Does Insurance Cover IOP?

Does Insurance Cover IOP

Get Outpatient Treatment Covered by Insurance at Purpose

Maybe you have just left long-term residential treatment or inpatient treatment and need to transition to a lower level of care. Perhaps you didn’t need inpatient but still need some support to function in day-to-day life.

Intensive outpatient programs may be the perfect fit for you or your loved one needing support, but does insurance cover IOP?

The short answer is yes, in many cases, IOP is covered by health benefits. And Purpose Healing Center’s treatment center can help provide the personalized help you need to function at your best. Our intensive outpatient program is covered by many, many forms of health insurance.

Keep reading to get more details, and to find out directly what your insurance covers, reach out to our admissions team today. We can verify your benefits and help you walk through the first steps to receiving treatment.

Up To 100% of Rehab Costs Covered By Insurance

Does Health Insurance Cover Intensive Outpatient Programs?

Intensive outpatient treatment can be a great step for anyone who needs assistance with mental health or who requires addiction treatment. It provides a more structured daily routine with different types of therapies that are proven to assist your functioning. If you are wondering whether IOP will be covered, there is good news.

In many cases, rehab insurance coverage extends to intensive outpatient treatment. It is a logical step down from inpatient treatment, which is often covered by insurance as well. The insurance company views an IOP program as a way to save money on the cost of treatment because it is both less intensive and less expensive than inpatient treatment.

Does Insurance Cover IOP? The Affordable Care Act Expands Coverage Options

Under the Affordable Care Act, insurance is required to cover the cost of addiction recovery. It is one of the ten mandated areas of coverage, but that does not necessarily mean it is going to be paid for in full. It may vary depending on dual diagnosis treatment options, what other mental health issues you might have, and the facility you select.

Even your individual plan may dictate exactly what will be covered. It is based on the plan selected, the deductible of your plan, the out-of-pocket maximums, and whether you select an in-network or out-of-network provider.

Different levels of care also dictate different levels of reimbursement. For example, some insurance providers may be more apt to cover a short stint in a residential treatment center while others would prefer to pay for IOP services after a 30-day stay here. Outpatient care should always be the goal so that you can return to your responsibilities and daily life.

Know in advance what your policy will cover.

That being said, how does addiction treatment work when thinking about insurance coverage?

What is Covered Under an Intensive Outpatient Program for Addiction Treatment?

Intensive Outpatient Program

Every treatment center may have a different definition of an intensive outpatient treatment program based on whether you are going for substance abuse treatment or mental health disorders. Purpose Healing Center has clear guidelines on how much support you will receive while enrolled in our IOP program.

Generally speaking, clients in our treatment center will have a minimum of nine hours of therapy each week. This is usually booked in back-to-back sessions lasting for three to eight hours per day, five to seven days per week. In between your sessions, you are free to come and go from the facility.

Your insurance will only pay for the treatment you receive rather than a board payment for your around-the-clock care. This makes it a bit more obvious why IOP is an appealing option for your insurance provider.

Evidence-Based Substance Abuse Treatment

Of course, your insurance providers won’t want to cover treatment that has no basis. They are much more inclined to cover proven methods, often referred to as evidence-based treatment. At Purpose Healing Center, we believe in offering each of our patients personalized care, and all our approaches are rooted in science and research.

Every therapy we offer (including both individual therapy and group therapy) is proven to help with both substance abuse and addiction treatment.

In many cases, you will receive the same services you would have received for your mental health or addiction treatment in an inpatient setting. The difference is that you have more flexibility and freedom during IOP, not that you receive a different quality of care.

Insurance coverage is less likely if you enroll in an IOP program, unlike Purpose, that offers experimental treatments as this could result in less favorable outcomes long-term.

Does Insurance Cover IOP? Ancillary Therapies Commonly Covered

Yoga Therapy

Sometimes, your insurance may go beyond paying for your one-on-one and group therapy sessions. If you are attending outpatient rehab treatment, they may also cover ancillary therapies that would not be covered by insurance if you pursued them on your own. This can include popular treatments like music therapy, art therapy, and even yoga therapy.

All of these supplementary treatments can equip you with real coping skills you can use to bolster your commitment to sobriety. Take advantage of them if they are offered to you under the umbrella of your insurance coverage.

These therapies may seem like they are an unnecessary addition to substance use treatment plans, but they can give you important life skills to cope when insurance funding runs out on your inpatient or IOP treatment program. You may even decide to pay for some of them out of pocket because they prove to be beneficial to your recovery.

We Accept Most Major Insurance Providers

Medication Management in Outpatient Drug Rehab

Many treatment providers want to monitor you for longer periods to ensure that you are tolerating your new prescriptions well. Medication management is an important piece of the puzzle for many people, especially those who may have co-occurring mental health challenges like anxiety or mood disorders.

