Medical Mutual Drug and Alcohol Rehab Coverage in Ohio

Does Medical Mutual Pay For Drug & Alcohol Rehab?

Fortunately, Medical Mutual of Ohio does offer coverage for drug & alcohol rehab services, but the extent of their coverage will depend on the severity of your condition and the specifics of your policy. Policyholders sometimes have out-of-pocket costs such as:

• Deductible: An annual out-of-pocket amount before insurance coverage kicks in
• Co-pay: A fixed amount you pay for covered services after you have met your deductible
• Co-insurance: When you are responsible for a percentage of total treatment costs 

Each plan has varying deductibles or other out-of-pocket rates, so it’s important to verify your benefits with a provider or your insurance company before choosing a treatment center. Medical Mutual may not cover treatment at all with out-of-network providers, in which case you would be responsible for all costs associated with rehab.

Medical Mutual HMO vs PPO Addiction Treatment

The common Medical Mutual policy types are HMO and PPO. These policies will affect which facilities you can choose and any out-of-pocket costs associated. 

HMO

HMO plans give you access to certain doctors or treatment centers within its network. With an HMO plan, you will be required to choose a rehab in-network with Medical Mutual, otherwise, you will be responsible for the entire cost of treatment. However, in-network PPO coverage is very good for addiction treatment, and often there is no deductible.

Some MedMutual HMO plans also require a referral from your primary care doctor (PCP) before you can enter addiction treatment. If you aren’t sure, you can contact us and we will let you know if you need a referral from your doctor.

PPO

MedMutual PPO plans offer more flexibility when choosing providers. Like HMO plans, there is still a preferred network of providers, but you can receive out-of-network coverage for providers that aren’t in Medical Mutual’s network. 

Unlike a HMO, PPO plans never require a referral from your primary care doctor to enter addiction treatment. However, PPO plans often require a deductible.

Whether you have a Medical Mutual HMO or PPO plan, out-of-pocket costs will be at a minimum at Ohio Addiction Recovery Center because we’re a proud network member of Medical Mutual of Ohio.

Types of Addiction Treatment Covered by Medical Mutual

Your frequency and severity of substance use will also determine the types of treatment services covered by Medical Mutual. This is usually determined in a pre-assessment with your provider. With a 15-20 minute phone call, our medical staff can help submit claims to Medical Mutual to let you know what they will cover.

Medical Mutual Detox Coverage

Medical Detox is considered the highest level of care. Many people start their journey to recovery in a specialized medical detox facility, like Ohio Addiction Recovery Center, which lasts 5-14 days inpatient. Because drug and alcohol withdrawal can be dangerous, Medical Mutual offers coverage for medical detox.

Not all addictions warrant medical detox, therefore your detox coverage will depend on the type of substances you are using and the frequency. Medical Mutual of Ohio usually covers detox from:

• Alcohol
• Benzos, such as Xanax
• Heroin
• Fentanyl
• Prescription Opioids, such as Oxycontin

Detox coverage may not be offered for Marijuana or Cocaine, though there are exceptions. It is usually best to contact us directly for an assessment. We will be able to let you know if Medical Mutual will cover detox in our facility.

Residential Rehab That Accepts Medical Mutual

Residential rehab is an intensive program lasting 30-45 days. Medical Mutual offers coverage for residential inpatient treatment. Residential treatment has better outcomes than outpatient treatment, so Medical Mutual usually approves residential rehab for a variety of addictions.

MedMutual Outpatient Rehab Coverage

There are various types of outpatient programs, such as partial hospitalization (PHP), intensive outpatient (IOP), and outpatient counseling. Outpatient programs have significantly lower costs than residential treatment, so Medical Mutual may recommend one of these programs if they do not approve residential treatment.

PHP may be a good alternative to residential treatment because it offers nearly identical programming as residential treatment. The only difference is clients sleep at home or a sober living home instead of residing at the facility. 

Does Medical Mutual Cover Mental Health Rehab?

Like addiction treatment, Medical Mutual also covers mental health treatment – even inpatient rehab. Ohio Addiction Recovery Center is a dual diagnosis rehabilitation center, which means we also treat co-occurring mental health conditions. These services are also in-network with Medical Mutual.

Medical Mutual at Ohio Addiction Recovery Center

We understand insurance can be confusing and overwhelming, especially when you are in a time of need. We’re here to offer clarity to you or your family while you research addiction treatment options. We’re available 24/7 to answer any questions you have or verify insurance benefits. You can reach us at 800-481-8457 or can verify your benefits with us online.