1199SEIU Funds provide comprehensive benefits to more than 450,000 retired and working healthcare industry workers and their families.1 If you are struggling with alcohol or drug use, your 1199SEIU Fund should cover some, if not all, of the cost of rehab.
1199SEIU Funds Insurance Coverage for Drug and Alcohol Rehab
What Are 1199SEIU Funds?
1199SEIU Funds provide comprehensive benefits to more than 450,000 retired and working healthcare industry workers and their families.1 1199SEIU Funds benefits include childcare, education, healthcare, job security, and a monthly pension at retirement for little to no cost to members.1
There are several 1199SEIU Funds, and each provides different benefits and coverage.2
- 1199SEIU National Benefit Fund: Covers active members and retirees who are at least 62.5 years of age and have 25 years of service. This fund offers dental, medical, prescription, and vision coverage.
- 1199SEIU National Benefit Fund for Rochester Members: This fund offers dental, medical, prescription, and vision coverage for those in Rochester.
- 1199SEIU Greater New York Benefit Fund: This fund offers dental, medical, prescription, and vision coverage for those in the Greater New York Area.
- 1199SEIU Greater New York Benefit Fund for New Jersey Members: This fund offers dental, medical, prescription, and vision coverage for those in New Jersey.
- 1199SEIU Home Care Benefit Fund: For home care members with health benefits, this fund provides coverage for dental, medical, prescription, vision, and wellness member assistance care. For home care members without health benefits, there are several benefits including Teladoc and wellness member assistance.
- 1199SEIU Licensed Practical Nurses Welfare Fund: This fund offers dental, medical, prescription, and vision.
Do 1199SEIU Funds Cover Drug and Alcohol Rehab Treatment?
1199SEIU Funds provide coverage for drug and alcohol misuse.3 If you or a family member needs help, you can speak to a Benefit Fund social worker via email at MemberServices@1199Funds.org or by phone at (646) 473-9200.
Coverage varies depending on your specific plan. For example, members with family coverage in wage classes 1 and 2 and member-only coverage in wage class 3 receive behavioral health benefits.4 If you are unsure what wage class you are in, you can call the number above or read more here.
Types of Addiction Treatment 1199SEIU Funds May Cover
1199SEIU Funds may cover these rehab options:
- Detox programs: Sometimes treatment includes detox, but this is not always necessary. The detox process can vary depending on the substance and if your body is physiologically dependent on it.
- Inpatient rehab: Inpatient rehab provides intensive, structured therapy in a home-like setting and gives you the resources you need to manage your addiction.
- Outpatient rehab: Outpatient rehab allows you to live at home and attend treatment during the day. Outpatient rehab uses several therapies, including individual and group counseling.
- Intensive outpatient program (IOP): With an IOP, you will typically attend treatment around 3 times a week while living at an assisted living facility.
- Partial hospitalization program (PHP): With a PHP, you will typically attend treatment 5 to 7 days a week. This option may be good for those who do not need medical intervention but would benefit from a stronger level of care.
- Aftercare: Aftercare helps ensure you maintain recovery and identify ways to prevent relapse.
Check Your 1199SEIU Funds Addiction Rehab Coverage
Determining which rehab is right for you and in-network with your insurance can feel overwhelming. The good news is most insurance companies cover at least part, if not all, of the cost of rehab treatment. Insurance coverage varies by company and policy so knowing exactly what is covered by insurance before you enter rehab can provide you peace of mind. Learning about your coverage is easy. Simply call the number on the back of your insurance card, verify your insurance online, or fill out the form below.
Do Alcohol and Drug Rehab Centers Need to be In-Network?
Whenever possible, try to choose a rehab center that is in-network with 1199SEIU Funds. In-network providers have contracts with 1199SEIU Funds, which allows them to offer services at a set price. If you go outside the network, you may get no coverage at all. If coverage is available, you may pay significantly more.5 Keep in mind if you cannot find an in-network rehab center, you still have options such as grants, loans, payment plans, and scholarships.
Do 1199SEIU Funds Cover Mental Health Treatment?
It is common for people experiencing a substance use disorder (SUD) to develop other mental illnesses (e.g., anxiety or depression). When two or more disorders or illnesses occur at the same time, it is known as comorbidity.6 If you have an SUD and a mental illness, it is important to get the care you need for both. Research shows that treating both conditions at the same time produces the best outcome for people with a dual diagnosis.6
Fortunately, the Affordable Care Act (ACA) lists both mental health and substance use as one of the 10 essential health benefits that all long-term health insurance plans must cover. That means your plan should include at least some coverage for mental health and substance use issues.7
Do 1199SEIU Funds Cover Private and Luxury Rehabs?
Different rehab facilities offer different amenities, such as luxury or more private accommodations, which can be appealing options for some patients. Depending on your specific plan, 1199SEIU Funds may cover part or all the costs of private or luxury rehabs. No matter which rehab you choose, it is important to verify your coverage benefits online to know what to expect in terms of coverage.
How Much of the Addiction Rehab Cost Do 1199SEIU Funds Cover?
The amount of coverage you receive depends on your specific plan coverage. You may have some out-of-pocket costs, such as a copayment or coinsurance, or deductible. Your copayment or coinsurance is your portion of the care cost, while the insurance pays the rest. Your deductible is the amount you pay before the insurance.8
What Should I Do If the Cost of Alcohol and Drug Rehab Is Not Fully Covered?
You may find that your 1199SEIU Funds policy does not cover all the expenses related to treatment at a drug and alcohol rehab facility. Contacting the rehab you are considering can help you understand what your financial commitment will be.
Not everyone has access to insurance that covers the full cost of rehab, but everyone deserves access to treatment. It is important to not let the cost of rehab stop you from getting the care you need. Many rehab facilities offer sliding scale options, in which the cost of treatment is adjusted based on your income and what you can realistically pay. Other options you can consider include grants, loans, and scholarships.
For additional reading on other ways to pay, visit these resources:
More Questions About 1199SEIU Funds Coverage for Drug and Alcohol Rehab?
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- 1199 SEIU Funds. (2023). History and Accomplishments.
- 1199 SEIU Funds. (2023). Healthcare.
- 1199 SEIU Funds. (2023). Behavioral Health.
- 1199 SEIU Funds. (2023). National Benefit Fund.
- Healthcare.gov (2022, Feb). What you should know about provider networks.
- National Institute on Drug Abuse. (2021). Comorbidity: Substance use disorders and other mental illnesses.
- Healthcare.gov. (n.d.). Mental health & substance abuse coverage.
- Healthcare.gov. (n.d.). Your total costs for health care.
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