Don’t make the mistake of trying to go it alone with your new medication. In IOP treatment, you will get check-ins with your medical team and therapists to ensure that you are making progress. If the dosage needs to be changed or the prescription altered, you are in a prime spot to do this under supervision.

As part of the intensive outpatient program cost, you should check whether you can continue to see the same medical team as you would have seen in an inpatient program.

4 Areas to Consider in Choosing IOP Treatment Programs

IOP Treatment Programs

There are tons of intensive outpatient programs out there, competing for your attention and insurance money. Selecting one that can assist you with relapse prevention and support you is key to addiction recovery, and at Purpose, we are always ready and waiting to help answer questions and provide more details on our accredited offerings.

Here are a few items you may want to verify if you want insurance to cover an IOP treatment program.

1) Joint Commission Accreditation

Make sure that the facility you select is in a prime position to offer safe and convenient care to everyone enrolled. This applies to residential treatment, but safety should still be a paramount concern for IOP. To this end, the Joint Commission accredits facilities that offer treatment services in alignment with OSHA and CMS standards.

They even include their own strict guidelines to improve the quality and safety of every patient. Always look for their gold seal of approval when selecting programs.

Purpose Healing Center is proud to be a Joint Commission-accredited facility. This accreditation lends us a degree of professionalism that may make your insurance provider more likely to cover your time with us in an IOP treatment program. Our addiction treatment options are the gold standard.

2) Duration of Your Stay in IOP Programs

While intensive outpatient does tend to cost less than residential treatment, you may find that insurance will only cover IOP for a limited time. This might mean several weeks of coverage at which point they expect you to make more progress in a less intensive program such as individual counseling once or twice each week.

This is not designed to be a long-term treatment program. Our support groups are there to give you the guidance you need in the early days of returning to your life when you no longer require 24/7 care from our team of clinical professionals. Eventually, we hope that you will be able to maintain these gains even without our support.

Once insurance stops funding your IOP treatment, make sure you know where you can turn for support groups that cater to your substance abuse or specific mental health issue. Arizona has a robust sober community that you can tap into when insurance coverage runs out and you can no longer afford the costs of treatment.

3) Affordable Payment Plans

While substance use disorder is a mandated diagnosis that should be covered by insurance, not all care will be covered in full. If you find that your substance abuse disorder and an IOP cost might not be covered by insurance, you should look for a facility that features affordable out-of-pocket expenses.

Purpose Healing Center never wants the cost of your treatment to prevent you from receiving help. We aim to make both our residential treatment and our IOP rehab costs affordable so that more people can access the life-saving help they need to live life sober.

Please reach out to our admissions staff if you feel that cost is the barrier to receiving our outpatient services. We can work with you to verify coverage, create affordable payment plans, and put your mind at ease regarding what most health insurance policies will cover.

Fill out our online contact form and we will reach out to you within fifteen minutes with answers.

4) Specialized Care for Dual Diagnosis

Specialized Care for Dual Diagnosis

If you have another diagnosis beyond substance use that needs to be treated simultaneously for you to gain stability, then you need a facility that caters to these needs. Dual diagnosis treatment can be more difficult to treat at many facilities without specialized programs such as ours. Your insurance provider may be more apt to cover both inpatient care and IOP programs if you have more than one issue plaguing you.

Purpose Healing Center has a team assembled to manage many different treatment needs in a desirable location. Whether you have a mood disorder, anxiety, or another condition, we can help with treatment options while keeping costs low.

Keep in mind that having IOP covered isn’t a given, even if you do have a dual diagnosis and can find an addiction treatment program that is a viable option.

Fast and Free Insurance Verification

Verify Insurance Benefits Today and Start IOP at Purpose

Are you ready to expand your support system and include proven professional support? If you are in active addiction or struggling to maintain your sobriety, our treatment facilities can provide you with the guidance and help needed to embrace lasting recovery success.

Stop doubting and asking yourself, ‘Does insurance cover IOP?’ At Purpose, the answer is quite often a resounding, yes! Purpose offers an accessible solution for IOP and is in-network with many health insurance providers in Arizona and nationwide.

Our warm and welcoming admissions staff is ready and waiting to verify your benefits right now. Learn more about what our treatment entails and whether it will be covered by insurance in a quick, easy, and confidential phone call today!

References

  1. National Archives and Records Administration. (n.d.). Substance Abuse and the Affordable Care Act. National Archives and Records Administration.
  2. Aletraris, L., Paino, M., Edmond, M. B., Roman, P. M., & Bride, B. E. (2014). The use of art and music therapy in substance abuse treatment programs. Journal of addictions nursing, 25(4), 190–196.
  3. Kuppili, P. P., Parmar, A., Gupta, A., & Balhara, Y. P. S. (2018). Role of Yoga in Management of Substance-use Disorders: A Narrative Review. Journal of neurosciences in rural practice, 9(1), 117–122.