GEHA Drug & Alcohol Rehab in Ohio

Will GEHA Pay For Rehab?

Yes, GEHA will pay at least a portion of drug and alcohol rehab. Any out-of-pocket costs will largely depend on your location and the specifics of your plan. GEHA offers various plan types – some requiring a deductible, copay, coinsurance, or an out-of-pocket maximum before addiction services can be rendered.

The Affordable Care Act, or ACA, mandates that health insurance companies, including GEHA, offer coverage for at least a portion of drug and alcohol rehab as an essential benefit. However, the extent of service coverage will depend on the severity of your condition, whether your provider is in or out-of-network, and your out-of-pocket requirements.

Some individuals may find drug and alcohol rehab is fully covered under their GEHA plan without any additional fees, provided they stay in-network. The best way to understand your specific GEHA plan and any out-of-pocket fees is to contact us at 800-481-8457. Our insurance experts can pull up your benefits and go over your coverage. Inquiries are always free and confidential.

Types of GEHA Plans

GEHA offers various plan levels similar to other health insurance providers. GEHA also offers Medicare plans, but this guide covers individual and family plans. We are unable to accept Medicare at this time, so it is best to contact GEHA for help with Medicare coverage.

GEHA offers plans in one of three categories:

1. Elevate / Elevate Plus

GEHA Elevate and Elevate Plus plans are designed for usually healthy individuals or families who want to save on their monthly premium by staying in-network for their care or paying more at the point of service. Both plans include a preferred provider network, which means the price of services are contracted between GEHA and the providers. The key difference with these plans is that Elevate plans offer both in and out-of-network benefits, though you will save money when you stay in-network. With Elevate Plus, you must choose a provider within the preferred provider network to receive coverage, except in cases of an emergency.

Both plans may require different levels of patient cost-sharing, which means you may have copays, coinsurance, or a deductible.

Because we are in-network with GEHA, we can accept both Elevate and Elevate Plus plans.

2. Standard / High

GEHA Standard and High are both like PPO plans offered by other insurance companies. These plans offer the most flexibility, offering both in and out-of-network coverage. They also keep point-of-service cost-sharing low in exchange for higher monthly premiums. 

With GEHA Standard or High plans, you typically have the freedom to choose any addiction treatment center regardless of their network status. However, you will save more money staying in-network – sometimes thousands of dollars.

3. High Deductible (HDHP)

GEHA high deductible plans are the most affordable in terms of monthly premiums. Aside from preventative care, most out-of-pocket costs for medical treatments are instead deferred to the point-of-service. Those covered under this plan usually have a Health Savings Account (HSA) to help save for unforeseen medical expenses, such as their deductible.

A plan is considered high-deductible when the annual deductible is at least $1,600. To give an example, a $1,600 deductible often means for drug and alcohol rehab, the patient may be responsible for $1,600 out-of-pocket, or the remainder balance on their deductible for the calendar year, before their insurance coverage kicks in. After your deductible is met, GEHA covers the remaining costs. This out-of-pocket cost can seem expensive for some, but it is often just a small fraction of the total cost for addiction treatment. This means regardless of a high deductible, GEHA usually covers the majority of treatment costs. For those who have already satisfied their deductible with other healthcare needs, rehab could be fully covered.

Not sure where your deductible stands or concerned about finances? We encourage you to contact us at 800-481-8457 to discuss your options.

Medical Detox Centers That Accept GEHA

At Ohio Addiction Recovery Center, we offer cutting-edge inpatient medical detox services specializing in managing drug and alcohol withdrawal. In our quiet residential setting in Columbus, Ohio, you or your loved one will receive round-the-clock medical care to keep withdrawal symptoms to a minimum.

Medical detox employs medications to safely and comfortably address chemical dependency and withdrawal symptoms. Detox is often just the first step in a comprehensive treatment plan, targeting the physical aspect of substance use disorders.

At OARC, GEHA Health Insurance covers medical detox when deemed medically necessary, particularly for substances that can lead to physical dependence, such as:

• Alcohol
• Heroin or prescription opioids
• Fentanyl
• Benzodiazepines, like Xanax and Valium

Discover more about our Ohio detox center.

Interested in checking bed availability? Reach out to us today at 800-481-8457

Residential Rehab That Accepts GEHA Health Insurance

Our residential rehab in Columbus offers comprehensive 30-45 day inpatient addiction treatment plans. While detox tackles the physical side of addiction, residential rehab delves into the psychological component and relapse prevention strategies. If medical detox isn’t required, some clients start directly in residential treatment.

Because we are an in-network GEHA preferred provider, residential rehab at OARC is usually mostly or even fully covered by GEHA.

In our private drug rehab, you or your loved one confront the root causes of substance use, engage in both group and individual therapy, develop coping mechanisms, and receive education on addiction. Additionally, you and your dedicated care team will craft an aftercare plan and begin building a support network for recovery.

Learn more about our residential rehab in Ohio.

GEHA Outpatient Rehab Coverage

At OARC, we also provide a range of aftercare outpatient services covered by GEHA Health Insurance. Those in our outpatient programs usually first complete residential treatment. Outpatient programs include:

• Partial Hospitalization Program (PHP): Though considered outpatient, PHP closely mirrors our residential program in structure and intensity. The primary difference lies in the absence of overnight stays. Clients participate in day-long group sessions, requiring a significant commitment akin to a full-time job, to ensure comprehensive treatment.
• Intensive Outpatient Program (IOP): Serving as a step down from residential treatment or PHP, IOP offers greater independence. Clients engage in evening group and individual therapy sessions three times a week, aiding their reintegration into daily life, whether returning to school or work, while providing necessary support and structure. Typically, clients transition to IOP after completing residential treatment.
• Addiction Counseling: Following IOP, clients can continue working with their primary counselor at a tailored frequency. It’s common for individuals to pursue counseling for the first year of their recovery journey, aiding in sustaining progress and managing challenges as they arise.

GEHA Mental Health & Dual Diagnosis Coverage

Ohio Addiction Recovery Center is a dual-diagnosis rehab, which means we also diagnose and treat any co-occurring mental health disorders in conjunction with addiction treatment. It is estimated 50% of individuals with a substance use disorder have a co-occurring mental health condition, such as depression, anxiety, or trauma. For that reason, we view mental health as a vital component of effective addiction treatment. We will utilize your GEHA coverage for any psychiatric needs.

Understanding Your GEHA Health Plan

We understand insurance policies and researching addiction treatment options can be overwhelming. Our representatives are standing by 24/7 to check your coverage and answer any questions you may have. Even if we aren’t a fit for you or your loved one, we are happy to suggest other options that may be covered by GEHA.

Start your journey to recovery today by chatting with us online in the bottom right corner of your screen or by calling 800-481-8457

• Sources
  1. GEHA – Medical Plan Overview
  2. GEHA – HDHP Overview
  3. GEHA – Standard Overview
  4. GEHA – High Overview
  5. GEHA – Elevate Overview
  6. GEHA – Elevate Plus Overview