Insurance and Cost

Insurance companies are big money businesses.

When you contact insurance providers, they only give you the cheapest local treatment option(s). They rarely take the time to assess your personal situation to match you with the best program that’s right for you.

Trying to get your insurance to cover the cost of treatment can seem overwhelming. Our insurance benefits professionals are here 24/7 to walk you through this difficult process, completely free of charge with zero obligation.

✔ We’ll gather your eligibility info fast.
✔ We’ll help you find the right program.
✔ We’ll help you get the best care at the best price.

You don’t have to enroll at 1 Method Center to take advantage of our verification services. We’re simply here to help. If you decide that our program is a good fit, our insurance department will fight hard on your behalf to get you the treatment you deserve.

To speak with an insurance specialist directly, call 1-800-270-1389 now.

Does my health insurance cover 1 Method Center?

Most health insurance policies with out-of-network (OON) benefits will cover all or some of the cost of treatment at 1 Method Center.

Please note that we DO NOT work with the following insurance plans:

• LA Care
• Medi-Cal
• Medicare
• Medicaid

If you have the above health care coverage – but no financial resources – there is still help available. Visit the SAMHSA treatment locator to view your treatment options. You can also call 1-800-662-4357 to speak with a representative.

Here is a partial list of the PPO insurance plans we DO work with:

We also work with many others including: Federal Employee Program Blue Cross Blue Shield, MVP Healthcare, GEHA Health plans, APS Healthcare, Greatwest, Value Options and more.

To see if your plan covers treatment at 1 Method submit your insurance online.

1 Method Center is proud to be accredited by the Joint Commission (JCAHO). We are among the only centers in the United States offering our unique model of integrated care to have earned a Gold Seal of Approval.

What is JCAHO?

The Joint Commission is an internationally recognized nonprofit tax-exempt 501(c) organization that accredits hospitals, health care organizations and programs. Most insurance companies and the majority of US state governments recognize Joint Commission accreditation as a condition of licensure for the receipt of Medicaid and Medicare reimbursements.

What services are covered by my health insurance?

Health insurance policies differ in the amount and type of treatment they will cover, but typically, they’ll cover (either partially or fully) one or more of the following services that 1 Method provides:

• Stabilization
• Medical Detoxification
• Residential Treatment
• Partial Hospitalization
• Intensive Outpatient
• Outpatient Care

The above isn’t an exhaustive list. In most cases, your health insurance will cover and require pre-certification, initial screening, and assessment. In turn, your diagnosis and to what degree a procedure or intervention is medically necessary will dictate how much coverage you will receive. Basic residential treatment may receive 100 percent insurance coverage, but add in amenities like a private suite and you may end up paying a higher out-of-pocket fee.

The Affordable Care Act (ACA) of 2008 and Mental Health Parity and Addiction Equity Act strengthened the requirement that your health insurance company covers behavior and mental health disorders (i.e. addiction, SUD, anxiety, depression, etc.) in a way that’s comparable to any other medical condition. In other words, although your insurer may make accessing benefits difficult – they have to cover treatment with 1 Method to the same extent they would cover treatment for diabetes or other medical issues. And the better news is this: If you’re looking for help covering the costs of treatment, the ACA ensured you don’t have to worry about being denied coverage on the basis of a pre-existing condition.

What are the non-insurance options?

There are three non-insurance options:

1. Super billing
2. Using private funds
3. Going to a free program

We recognize that Life is priceless. If you or your loved one doesn’t have health insurance, don’t despair. You can still get help. Visit SAMHSA to learn more about the free treatment options available in your state.

If you have health insurance – but we are unable to work with your plan – you can pay privately and we will provide you with a Superbill. Most insurance companies will directly reimburse you for OON treatment, in many cases, upwards of 80% of usual and customary rates (U&C). You can also combine both your insurance and cash to reduce the total cost for 1 Method Center.

How to verify your health insurance.

Verifying your insurance coverage is quick and easy. Our insurance specialists can usually complete verification in about an hour. As part of our commitment to making 1 Method as affordable as possible for you and your family, we work with various providers to maximize your insurance coverage, so that you receive all of the benefits to which you are entitled.

Call 1-800-270-1389 to talk with us about your coverage or submit your insurance online. We’re here for you, anytime.

The Cost of Rehab: Paying for 1 Method

We accept most major PPO insurance plans to help cover the cost of treatment. In fact, we have years of experience working with insurance companies and will handle all the back and forth with them to determine the specifics of your coverage. We work directly with your insurance company so you can focus your energy on treatment and recovering.

The cost of treatment at 1 Method is based on each client’s level of care, individualized needs, and treatment plan. Contact admissions at 1 (800) 270-1389 for an estimate of treatment costs based on a confidential consultation.

1MC works with many PPO insurance plans to help offset the cost of treatment. Your insurance plan may cover a large portion of the treatment for alcohol and drug addiction, dual diagnosis, and mental health disorders. Submit your insurance online for a quick and easy insurance benefits check. We’ll do all the legwork so you can focus on getting better.

Insurance FAQs: What You Need to Know

Here are answers to some frequently asked questions about insurance coverage for alcohol, drug, and mental health treatment.

What does “In Network” mean?

