How to Pay for Addiction Treatment with Your Tufts Insurance Plan?
The answer is most likely, especially if you have Tufts Health Plan. After all, this is among the only insurance companies in Massachusetts to provide health coverage to everyone, no matter the income or age.
More than 51,000 healthcare providers and 110 hospitals across Mass accept Tufts Health Plan. So when you need rehab insurance, this plan should help you quite a bit. But does your insurance cover rehab? And if so, what does Tufts insurance cover specifically? Here’s what you need to know about your Tufts insurance coverage.
Will My Addiction Treatment Be Covered By My Tufts Insurance Plan?
Several Tufts Massachusetts insurance plans include some type of rehab coverage. This means you should have partial or complete drug addiction treatment insurance coverage through all Tufts options in MA.
Keep in mind that this is regardless of where you get your Tufts plan, as it applies to plans from the following:
As long as your addiction treatment services are considered medically necessary, your Tufts plan will serve as the rehab health insurance you need to cover some or all of your costs.
Just note that the provider you choose must be in your plan’s network for you to get treatment coverage. Any services from out-of-network providers will not typically be covered by Tufts. So checking with rehab centers for insurance that they accept is a good idea before you choose a provider for drug treatment.
How to Check Tufts Addiction Treatment Coverage
As you might have noticed, health insurance is often complicated. And getting substance abuse treatment without insurance can be costly. That’s why it’s important to check your treatment insurance coverage with Tufts before you choose a provider in or around Boston, Massachusetts.
Fortunately, you have a few resources to use when you need to check your Tufts rehab coverage. They include:
- Calling Tufts Health Plan
- Checking your member portal online
- Asking local treatment centers about the rehab insurance they accept
Check Your Benefits Online
If you plan to use Tufts for rehab, you can check on your treatment coverage by making an account through the member portal, called Tufts Health Member Connect. All you need to sign up is your Tufts Health Plan member ID card.
When you sign up for the portal, you can view information on the following:
- Your health benefits
- Steps to confirm authorizations
- Which Mass rehab centers accept Tufts
Call Tufts to Check Your Coverage
Another way to check on your insurance coverage for addiction treatment is to call the number on the back of your Tufts insurance card. Be ready to give your member ID number to confirm what kind of insurance coverage for rehab you have available to you.
Contact Local Treatment Centers About Your Coverage
Contacting local rehab centers about insurance coverage is another simple way to find out what Tufts will pay for. When you get in touch with a rehab center, such as Bedrock Recovery Center in Canton, MA, they’ll contact Tufts to determine if they’re an in-network provider. If so, they’ll find out which programs are covered.
In addition, the treatment centers you call can find out from Tufts if you need prior authorization to start rehab. They can also confirm whether you’ll owe a copay, coinsurance, or deductible.
How Does Tufts Rehab Coverage Work?
If you plan to use your policy with Tufts for drug rehab, there are a few important steps to take. The first step is to be prepared to prove that you have a medical need to get drug treatment, as Tufts requires this in order for you to use insurance for drug rehab.
To do this, you should contact your doctor so you can get a referral for drug treatment that will be covered by Tufts. Once you have a referral, you can file a claim with Tufts, which the provider you selected can help with.
So if you’ve chosen a rehab provider in the network that Tufts covers, that provider’s admissions team can contact Tufts to check coverage and complete any paperwork. After your drug rehab insurance coverage has been confirmed, you will get an explanation of benefits (EOB) from Tufts, which will outline the following:
- Summary of submitted charges: This lists the bills your provider sent to Tufts.
- Plan Accumulations: This is the amount you’ve paid for all medical care for the year, including how close you are to reaching your deductible.
- Claim details: This is the details on each claim your drug treatment provider submitted to Tufts, such as what services you’ve received, when you got them, and the charges for them.
If you’re confused about what you owe the provider after your rehab insurance coverage has been applied, you should contact Tufts to get answers. You can also talk to your drug rehab provider to find out more about any bills you have. At Bedrock Recovery Center, our admissions team is happy to help you understand your bill any time you have questions.
Tufts Employee Assistance Program for Drug and Alcohol Abuse
Tufts Health Plan features an Employee Assistance Program (EAP) for employees who need counseling or substance abuse treatment. So if your Tufts insurance policy is through your employer, you qualify for the EAP for free.
When you use this program, you can call a number for help any day, at any time. Once you talk to a representative, arrangements will be made for you to get free counseling for any problem you’re facing. Some examples include:
- Substance abuse
- Mental health struggles
- Stress-related disorders
- Marital problems
- Financial difficulties
If the representatives determine that you would benefit from addiction treatment, they will assist you in finding a Massachusetts provider. They can also go over your insurance coverage for substance abuse treatment so you know what’s covered. This way, you don’t have to worry about paying for addiction treatment without insurance.
Do Tufts Insurance Plans Cover Addiction Treatment?
All Tufts insurance plans are required to cover addiction treatment, just as they would cover nearly any medical condition you might have.
As long as you abide by the following, you’ll have health insurance that covers drug rehab when you have Tufts:
- You can prove that your substance abuse treatment is medically necessary
- You follow any preauthorization requirements
- You get a referral from a doctor when necessary
- You choose an in-network provider
Tufts Coverage for Detox Rehab Treatment
If the drug you use requires medically supervised detox at the beginning of your recovery journey, you can use your coverage from Tufts for detox at a rehab center. To find out exactly what your detox insurance
How Much Does Tufts Insurance Pay for Detox Rehab?
In most cases, you’ll only have to pay a copay, so you won’t have to worry about the costs of drug detox without insurance. But in some cases, your plan will require you to pay coinsurance, which is a percentage of the total cost. You’ll have to call Tufts to confirm what you’ll owe when you use detox treatment programs.
How Long Does Tufts Insurance Cover Detox Rehab?
The amount of time you need for detox rehab treatment will depend on a few factors, such as what type of drug you’re abusing and how long you’ve been on it. On average, detox can last one or two weeks. If you’re not sure if your health insurance for rehab coverage will pay for your entire stay at a detox facility, you should call Tufts to find out.
How to Cover Detox When Tufts Insurance Won’t
It’s possible your Tufts plan won’t pay for 100% of your detox costs. If this is the case, you have a chance to appeal the decision by contacting Tufts. If this doesn’t work, you should ask your drug treatment provider about other options. Some have financing plans or are aware of scholarships you might qualify for to get your detox costs covered.
Verifying Tufts Coverage and Finding the Best Detox Services
You can confirm your detox coverage by either logging into the Tufts Health Member Connect portal or calling the number on the back of your insurance card. Tufts can let you know not only what your coverage is, but also how to find drug rehab centers that are in your network.
Coverage Estimates for Detox Rehab Treatment
Tufts has four types of plans. The coverage you get for detox will depend on the plan you have.
- Bronze Plans: These plans have low monthly premiums, but they have the highest deductibles and the most out-of-pocket expenses compared to the other tiers.
- Silver Plans: These plans have moderate premiums, deductibles, and out-of-pocket costs.
- Gold Plans: When you’re on the gold tier, you have high premiums, but the tradeoff is a lower deductible and low out-of-pocket costs.
- Platinum Plans: These plans have the highest premiums, but there’s no annual deductible to meet, and the out-of-pocket expenses are very low.
So if you have a bronze or silver plan, you’ll likely pay more for detox treatment than you would with a gold or platinum plan. You can call Tufts to confirm your coverage before you enroll in a detox program.
Tufts Coverage for Inpatient/Residential Rehab Service and Costs
Tufts covers most of the costs of in-network inpatient and residential rehab programs. As always, your out-of-pocket costs will depend on your plan.
How Much Does Tufts Insurance Pay for Inpatient Residential Rehab?
If you plan to use Tufts as your inpatient rehab insurance coverage, you should call to confirm your exact coverage. In many cases, you’ll simply need to pay a copay, coinsurance, or your deductible to start treatment. It all depends on which plan you have.
How Long Does Tufts Insurance Cover Inpatient Residential Rehab?
If you’re wondering how long Tufts insurance covers inpatient rehab for, the answer depends on how long is medically necessary. The medical professionals at your inpatient rehab program will have to let Tufts know how long you need to stay.
How to Cover Inpatient Residential When Tufts Insurance Won’t
Many types of health insurance for drug rehab have limits on how much they’ll pay. So if you have to stay in treatment longer than average or need extra services, you might have to pay out of pocket.
Rather than shouldering the costs of continuing drug rehab without insurance, you should look into the following options:
- Signing up for a payment plan at the rehab center
- Applying for rehab grants or scholarships
- Calling social services to find out other options
Inpatient Rehab Tufts Insurance Coverage Estimates
There’s no way to tell you exactly what you’ll pay when you use coverage from Tufts at rehab centers. The best way to get an estimate is to call Tufts to verify your coverage.
In general, the amount of services that will be covered by Tufts ranges from low to high based on your plan:
- Bronze: If your Tufts inpatient rehab insurance plan is bronze level, you’ll typically pay a set fee for certain addiction treatment services.
- Silver plans: At this level, you’ll pay a set fee for each service when you use Tufts for addiction treatment.
- Gold plans: You’ll pay a copay at admission, but most costs after that will likely be covered.
- Platinum plans: You’ll pay a copay at admission, but it’s likely that most costs beyond that will be covered by your platinum plan.
Medication-Assisted Treatment (MAT) Services and Costs
How Much Does Tufts Insurance Pay for Medication-Assisted Treatment?
The amount of insurance coverage for medication assisted treatment depends on your plan.
To get a good idea of what your medication assisted treatment insurance will cover, you’ll need to contact Tufts.
How Long Does Tufts Insurance Pay for Medication-Assisted Treatment (MAT)?
When you have Tufts, MAT will be either partially or fully covered for as long as it’s medically necessary. Your treatment provider will need to provide proper documentation to Tufts to ensure coverage.
How to Cover Medication-Assisted Treatment (MAT) When Tufts Insurance Won’t?
