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Health Plan of Nevada Insurance Coverage for Alcohol Rehab

Insurance can be confusing, but we try to make it easier to understand. Read on to learn more about Health Plan of Nevada (HPN) insurance coverage for alcohol addiction, how to check your benefits, and treatment options.
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What Is Health Plan of Nevada?

Health Plan of Nevada (HPN) is an insurance company that is part of UnitedHealthcare.1 Health Plan of Nevada has provided quality care to the people of Nevada since its founding in 1982.1 It is the oldest and most experienced health maintenance organization (HMO) in the state.1

With Health Plan of Nevada insurance, members can choose from a wide variety of coverage options, such as traditional HMO plans, individual plans, group POS plans, and Medicare options.1 In addition, HPN provides Medicaid for the state’s lower-income residents.2

Does Health Plan of Nevada Insurance Cover Alcohol Rehab?

All of Health Plan of Nevada coverage options include mental health and substance use services, including alcohol misuse or addiction treatment.3

Having expanded the Medicare program when it was passed in 2010, the Affordable Care Act (ACA) offers affordable insurance to households with low to moderate income and supports methods that generally lower healthcare costs overall.4 The ACA also mandates that all Marketplace healthcare plans offer Essential Health Benefits to members. These benefits include, but are not limited to, mental health and substance use treatment.5

Of course, each person’s specific policy and tier level will vary. That means each person’s costs and coverages will vary too. It’s a good idea to check with both your insurance plan and the rehab facility before treatment to see what is and isn’t covered.

Types of Alcohol Treatment that Health Plan of Nevada May Cover

HPN may cover the costs of various treatment levels that are necessary as you progress in treatment. Some of these treatment programs that may be covered include:

  • Inpatient or residential rehab. This type of treatment involves 24/7 care in a residential setting, with support and therapeutic services conducted by professional clinicians. Patients remain in the program for as long as needed.6
  • Partial hospitalization program (PHP). A PHP is an extensive treatment program that lasts most of the day, every day of the week. Patients will go to their own homes at night.7
  • Intensive outpatient program (IOP). IOP consists of intense therapy sessions, lasting throughout the day but less than PHP. It’s conducted on an outpatient basis, so patients can work around their schedules.6
  • Standard outpatient treatment, where you have regular office visits for counseling and treatment medicines, if necessary. Standard outpatient programs typically require attending treatment 1 to 3 times per week, though some meet every day.7

Health Plan of Nevada Insurance Plan

Health Plan of Nevada insurance coverage breaks down into 2 main categories:8

  • Health Maintenance Organization (HMO) In an HMO plan, you choose a primary care physician (PCP) and use facilities and services within the insurer’s network. This makes an HMO a bit less expensive than other plans. If you need to see a specialist, you will need to get a referral from your PCP.
  • Point-of-Service (POS) HPN has 3 POS tier levels, with each tier having different requirements and cost points. POS plans offer more flexibility since you can go out of network, but you will pay more for services.

In addition to these plans, members can also enroll in Health Plan of Nevada HMO coverage for Medicare.9

Even with insurance, you may have certain costs you need to pay for. These are called out-of-pocket costs and may include:

  • Deductible: The yearly total amount you pay for health services before HPN will pay. For example, if your deductible is $1500, you pay the first $1500 of any costs yourself, and HPN covers the rest.10
  • Copayment (or co-pay): The amount you pay for each service after you’ve met your deductible.11 For example, $30 for each office visit.
  • Coinsurance: The percentage of total costs you pay for each service after you’ve met your deductible. For example, if the coinsurance is 30% for a $100 visit, you would pay $30 and HPN would cover the remaining $70.12
  • Out-of-pocket limit/maximum: The maximum amount you have to pay for services per year (excluding monthly premiums). Once you hit this amount for services—including any deductibles, copayment, and coinsurance—your insurance covers the rest.13

How to Check My Health Plan of Nevada Insurance Benefits

You can quickly and easily check your My Health Plan of Nevada insurance benefits in a few ways:

  • Visit the HPN member portal and log in to your account.
  • Call your Health Plan of Nevada customer service line. You can find the number on the back of your card.
  • Check directly with the rehab treatment center. Most rehab centers, including American Addiction Centers (AAC), can quickly verify your insurance and tell you about the benefits you have under your plan.

How to Use Health Plan of Nevada for Alcohol Rehab

You can begin your alcohol recovery journey by using your Health Plan of Nevada insurance benefits. If you’re unsure about how to get started, reach out to your primary care physician as a first step in the process. Your PCP will be able to guide you in the right direction about alcohol addiction treatment options, and if you need any pre-authorization or referrals, they will be able to accommodate you.

You may also want to contact various rehab facilities to find one that accepts Health Plan of Nevada coverage. Once you find one, you can discuss what the out-of-pocket costs will be and start the admission process. AAC is in-network with Health Plan of Nevada. Call us at to discuss your treatment options.

Sources

  1. Health Plan of Nevada. (2022). About Health Plan of Nevada.
  2. Health Plan of Nevada. (2022). Welcome to Health Plan of Nevada’s Medicaid.
  3. Health Plan of Nevada. (2022). Mental health and substance use benefits.
  4. gov. (n.d.). Affordable Care Act (ACA).
  5. gov. (n.d.). What marketplace health insurance plans cover.
  6. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
  7. Center for Substance Abuse Treatment. (2014). What is substance abuse treatment? A booklet for families. HHS publication no. (SMA) 14-4126. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  8. Health Plan of Nevada. (2022). How to use your health plan.
  9. Health Plan of Nevada. (2022). Medicare options.
  10. gov. (n.d.). Deductible.
  11. gov. (n.d.). Copayment.
  12. gov. (n.d.). Coinsurance.
  13. gov. (n.d.). Out-of-pocket maximum/limit.
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