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SUBSTANCE ABUSE & TUFTS HEALTH PLAN

What is Tufts Health Plan?

Getting help for substance abuse or mental health disorders takes great courage, but it also seems to take a great deal of money. So many people wonder what coverage they have through their health insurance policy.

 

With Tufts health plan, rehab is usually covered to some degree. Tufts Health Plan provides a wide range of health insurance benefits to treat substance use disorders as well as partial hospitalization and mental health treatment at little or no additional cost.

 

Tufts health insurance was founded as a nonprofit organization in 1979. Today they still focus on providing high-quality and affordable health concerns along the Northeast.

  1. Multiple employer plans are available, including HMO plans, PPO plans, advantage or third plans, and more.
  2. You might also have a connector plan for qualifying individuals and groups using Federal Premium tax credits.
  3. Tufts Health Care offers Medicaid plans and Medicare plans, but there is a handful of each, and they vary in terms of what gets covered and which state you live in.

 

Not sure which plan you have? Let Prevail Recovery help. The admissions team at our Florida rehab can help you verify your insurance coverage today.

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INSURANCE FOR SUBSTANCE ABUSE TREATMENT 

Does Tufts Health Insurance Cover Addiction Treatment?

Tufts Health Plan does provide some coverage for addiction treatment. Most health plans provide outpatient care services for substance abuse, including an initial evaluation, ongoing monitoring, and medication.

 

You can also receive an outpatient diagnosis and get treatment for co-occurring disorders like eating disorders, anxiety, or depression.

 

Tufts Health Plan gives coverage for inpatient and emergency services. For example, if you are struggling with opioid addiction, there are medication-assisted treatments for which you might qualify.

Treatment coverage by Tufts health plan might include:

  • Medical detox
  • Acute residential rehab
  • Partial hospitalization programs
  • Intensive outpatient programs
  • Outpatient therapy
  • Medication management

 

Prevail Recovery can help you look into your rehab covered by Tufts health plan. 

PAYING FOR INSURANCE

How Long Will Tufts Health Plan Cover Rehab?

Once you know that your needs are covered, you probably want to know: how long is rehab covered by Tufts health plan? The length of treatment coverage by Tufts health plan depends entirely on your plan.

 

At Prevail Recovery, we can help you verify the length your benefits cover.

VERIFY BENEFITS

How to Verify Insurance Coverage Through Tufts Health Plan?

If you need to know whether rehab covered by Tufts health plan is part of your benefits package, you have a few options for verification:

 

  1. You can try to find your Benefits Summary and check the treatment coverage by Tufts health plan. You can find a copy in an online customer portal or Tufts Health Member Connect or request one from your insurance provider.
  2. If you are going to contact your insurance provider, you can call them at 888.257.1985 (TTY: 711). This helps you circumvent the issue of trying to locate what your benefits are on your own. However, this process can be very lengthy and time-consuming.
  3. Perhaps the easiest and fastest way to check your coverage is to let insurance specialists help. At Prevail Recovery, we have staff members trained to contact insurance providers on your behalf and verify your benefits. We can turn around and explain exactly what’s covered, for how long, and the alternatives for treatment that isn’t covered. 

IN-NETWORK VS OUT OF NETWORK

How to Find an In-Network Rehab Covered by Tufts Health Plan

If you want to get help from an out-of-network provider, you have to get prior authorization from your insurance company, and they will determine whether there is a medical necessity. Medical necessity means they want to make sure there are no in-network providers available in your area, in which case you have no other option. 

 

However, this is rarely the case because the insurance provider works hard to generate a reputable list of top-rated rehab programs and mental health specialists in-network. So how do you find one?

 

Ask. 

 

If you are struggling with addiction or mental health problems, you can turn to your primary care physician and ask them for a list of inpatient rehab centers that are covered by your plan. You can also reach out directly to your insurance provider for the same.

 

Once you have that list, it’s up to you to narrow down the results and find a facility that best fits your needs. Consider the following:

How qualified is the staff?

Verify how qualified the staff is. If, for example, you are looking for partial hospitalization or outpatient detox service from your rehab center, you will probably want a facility that has a doctor as part of their staff to administer medications as necessary during the worst of your symptoms.

 

Make sure that they are board-certified and that any nursing staff also has certificates or a great deal of experience with things like rehab, mental health, and holistic care.

Do they provide assistance with insurance questions?

If you are looking for treatment coverage by Tufts health plan information, it can get very complicated trying to find a copy of your summary benefits or linger on hold while customer service asks you to verify 17 different account numbers. 

 

Instead, you might consider searching for a facility that offers assistance verifying rehab coverage by Tufts health plan and explaining certain billing practices or common questions you might have.

How do they develop treatment plans?

Talk to the facilities, call them, and ask how they develop treatment plans. You might have a treatment plan that includes a psychologist, physician, and nurse all working together. Good rehab facilities will have you complete an initial evaluation or assessment with their staff to help determine the most appropriate therapy for your situation. Good rehab facilities won’t provide a cookie-cutter plan but will customize treatment.

Do they provide individual or group-only therapy?

You might prefer having individual or one-on-one therapy sessions instead of any type of group setting. Perhaps you have tried therapy before but only with a group and found it difficult to express yourself. No matter the reason, you should be able to discuss these needs with the facility you are considering. Your in-network rehab for Molina health insurance should allow you to tailor a plan that meets your needs.

 

Remember that group settings can offer social opportunities, emotional support, and encouragement that you simply can’t get elsewhere. So consider with openness integrating both types of therapies into your routine at a comfortable pace.

PREVAIL RECOVERY CENTER

Why Choose Prevail Recovery

If you are ready to get rehab covered by Tufts Health Plan, let Prevail Recovery help. We help you transition through different levels of care so that you have the highest chance of staying sober. At our Florida outpatient rehab centers, you work with a team of specialists who bought with their own addictions before committing themselves to time-proven treatments and comprehensive care for those in need. We provide rehab covered by Tufts health plan for mild and severe cases, guiding you so that you have the opportunity to prevail too.

 

Ready to get help? Let Prevail Recovery lend a hand verifying your Tufts health plan rehab coverage and learn more about our South Florida addiction treatment programs today.

Get Help Today

We are here for you.

Contact us to schedule a tour or talk more about treatment options.

We are here to help you on your journey every step of the way.

OUR ADDRESS

3223 NW 10 Terrace Suite 607
Ft. Lauderdale, FL 33309

OUR PHONE

1-(800) 535-2970

We Accept Most Major Insurance
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