Sierra Health and Life Insurance for Alcohol Rehab
This page will help members who have Sierra Health and Life coverage and need alcohol addiction treatment. With Sierra Health and Life insurance, you have access to mental health and substance misuse treatment.1 Keep reading to learn how you can learn access your benefits.
Does Sierra Health Cover Alcohol Rehab?
Yes, Sierra Health and Life does cover alcohol rehab services. Under the umbrella of Behavioral Healthcare Options (BHO), Sierra Health members have access to a range of mental health services, including substance use treatment. Some of these treatment options include:1
- Mental health and substance use services.
- Online educational resources.
- Inpatient and outpatient treatment programs.
- 24/7 crisis support.
In addition, marketplace plans must follow the guidance of the Affordable Care Act (ACA). The ACA mandates that all health insurance providers must cover mental health and substance use services at the same levels as other medical and surgical services.2
It’s important to check what your insurance does and doesn’t cover before checking into an alcohol rehab facility. A rehab center will verify your insurance for you. You can also check to see if you will have any out-of-pocket costs before choosing a treatment center. You may need to contact Sierra Health to find out if there are any co-payment or deductibles.
Types of Addiction Treatment Covered by Sierra Health and Life
Sierra behavioral health insurance for addiction rehab offers several levels of treatment. Treatment will look different for each person depending on your recovery needs. Some of the treatment programs that Sierra Health and Life insurance may cover include the following:3
- Detox. Alcohol withdrawal can be a difficult time, but detox can help you safely rid your body of alcohol with the care and support of medical staff.
- Hospital inpatient. During an inpatient program, you stay onsite during treatment and have care around the clock.
- Patients can live at the residential facility and have a home-like environment while also participating in ongoing counseling and receiving support.
- Outpatient treatment. In an outpatient program, you attend set treatment appointments during the week but still live at home.
Does Sierra Health Insurance Cover Mental Health Treatment?
The ACA mandates all marketplace insurance plans offer 10 essential health benefits, including mental health and substance misuse treatment.2 It’s common for patients to have a mental health and substance use disorder at the same time.4 When this happens, it is referred to as a co-occurring disorder, and people can benefit from having both disorders treated at the same time.4
Sierra Health Plans and Coverage Levels
Sierra Health offers two types of health plans:5
- Preferred Provider Organization (PPO) plan. This plan fully covers most in-network treatment, and you don’t need a referral to see a specialist. If you seek treatment outside the network, you may have to pay more for the services.
- Health Savings Account (HSA) compatible PPO plan. This plan works like the PPO plan, except it has a lower monthly premium, and you must pay an annual deductible. After you meet your deductible, your Sierra Health and Life benefits coverage starts. With this plan, you can also put money into a health savings account tax free and use this fund for certain medical expenses.
Even with Sierra health insurance, there may be costs you have to pay yourself. These are known as “out-of-pocket” costs and may include:
- This is a fixed amount you must pay for a service covered by insurance. For example, $30 for each doctor visit.6
- This is the amount you must pay before insurance will pay for its part. For example, if your deductible is $1,000, you must pay that amount in services before your insurance plan begins paying for services.7
- After your deductible is met, you may still have to pay for a percentage of services—this is the coinsurance. You share the expense for services with the insurance company.8
- Out-of-pocket maximum. Insurance companies usually set a maximum amount you will have to pay for all the above items in a one-year period. Once you reach that amount, you won’t have any more copayments or coinsurance; the insurance plan pays for all covered services.9
How to Check My Sierra Health Insurance Coverage for Alcohol Rehab
If you are unsure about any of the details listed above or what your out-of-pocket costs might be, you can find the answers to your questions in one of three ways:
- Online Member Center. Sierra’s Online Member Center lets you chat with an agent, check your benefits, review your copay and deducible information, see who’s in-network, and more.
- Call Sierra Health and Life insurance. You can call the number listed on the back of your insurance card. Ask about going to an alcohol rehab center and find out what steps you need to take.
- Call a rehab treatment provider. You can also call the alcohol rehab center directly. An admissions navigator will go over your insurance details and then check your benefits while you wait. You can check your insurance and begin the admission process all in one call.