We work with most insurance and managed-care companies.
While you can’t put a price tag on health, our rates compare very favorably with other addiction treatment providers. We know, because we’ve done the comparisons.
The best and most cost-effective way to deal with addiction is proper and timely treatment. The admissions staff and financial counselor will work with you to achieve the best level of care possible.
In addition to cash payment, we accept most forms of commercial health insurance. Our admissions staff is trained to help you understand what co-pays, deductibles or limitations may apply. We recommend that patients or referral sources investigate this prior to admission. A financial-assistance counselor is here to help.
Livengrin takes responsibility for evaluating a patient’s medical and clinical needs, by using nationally-recognized criteria. However, the decision is often made by the managed-care company used by your insurance carrier on the amount and kind of care provided.
Often they are in agreement with our assessment of a patient, but sometimes not. We can appeal their decision, and fight for what we think you need, but the final say regarding payment is up to them.
If you are unhappy with your insurance coverage or your managed-care company’s determination of what they will pay for, we can usually provide you with the contact information so that you or your family can speak directly to them.
The benefits manager at your place of employment can often give you useful information about your policy. Although it may be uncomfortable to reveal information about your care to this person, that can be a small matter compared to the importance of treatment.
Call 215-628-5200 today for a free and confidential 1-on-1 consultation and insurance verification.
Insurance in Pennsylvania
Insurance coverage for addiction treatment is mandated by law in Pennsylvania. All group health plans, including health maintenance organizations, are required by Act 106 of 1989 to provide coverage for the treatment of alcohol and drug addictions.
There are specific parameters for treatment of substance abuse that insurance companies in Pennsylvania are required to adhere to. The Commonwealth’s Insurance Commission and the State Insurance Department have consistently reaffirmed Act 106, the regulation stating that insurance providers must provide certain minimum coverage for treatment.
According to Act 106, a person seeking addiction treatment through insurance coverage needs only a certification of the medical problem and referral by a licensed physician or psychologist. It is the doctor who should determine the patient’s level of care and length of stay in an outpatient, inpatient or detoxification treatment program.
These days, “managed care” organizations would prefer to have a say in how much coverage a patient gets – thus determining how much treatment, and for how long. Under Act 106, managed care should not play a role in this determination, except to say what treatment facilities are in their network.
According to Act 106, all group insurance policies in Pennsylvania must pay for these minimum levels of treatment for substance addiction:
- Up to seven days of detoxification per year, (hospital or non-hospital residential detoxification), 4 admissions per lifetime.
- Minimum of 30 days of rehabilitation per year, 90 days per lifetime (non-hospital residential)
- Minimum of 30 units of outpatient/partial hospitalization per year, 120 units per lifetime (outpatient/partial hospitalization)
All services must be provided in facilities licensed by the Department of Health to provide alcohol and drug addiction treatment services.
Again, managed care companies may not overrule the recommendation for length and type of care that is certified by the referring physician or psychologist.
If you, a loved one, or employee is having trouble accessing insurance coverage for treatment, discuss this with the financial counselor or other admissions staff members. The policy of Livengrin is to do everything it can to help a patient receive every medical and therapeutic benefit possible, as mandated by Pennsylvania state law.
There are financial-assistance companies in the marketplace that offer plans covering addiction treatment. We have examined the offerings of several and (while not recommending any firm in particular) make one of the major companies available here for consumer research and inquiries.
Loans can cover treatment and other costs, perhaps even transportation to and from the program. Some firms feature multiple loan products with competitive rates, and a possible deferral of interest for a period with no prepayment penalties or cancellation fees.
The loan qualification and application process can be confusing, so consumers should ask questions. A good company works with many families and individuals each day, guiding them through the loan process. For those who initially don’t qualify for a loan, the company should advise you in ways to qualify, including adding a co-signer or considering credit repair. Look for competitive interest rates, quick credit decisions, affordable payments and complete confidentiality, among other benefits to consumers.