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HealthSmart Insurance Coverage for Drug & Alcohol Rehab

HealthSmart is one of the largest third-party administrators in the country and provides customizable and scalable health plans employers.1 It offers health plans for self-funded employers.1

If you have HealthSmart insurance and are looking for drug and alcohol addiction treatment, you likely have some questions about what is covered by your insurance policy and what out-of-pocket expenses you can expect. Does HealthSmart cover addiction treatment? The quick answer is yes; HealthSmart will cover at least some of your drug and alcohol rehab but read on to learn more about HealthSmart’s coverage of substance use disorders (SUDs).


Does HealthSmart Cover Addiction Rehab?

Does HealthSmart cover addiction treatment? Yes, HealthSmart insurance plans will provide at least some coverage for inpatient and outpatient alcohol and substance abuse treatment services, although the amount of coverage 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 Affordable Care Act (ACA) requires that insurance companies provide some degree of coverage for mental health treatment, which includes substance use disorder (SUD) treatment (including coverage for drug and alcohol addiction), so HealthSmart does cover addiction treatment.2 Healthsmart insurance plans may cover rehabilitation as part of its mental health care services. However, Healthsmart may not cover every kind of therapy or all lengths of treatment. You may have to get a referral from your primary clinic before Healthsmart is willing to pay for your claims in some cases.

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.


How to Check Your Insurance Benefits?

It’s always best to be sure about what your healthcare benefits entail. You don’t want to be caught by surprise with unexpected financial costs. You may wonder if HealthSmart covers drug rehab, and the only way to really have the answer is to check your HealthSmart health plan coverage.

Knowing exactly what HealthSmart 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. You can check your Health Smart coverage by calling , click here, or fill out the form below.


What Different Types of Addiction Treatment Does HealthSmart Cover?

Getting the proper addiction treatment is essential for your recovery effort. The type of treatment plan you need will depend on the severity of your addiction and where you are in the journey to well-being. You might start out at one level of treatment and work way to another level, then continue until you don’t need treatment.

Some of the treatment programs that may be covered through HealthSmart include:3,4

  • Detox services: In some cases, you may need assistance when detoxing from drugs and alcohol, which can potentially be uncomfortable, painful, or even life threatening. Medical detox helps you safely withdrawal from drugs and alcohol, as you’ll receive around-the-clock medical supervision. You might also be given medications to help minimize withdrawal symptoms.
  • Inpatient or residential care: Inpatient/residential live-in treatment centers provide drug and alcohol rehab while you live onsite at the facility. Most inpatient programs last anywhere from 15–90 days, depending on the program you’re in and your individual needs.
  • Partial hospitalization (PHP): Partial hospitalization programs give you the opportunity to live at home while attending treatment during the day.
  • Intensive outpatient program (IOP): Intensive outpatient programs involve attending treatment programs a few evenings a week. In an intensive outpatient program, you can live at home and even go to work during the day.
  • Outpatient treatment: Individuals who have completed inpatient treatment often attend outpatient treatment for ongoing support on their journey to sobriety. You live at home and spend 10–12 hours a week at the treatment facility for therapy and support.

What Should I Do if HealthSmart Won’t Cover the Total Cost of Rehab?

If your insurance plan won’t cover your rehab, don’t despair, because many facilities offer payment plans that will allow you to get the treatment you need. Government programs also offer aid to recovering addicts that can prove helpful. Many facilities will work with you to figure out how to have access to treatment and make it affordable.

There are other resources to help you cover the cost of rehab. You can check with the rehab facility for a sliding scale fee or payment arrangement. Additionally, some facilities offer financial aid or scholarships for treatment. If those options aren’t available, you could try to get a loan from family or friends.

Here are some resources that can help:

So, can you use your HealthSmart insurance coverage for addiction treatment? Yes, you can! The specific details and how much the insurance pays for will depend on your plan and the provider you choose. However, there are options to help you pay if your insurance doesn’t cover the full cost.

What’s most important is that you can get the help you need to treat your addiction. There is a lot of information regarding health insurance that can be confusing and perhaps overwhelming. If you would like some help in sorting through this information to the get the addiction treatment you need, make sure to call your insurance company or speak to one of our admissions navigators today. They can outline the details of your plan and help guide your search.

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.







More resources about HealthSmart Insurance Coverage for Drug & Alcohol Rehab: