ConnectiCare Insurance Coverage For Alcohol & Drug Rehab

ConnectiCare Inc. & Affiliates has offered commercial (private) and Medicare health insurance plans to Connecticut residents since it was founded in 1981. Its coverage area extends into western Massachusetts and four counties in southern New York.

Members of ConnectiCare expect personalized services from a relatively small company of about 500 employees who live and work in Connecticut communities.

Does ConnectiCare Cover Rehab?

Yes, ConnectiCare covers addiction treatment as well as other mental health treatment for people facing drug and alcohol abuse.

Coverage is determined by medical necessity. ConnectiCare requires its members or the treatment providers they use to get prior authorization for any substance abuse treatment services or programs.

Substance Abuse Treatment Services Covered By ConnectiCare

ConnectiCare reports on its website that “substance abuse treatment is covered, when medically necessary … for most members.”

What ConnectiCare requires is that members or anyone coordinating treatment options for members call them to get prior authorization for addiction treatment or treatment extension.

Preauthorization is generally required for inpatient treatment but not outpatient treatment.

ConnectiCare Coverage By Treatment Type

Since ConnectiCare evaluates the individual needs of each client for medically necessary drug and alcohol treatment, it does not offer many specifics on coverage of treatment services.

However, in the tabs below, you can find more information about treatment options that are generally covered.

ConnectiCare Plan Types

ConnectiCare provides several different plan types sold as commercial insurance or as Medicare plans.

Plans are divided into the following:

• co-payment plans
• high deductible plans
• deductible plans
• coinsurance plans

For people seeking Medicare Advantage coverage, ConnectiCare offers eight different plan types that offer a range of deductibles and co-pays depending on your needs.

This insurance company also offers standard, alternative, and flex plans within the three general categories of gold, silver, and bronze plans.

Each of the categories and sub-categories seeks to address as many different financial needs as possible.

How To Use ConnectiCare Coverage For Substance Abuse Treatment

ConnectiCare has a large group of in-network providers in Connecticut (and certain regions of Massachusetts and New York) for people facing drug and alcohol addiction.

If you live in one of these areas and have ConnectiCare, you can call the company to begin the pre-authorization process, or you can have your treatment coordinator do it.

ConnectiCare also offers out-of-area coverage in 35 states if you face an emergency such as an overdose or complications from unexpected withdrawal.

ConnectiCare Co-Pays And Deductibles For Addiction Treatment

Given the number of treatment plans it offers, ConnectiCare has a wide range of deductibles, coinsurance, and co-pays for addiction treatment.

For example, the Bronze Standard POS HSA plan requires 20% coinsurance from the insured on all services, from office visits to PHP, IOP, or inpatient treatment.

On the other hand, the Gold Standard POS plan requires only a $20 co-pay for office visits and a $100 co-pay for PHP or IOP. For inpatient treatment, insureds pay a $500 co-pay per day to a maximum of $1,000 admission.

What Addictions Does ConnectiCare Cover?

ConnectiCare covers a variety of addictions and mental health disorders.

These include alcohol, opioid, and stimulant use disorders, as well as dual diagnoses involving depression, anxiety disorders, PTSD, and other mental health disorders.

What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?

If you can’t find insurance coverage for the treatment plan that you need, you have other options that you can turn to.

Alternative payment options include:

• government grants through agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA), which are distributed to all 50 states as block grants or to individual rehab centers through awarded grants
• state-funded addiction treatment centers that offer services for free or at a low cost
• government-sponsored health insurance plans such as Medicare or Medicaid, which may provide coverage for services at little or no cost to you provided you qualify for coverage under these plans
• payment assistance through treatment facilities such as payment plans or a sliding fee scale, which adjusts the cost of treatment according to your income level
• scholarships through treatment centers or non-profit organizations

Finding A Rehab Center That Accepts ConnectiCare

It is probably easiest to find an in-network addiction treatment provider by calling ConnectiCare and getting recommendations. This process may be easier given the smaller size of the company.

On the other hand, given how broad ConnectiCare’s network is throughout the state of Connecticut, you may also have success beginning your interaction with a treatment center that works with ConnectiCare.

Most treatment centers state on their websites whether or not they take a particular insurance, and many have an insurance verification form that you can access.

Find Addiction Treatment Today

If you are looking for addiction treatment for yourself or a loved one, you can find it today. Call us to learn more about your treatment options and what the recovery process entails.

Updated on November 27, 2023

Written by the Addiction Resource Editorial Staff