Does Emblem Health Cover You?

Substance abuse treatment does not come at a small price, and most individuals having to go through the process are not aware that their insurance provider can cut down the cost of treatment immensely. Here at Coastal Detox, our trained specialists will review your coverage plan and provide more information on the amount of financial help you are able to receive from your insurance company.

Emblem Health Benefits for Substance Treatments

Emblem Health is a smart option when considering which insurance policy is right for your certain treatment needs because they are able to help cut down the cost of treatment payments in order to make them more affordable. The amount of coverage provided will depend the certain policy an individual has. 

As a private held, non-profit company, Emblem Health has over 3.1 million members in the state of New York. Starting in the 1930’s, two companies merged together to form one. It has grown to be one of the United States’ largest non-profit health insurers and focuses on the quality and affordability of health insurance they provide.

Although it may seem overwhelming, our team at Coastal Detox is here to help along the way with your financial needs. We have helped countless potential patients realize how much their insurance really covers. All we need from you is a quick phone call to start the process today!

Is In-Network Necessary?

We understand not everyone is able to afford substance abuse treatment on their own and this is why we educate potential patients on in-network and out-network facilities. By choosing an in-network provider versus an out-of-network provider, individuals can increase their chances of being able to attend rehabilitation programs for the amount of time recommended by our staff. 

Because it is an in-network company with Emblem Health, our Coastal Detox specialists are able to give you a quote right away on the financial cost of your specific treatment plan. 

Other Benefits of Emblem Health

An Emblem Health policy is not only beneficial to your substance abuse recovery, but it is also beneficial to your life once treatment is completed. Emblem Health is there to cater to every aspect of your lifestyle needs.

Emblem Health offers many benefits to its members when choosing to lead a healthy lifestyle. They offer discounts on popular dietary plans, health club memberships and even vitamins and supplements. Along with health and wellness, Emblem Health focuses on making hearing and vision health easier for their members to afford. Policyholders have access to discounted hearing aids, eye examinations and glasses through Emblem Health.

They are also partnered with a New York-based physicians group called Advantage Care Physicians that uses a team-based approach to medical assistance. Through this partnership, policyholders have access to doctors, nurses, social workers, nutritionists, behavioral health specialists and many other healthcare professionals.

Reviewing Your Policy

At Coastal Detox, an independent review of your Emblem Health coverage will determine:

  • Which alcohol and drug rehabs you are eligible for
  • How long you can attend the program (30, 60, 90 days, etc.)
  • Which level of care will be covered

By allowing us to review your Emblem Health policy, our team at Coastal Detox is able to help you understand how much you can expect to pay out of pocket for treatments and how much your policy will cover.

Coverage for Treatment

When it comes to insurance coverage, different factors can play into an individual’s amount they are required to pay. Because Coastal Detox is an in-network facility, this will also help cut down the costs greatly through an Emblem Health plan. The amount of treatment paid for by Emblem Health will depend on whether the member has a Basic, Bronze, Silver, Gold, or Platinum Plan through the company. The days paid for may be limited if a member has a Basic or Bronze Plan, but there are no limits on the Silver, Gold or Platinum Plans. No matter which plan a patient has, they will always have to pay some amount in the form of copay.

Coverage for Detox

Inpatient detox for substance abuse treatment is not generally covered by an Emblem Health plan. Hospitalization in an in-network facility that has been pre-approved is almost always covered. 

Coverage for Mental Health

Emblem Health has created a Health and Recovery Plan that is designed to help their members struggling with mental health disorders. All qualifying members will be assigned to Health Homes that coordinate their care and treatments. Individuals needs and treatments through these Health Homes will be covered through their policies with Emblem Health

Inpatient and Outpatient Treatment Coverage

There are two different types of addiction treatment. The most notable is inpatient treatment where the patient is required to stay at the facility 24 hours a day, 7 days a week during the recovery process. The other is outpatient treatment where an individual is still immersed in daily life, like attending school or work, while attending treatments. Whether a potential patient is admitted into an inpatient or outpatient treatment program will depend on his or her medical and mental status. 

As far as covering costs of inpatient treatment, Emblem Health plans rarely cover any treatment costs. The facility costs are not covered by their plans because of the amenities that are associated with most inpatient centers. However, Emblem Health policies do not require pre-approval for treatments at their outpatient treatment centers. All costs are mostly covered by an Emblem Health plan, but the number of visits per year are limited to a certain amount.

How Coastal Detox Can Help

Our main objective at Coastal Detox is to serve you in every way we can.  Our team understands the importance of being a treatment facility that suits all of your needs, so that you may have the best and fastest recovery possible. We want to give you piece of mind and make the process as easy as possible along the way, and we know that requires getting every ounce of financial help we can find for you. 

If you or someone you know is caught in the grips of substance abuse and is seeking help, we are here to assist. Don’t hesitate to contact us today by calling (855) 783-5226.

Content Reviewed by Jacklyn Steward

Jacklyn StewardJacklyn is a Licensed Mental Health Counselor (LMHC) and an EMDR trained trauma therapy specialist with over 6 years of experience in the field of addiction. She has a Masters Degree in Mental Health and Substance Abuse Counseling from Nova Southeastern University.