Rehab that Accepts Health Partners
Finding a rehab or detox that accepts Health Partners is an option when you purchase insurance through this group. Health Partners provides two health insurance options for their insured’s. To find out if Health Partner’s will cover the cost of your care at Solution Based Treatment, call us at (833) 999-1941.
Here’s more information on the rehabs that take Health Partners and the detox program Health Partners insurance will cover.
Health Partners Insurance Plan Options
Health Partners offers two types of plans: Exclusive Provider Organization (EPO) and High Deductible Health Plans (HDHP). The type of plan you choose will determine your benefits. For example, the EPO plan has higher premiums but no deductible for the majority of services. On the other hand, the HDHP has lower premiums but does have a deductible and option to have a health savings account (HSA).
Addiction Treatment Options
Both inpatient and outpatient services are covered by Health Partners of Northern CA, opening up opportunities to get coverage when you want to seek mental health, behavioral health, or substance abuse services. The exact amount you’ll pay will depend if you’re on the EPO or HDHP plan. And, keep in mind that Health Partners can connect you with ComPsych Guidance Resources EAP, which is a confidential, completely free program. The EAP does assist with substance abuse concerns and includes up to five in-person sessions with a counselor per year, unlimited toll-free access by phone, and online resources. The EAP is available to members via its website or by phone at 877-533-2363.
Health Partners for Medical Detox
Looking for a detox program Health Partners insurance covers? Solution Based Treatment can let you know if your benefits will cover alcohol detox, prescription drug detox or one of our many other detox programs. However, it does cover hospital stays with a $150 copay per admission with preauthorization. If you need emergency medical attention at an urgent care or emergency room, you’ll pay $20 or $75 for your copay. You can go to an in-network or out-of-network hospital in an emergency, but only in-network urgent care facilities are covered.
Health Partners Coverage for Residential Treatment
When looking for a rehab program Health Partners insurance covers, remember that it will cover inpatient treatments. Health Partners’ plans cover inpatient substance abuse services with a copay of $150 per admission with preauthorization.
Health Partners Coverage for Outpatient Treatment
Health Partners’ plans do cover outpatient treatment. The cost to you varies by the program.
Intensive Outpatient Programs (IOP)
Intensive outpatient programs (IOP) may be covered with a $20 copay per office visit, $10 copay per mental health visit, and $5 copay for substance abuse group therapy. There are no other charges for other outpatient services when you see a provider who’s in network, and you don’t need a preauthorization.
Partial Hospitalization Programs (PHP)
Health Partners states that all inpatient services for substance use disorders are covered at a rate of $150 per admission with preauthorization. Outpatient services have no charge unless they are office visits, mental health visits, or substance abuse group therapy as long as you’re in-network. There is no out-of-network coverage.
Outpatient Treatment
Outpatient treatment is covered in both of the Health Partners plans. You’ll pay $20 for office visits, $10 for mental health visits, and $5 for substance abuse group therapy until you hit your deductible (if you have one). You must see a provider who’s in-network, but you don’t need a preauthorization.
Health Partners Rehab Coverage FAQs
Does Health Partners insurance cover drug and alcohol rehab?
Yes. Health Partners of Northern CA does cover inpatient and outpatient drug and alcohol rehabilitation. When looking for a rehab program that takes Health Partners, you’ll need a preauthorization for inpatient services.
How can I verify my Health Partners insurance benefits?
To verify your Health Partners insurance benefits, you can call Solution Based Treatment for a free verification of benefits at (833) 999-1941. Or, you can visit www.healthpartnersnca.org.
Does Health Partners cover outpatient addiction treatment?
Yes, Health Partners of Northern CA insurance does cover outpatient addiction treatment through both of its plans. The EPO requires you to pay a $20 copay per office visit, $10 for mental health visits, and $5 per visit to substance abuse group therapy, but there are no charges for other types of outpatient services as long as you stay in-network.
The HDHP also doesn’t provide coverage out of network, but you will have the same coverage when you’re in-network.
Does Health Partners cover inpatient mental health?
Yes. Health Partners covers inpatient mental health care with a $150 copay per admission for those services. You should receive preauthorization before you seek care, or your benefits could be reduced by up to 100% of the cost of the overall service.
Do treatment centers need to be in-network?
Yes. Through both the HDHP and EPO, Health Partners requires you to have an in-network provider, or it will not cover any costs associated with your care.
How much does Health Partners insurance cover?
Health Partners insurance has a $1,600 deductible per person on the HDHP plan. The maximum out-of-pocket cost per person is $3,000.
For the EPO plan, you have no deductible and a maximum out-of-pocket limit of $1,500 per person. Beyond those costs to you, the plan will cover the remaining services in full as long as they’re in-network.
How do I pay for costs not covered by Health Partners insurance?
To cover costs not covered by Health Partners insurance, you will need to use a credit card, cash, or otherwise pay out of your own pocket.
How is a Health Partners HMO different from a PPO?
Health Partners uses its own provider network. You must see a provider within the network to have coverage. Health maintenance organization (HMO) plans have smaller networks than preferred provider organization (PPO) plans but are generally more affordable when you stay in-network.
Can you get a single case agreement with Health Partners?
Other than in medical emergencies, the majority of services will not be covered if you’re not seeing an in-network provider.
*Solution Based Treatment helps people from all over the country gain admission to the best inpatient treatment programs. We also offer Intensive Outpatient and Day Treatment programs for those living in Temecula, CA, Murrieta, CA, Menifee, CA, Wildomar, CA, French Valley, CA, Lake Elsinore, CA, Canyon Lake, CA, French Valley, CA, Corona, CA, Vista, CA, Escondido, CA, San Marcos, CA and Fallbrook, CA.
Sources:
https://healthpartnersnca.org/
https://www.stancounty.com/riskmgmt/docs/eb-forms/hpnc-faq.pdf
https://www.stancounty.com/riskmgmt/docs/eb-forms/uhc-epo-sbc.pdf
https://www.stancounty.com/riskmgmt/docs/eb-forms/hpnc-hdhp.pdf