If Tufts won’t cover some or all of your MAT costs, you can appeal the decision by calling them. You can also ask the rehab center about financing or scholarships you might qualify for so you don’t have to pay for this type of drug addiction treatment without insurance.
Medication-Assisted Treatment (MAT) Coverage Estimates
The amount of coverage you have for MAT depends on your plan:
- Bronze Plans: Since you have the lowest premium, expect to pay more out of pocket for prescription drugs when you get MAT.
- Silver Plans: These plans also tend to have low premiums and higher costs for medication.
- Gold Plans: With a gold plan, you’ll have a low copay for most medications.
- Platinum Plans: These plans have the lowest copays for medications.
In some cases, outpatient treatment is fully covered. In others, you’ll pay a copay for every visit to an outpatient treatment center. The copay amount varies depending on your plan, so check your summary of benefits and coverage—or call Tufts—to find out.
This kind of treatment often requires a copay for each visit. But due to the intensive nature of this program, you might need more outpatient visits than the typical plan allows for. So you might need preauthorization from Tufts to get coverage for every visit.
The amount of substance use treatment insurance coverage you have for partial hospitalization depends on your plan. Contact Tufts to find out what you can expect to pay out of pocket, if anything.
What Types of Addictive Substances Are Covered By Insurance?
Tufts provides rehab insurance coverage for a variety of addictive substances. So whether you’re struggling with an addiction to alcohol, stimulants, or opioids, you likely qualify for coverage.
Is Alcohol Addiction Treatment Covered By Tufts Insurance?
When you have coverage from Tufts, alcohol rehab treatment will typically be covered if it’s medically necessary. This means if you want to enter detox, inpatient residential rehab, outpatient, or a MAT program for alcohol addiction, you’ll have the financial help of alcohol rehab insurance.
Is Cocaine Addiction Treatment Covered By Tufts Insurance?
If you’re ready to quit your cocaine addiction, Tufts will cover some or all medically-necessary treatment options. When you’re ready to use your cocaine rehab insurance coverage from Tufts, the cocaine rehab options you have access to include detox, residential inpatient, outpatient, and more.
Is Heroin Addiction Treatment Covered By Tufts Insurance?
Tufts provides the heroin rehab insurance you need if you’re ready to quit this dangerous opioid. One of the most common treatment options for heroin addiction is medically supervised detox, which is usually followed by residential inpatient treatment, during which you can undergo several types of therapy. You can also get MAT through Tufts. Under some plans, MAT drugs like methadone, naltrexone, or buprenorphine are free or affordable with a copay. So if you’re looking for health insurance that covers methadone treatment and more, contact Tufts to find out what you’ll pay on your plan.
Is Meth Addiction Treatment Covered By Tufts Insurance?
If you have a meth addiction and you’re covered by a Tufts plan, you have meth rehab insurance you can count on. As long as you can show proof of stimulant use disorder, you should be able to get some or most of your costs covered for meth detox, inpatient care, intensive outpatient care, or outpatient treatment.
Is Prescription Drugs Addiction Treatment Covered By Tufts Insurance?
If you’re dealing with a prescription drug addiction, you deserve to get treatment fast. Opioids like morphine, fentanyl, oxycodone, hydrocodone, and similar prescription medications are highly addictive and therefore often abused. This can lead to overdose. Popular stimulants, such as methylphenidate or amphetamine, can also cause dangerous addictions. Luckily, Tufts offers prescription drugs rehab insurance coverage for everything from detox and inpatient treatment to outpatient care. Contact Tufts to find out what your exact coverage is.
Do Treatment Centers Need to Be In-Network?
For most Tufts plans, your treatment will only be covered when you choose an in-network rehab center. In some cases, you can get some costs covered out of network, but you’d need preauthorization first. Either way, you should call Tufts for help finding in-network providers or getting preauthorization for an out-of-network provider.
How Can I Pay the Costs Not Covered By My Tufts Plan?
If your Tufts plan doesn’t cover your full costs at first, you can file and appeal to see if the decision will be reconsidered. If this doesn’t change anything, contact the rehab center you plan to use so you can ask about discounts or financing. You can also ask if there are any scholarships for patients who can’t afford drug or alcohol addiction treatment without insurance.
Tufts Addiction Resources
If you have any concerns about how you’ll pay for addiction treatment, don’t hesitate to contact Tufts Health Plan for guidance. Even if your plan doesn’t cover everything you need, the representatives at Tufts can put you in touch with resources local to you, including detox centers, inpatient facilities, and 12 step programs in your city. You can also contact Bedrock Recovery Center in Canton, MA for help with local resources.
Why Bedrock Recovery Center?
If you’re ready to get help for your addiction, come to Bedrock Recovery Center. Our campus is conveniently located within a short drive of Boston and features everything from Starbucks coffee and an indoor gym to on-site laundry and yoga classes.
Our team of experienced medical professionals can compassionately guide you through detox, inpatient residential care, and medication-assisted treatment, depending on your specific needs for your addiction. Contact us today to learn more!