People battling addiction can get the majority of their treatment costs covered through the use of Health New England insurance plans.
Health New England serves members in Berkshire, Franklin, Hampden, and Hampshire counties in western Massachusetts and Worcester County, as well as the Medicaid population around Holyoke, Northampton, Springfield, and Westfield.
People with Health New England can gain access to an array of effective behavioral health services including inpatient or outpatient treatment, medication-assisted treatment (MAT), and more.
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Does Health New England Cover Rehab?
Health New England offers mental health and substance use disorder coverage to all members, including children and adolescents.
Its Substance Abuse Case Management Program assists policyholders with locating inpatient programs, making referrals for outpatient services, and connecting members to other essential services.
There is also a Behavioral Health for Children and Adolescents (BHCA) program for people in need of intensive community-based acute treatment, family stabilization, and more.
Substance Abuse Treatment Services Covered By Health New England
Health New England will cover most evidence-based treatment services for addiction. The amount of coverage, however, will depend on the specifics of the plan.
|Treatment Type||Covered||Not Covered|
|Dual Diagnosis Treatment||✔️|
Health New England Coverage By Treatment Type
The diverse array of covered services by Health New England ensures that members can access the treatments that best suit their unique needs.
Health New England Plan Types
Health New England offers both health maintenance organization (HMO) and preferred provider organization (PPO) plans.
Members with HMO plans should seek treatment providers that are in-network, while a PPO plan may be more suited for out-of-network treatment programs.
Health New England insurance plans sold on the Health Insurance Marketplace will be available in the form of metal tiers that differentiate the level of coverage.
- Bronze plans — feature the lowest monthly premiums and the highest deductibles and co-pays
- Silver plans — moderately priced monthly premiums, deductibles, and co-pays
- Gold plans — higher monthly premium with the lowest deductibles and co-pays
- Platinum plans — highest monthly premium with very low deductibles and co-payments
How To Use Health New England Coverage For Substance Abuse Treatment
The most efficient way to use Health New England insurance for addiction treatment is by contacting the Substance Abuse Case Management Program at Health New England.
A Health New England representative can assist the policyholder in finding an in-network or out-of-network treatment program that will offer the level of care needed.
Health New England Co-Pays And Deductibles For Addiction Treatment
Below are some examples of the co-pays and deductibles that may be assessed while using Health New England for substance use disorder treatment.
Examples of costs may include:
- 10% coinsurance after the deductible is met for HMO plans
- a $1,000 co-pay upon admission to residential treatment and a $500 co-pay for outpatient admission for HMO Silver plans
- a $25 co-pay for in-network care and 20% coinsurance for out-of-network care using a PPO Wise plan
To learn more about the details of Health New England’s co-payments and deductibles, contact a representative or visit Health New England’s website.
What Addictions Does Health New England Cover?
Members with mental health disorders such as depression, anxiety disorders, or post-traumatic stress disorder (PTSD) can also get help using the Mental Health Case Management Program.
What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?
If your insurance plan does not provide adequate coverage, there are several other ways you can access the behavioral health services you need.
Other ways to pay for treatment include:
- using block grant funds provided by the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUBG)
- attending a faith-based or non-profit rehab program that is funded by donations
- applying for a scholarship for substance abuse treatment
- crowdfunding from friends and family
- using Medicaid, Medicare, or other types of government health insurance
- accessing a sliding fee scale or other payment assistance plans
There are also free rehab centers throughout the United States that provide evidence-based treatment at little or no cost to the person seeking care.
It’s important to keep in mind that free drug and alcohol treatment programs usually have a long waitlist due to high demand.
Finding A Rehab Center That Accepts Health New England
Health New England policyholders have an array of resources available to help them find an addiction recovery program.
Ways to find a rehab center include:
- asking a doctor for a referral
- calling Health New England and asking about in-network providers
- using Google search
- visiting the Health New England member portal on the website
Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) search tool can help narrow the search for a rehab program by location, insurance type, and more.
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Updated on November 29, 2023
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