Government Employees Health Association, Inc. (GEHA) is a medical benefit provider that exclusively serves current and former federal employees, military retirees, and their families. GEHA provides access to millions of health providers across the country, and it also provides telehealth access.

If you or a loved one has a GEHA Health plan, you may be wondering if they cover drug and alcohol addiction treatment. Because GEHA offers a wide range of plans, your coverage may depend upon your specific plan. However, GEHA insurance plans should cover at least some of the costs of drug and alcohol rehab. 

American Addiction Centers (AAC) strives to provide you with the most updated information on each carriers’ addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.

Checking Your GEHA Health Plan Insurance Benefits

Knowing exactly what GEHA plans cover can give you peace of mind while you or your loved one is in rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. For more information on GEHA insurance plans and to check what your plan covers, call , click here, or fill out the form below.

Do GEHA Insurance Plans Cover Substance Abuse Addiction Rehab?

When you have a substance use disorder (SUD), treatment incredibly important to help you begin on your path toward recovery. Whether you are dealing with a drug or alcohol addiction, detox and rehab are instrumental in addressing your SUD. You may be wondering whether GEHA insurance plans cover rehab?

The Affordable Care Act (ACA) mandates that almost all health plans in the United States, including GEHA plans, cover at least some of the cost of addiction treatment. This is because rehab is considered to be a substance use disorder (SUD) treatment, which falls under the classification of mental and behavioral health services, which are considered to be an essential health benefit under the ACA.2 Consequently, most insurers must provide coverage in some capacity for this treatment type, as well as coverage for inpatient and residential mental and behavioral treatment and behavioral health services.7

Even if your GEHA Health Plan covers rehab, it may not cover the entire cost. How much is covered may depend upon your coverage type. Coverage may also vary depending upon the type of facility offering your rehab treatment.

Do Treatment Centers Need to Be In-Network?

In-network providers have a contract with the insurance carrier to offer services at a set price. This means that your out-of-pocket expenses will typically be lower than if you choose an out-of-network facility. In some cases, you may even be responsible for the full cost of rehab if you choose an out-of-network facility.

Whenever possible, try to choose a facility that is in-network with GEHA. If you are unable to find an in-network provider or prefer a facility that is out-of-network, you may be able to work out a payment plan with the facility so you can pay back the cost of treatment over time.

What Are the Coverage Levels and Plans for GEHA?

If you or someone you love is struggling with a drug or alcohol addiction, you may need to get help from an addiction facility. The right facility will be able to treat you for all of your issues and will be able to offer you the level of comfort that you need. A wide range of luxury facilities are available that offer executive amenities and exclusive services. Your plan may be willing to cover these services, but you may have to pay a copay.

Luckily, GEHA Health Plans have a cap on the amount of coinsurance and deductibles that their clients have to face each year. Thus, if your plan covers specialty treatment, your out-of-pocket payments will not exceed the following amounts based on your plan:

  • Standard plan in-network: $5,000
  • Standard plan out-of-network: $7,000
  • High option in-network: $4,000
  • High option out-of-network: $6,000
  • HDHP option for individual plans: $5,000
  • HDHP option for family plans: $10,000

The amount of coverage you have can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.

What Different Types of Drug and Alcohol Addiction Treatment Does GEHA Cover?

Depending on the severity of your drug and alcohol addiction, you may require a certain level of addiction treatment. Oxford health may provide coverage for the following addiction treatment programs:5

  • Medical detox: In this program, you will be monitored during the withdrawal phase of your treatment. Clinicians will ensure your safety during this time.
  • Inpatient programs: This includes physician oversight and 24/7 monitoring until you complete the program.
  • Partial hospitalization programs (PHPs): This is a step down from inpatient treatment and includes coming to the facility most days of the week for most of the day. You will return home at night.
  • Outpatient programs: You’ll come to the facility for therapy regularly, usually once or twice a week unless it’s intensive outpatient treatment.
  • Intensive outpatient programs (IOP): These outpatient programs require that you attend treatment programs for longer and more frequent sessions than you would in a standard outpatient program.
  • Aftercare: Aftercare programs support sustained sobriety after more intensive rehab. There are many types of aftercare, including support groups, therapy, and community programs.

Which Rehab Centers Take GEHA Insurance?

There are American Addiction Centers (AAC) rehabilitation facilities located throughout the United States, and some of them might work with GEHA to provide you with substance use treatment. As you familiarize yourself with your health insurance coverage through GEHA, take some time to think about which facility is going to work best for you. Some of AAC’s facilities include:

  • AdCare Rhode Island: Situated in Rhode Island, AdCare Rhode Island specializes in medically monitored withdrawal management, crisis stabilization, an outpatient program, and a complimentary informational session for families of those seeking treatment.
  • Desert Hope Treatment Center: This Nevada-based treatment center features individual and family therapy, medical detox, aftercare, and substance abuse programming specific to veterans and first responders.
  • Greenhouse Treatment Center: Based in Grand Prairie, Texas, Greenhouse Treatment Center features a family program, individualized treatment, medical detox, and treatment for co-occurring disorders.
  • Laguna Treatment Hospital: Laguna Beach is not too far away from Laguna Treatment Hospital, which utilizes 12-Step involvement, offers a family program and individualized treatment, and follows up with aftercare support.
  • Oxford Treatment Center: Located in Etta, Mississippi, Oxford Treatment Center has residential treatment (both short- and long-term), individualized treatment, medical detox, and a family program.
  • River Oaks Treatment Center: River Oaks Treatment Center is located near Tampa, Florida. This facility is home to addiction-focused healthcare in its inpatient residential program and outpatient therapy. A family program, medical detox, and aftercare support are also available as part of your treatment.
  • Sunrise House Treatment Center: Sunrise House Treatment Center is in Lafayette Township, New Jersey, and it specializes in cognitive behavioral therapy (CBT). Sunrise House offers a family program, IOP, and a residential inpatient program.

You can use our directory and filter by “insurance” to locate in-network facilities close to you if AAC is not in-network for you. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of other facilities and programs.

More Questions About GEHA Health Plans Insurance Coverage for Drug & Alcohol Rehab?

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