Healthcare providers that are “in network” with your insurance company typically will be more affordable, as they have negotiated agreed upon rates for care with physicians, therapists, or mental health and substance abuse facilities. For example, an outpatient therapist who usually charges $120 per session might be contracted with an insurance provider to only charge them $70 per session. The insurance company can pass the savings along to its members. In-network providers are also known as preferred providers or participating providers.

How do I know if my insurance covers residential treatment?

If your insurance plan covers residential treatment for mental health disorders and addiction, it will include a component called “mental health and substance abuse coverage.” The easiest way to determine what type of mental health and substance abuse insurance coverage you have is to submit your insurance online. Once you provide your insurance details, we’ll call your insurance provider and work with them directly, to determine exactly what mental health and substance abuse benefits you’re eligible for under your plan. We then reach back out to you to discuss how the benefits are applicable for care in our program, as well as deductibles met, co-insurance and out of pocket expenses not covered under your plan.

What are “Out-of-Pocket” costs?

These are costs not covered or reimbursed by your insurance company.

What happens when I call for an insurance benefits check?

We’ll assist you in managing the logistics – the process is swift, simple, and free:

1. Phone consultation– Speak with a licensed counselor about what’s been going on, so they can recommend treatment options that fit your needs and preferences.
2. Benefits check– Once you decide which treatment option you prefer, a team member will contact your insurance company to determine the details of your coverage applicable, including deductibles met, co-insurance, out-of-pocket expenses or applicable non-covered care.
3. Estimate– Using the information from the conversation with your insurance company, we’ll provide a treatment cost estimate which considers any out-of-pocket costs (outstanding deductibles, co-insurance, non-covered care). An insurance deductible is the amount your insurance requires you to pay before they begin covering the costs for care: For example, if your deductible is $2500, you’ll pay for the first $2500 of treatment service costs before your insurance starts paying their portion.
4. Treatment reviews– All services we provide must be authorized by the insurance company. This, however, is not a guarantee of insurance payment, as all payment is subject to eligibility and other terms of the benefit.
5. Concurrent review and continued stay certification– Most insurance policies today require ongoing communication from the treatment facility utilization management team and the managed care review department at your insurance company. This is done to ensure your healthcare dollars are being used appropriately. This communication may be required weekly or daily and is contingent upon the requirements of your insurance policy.
6. Medical necessity for care– All insurance policies have their own policy requirements, which may allow them to certify an admission or continuation of care. Each insurance policy is unique and governs how treatment stays are initially reviewed after admission and subsequently certified. Please understand that admission authorization or concurrent treatment certification is not a guarantee of payment to the treatment facility. All care is governed by insurance policy requirements, insured and dependent eligibility, and terms of the contractual agreement between the insurance company and the person insured.

Will my insurance benefits cover my entire length of stay?

It depends on your insurance provider and what it considers “medically necessary.” Our treatment team will conduct a thorough review when you enter treatment to assess your physical and mental health. We’ll then make a recommendation on the length of stay we feel is appropriate based on the severity of the presenting symptoms. We’ll communicate with and submit all the required documentation to your insurance provider. Please note that each insurance company has different requirements about what is considered “medical necessity.” Our recommendation for how long you stay is not a guarantee your insurance company will approve the same length of stay.

Do I need to submit insurance claims for treatment?

No. Our billing department will handle all the paperwork. We submit bills directly to your insurance provider. We can also provide you with a Superbill if you request one.

Will I know out-of-pocket costs before entering treatment?

After we determine your insurance coverage for SUD and mental health treatment, we’ll provide a detailed estimate of any out-of-pocket costs you are likely to incur. We’ll also keep you updated throughout your stay should that amount change. Please note that an estimate is not a guarantee of costs.

What if my insurance won’t cover treatment?

If you don’t have insurance coverage or your insurance provider does not cover mental health and addiction treatment, you have a couple of options:

1. Self pay– You may pay costs out-of-pocket at the self pay rate.
2. Step down level of care– We can help you determine if your insurance provider will help pay for outpatient treatment.

We encourage you to discuss this with admissions. We have relationships with many facilities and providers throughout the nation and are solution focused. Our commitment is to help you find the next best treatment solution should your insurance benefits or financial ability not cover the cost of residential care in our facility.

What if I decide to use my insurance later?

You may request to use your insurance upon discharge. Our central billing office will provide a comprehensive statement (Superbill) to the address provided as a courtesy to you. However, once treatment has begun, it is unlikely to receive certification for services to be covered. It is best to work with you and your insurance company at the beginning of your treatment and increase the possibility for coverage for your care.

Do You Have More Questions About Using Your Insurance?

Navigating your insurance plan to determine what type of substance abuse coverage you qualify for can be overwhelming. Our insurance specialists are available 24 hours a day to assist you.

Contact 1 Method Center if you’re seeking help with any of these mental health, dual diagnosis, or alcohol and drug rehab-related services:

• Detoxification
• Inpatient Treatment
• Short or Long-Term Residential Care
• Intensive Outpatient Treatment and Aftercare

We can help you review your insurance benefits and then recommend which steps you should take next. Call 1-800-270-1389 to talk with us about your coverage or submit your insurance online.