorders. Our goal is to ensure that your insurance provider makes it possible for your teen to receive the most comprehensive and highest-quality treatment available.

Coverage Amount

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

Insurance Verification Form

Get started - Call us at 877-929-5105Call us at 855-404-9816
or if dialing from outside the US, +1-714-798-9320