Does Univera Cover Rehab Treatment?

Univera is a health insurance company that is committed to the health and well-being of residents of upstate New York.

Published On

October 1, 2023

Understanding Univera Insurance

If you or a loved one is struggling with addiction, seeking rehab treatment can be a crucial step towards recovery. However, the cost of rehab treatment can be a barrier for many people. One question that often comes up is whether insurance will cover the cost of rehab. In this article, we will explore whether Univera covers rehab treatment.

Univera is a health insurance company that is committed to the health and well-being of residents of upstate New York. They understand that navigating the healthcare system can be confusing and overwhelming, which is why they offer a variety of health insurance plans to meet the unique needs of individuals, families, and businesses alike.

Univera's health insurance plans are designed to provide comprehensive coverage for a range of services, including preventive care, emergency care, hospitalization, and prescription drugs. They also offer a range of wellness programs and resources to help their members live healthier lives.

In addition to their commitment to their members' health, Univera is also committed to the communities they serve. They actively support local organizations and initiatives that promote health and wellness, and they are dedicated to making a positive impact on the lives of those around them.

Does Univera Cover Rehab Treatment?

The short answer is that it depends on your specific plan. Univera offers a variety of plans to meet the unique needs of individuals and families. Some Univera plans do cover rehab treatment, while others do not. It's important to review your plan carefully to understand what is covered and what is not.

If your plan does cover rehab treatment, there may be some limitations on what is covered. For example, your plan may only cover certain types of rehab treatment or may limit the number of days that you can receive treatment. It's important to understand these limitations so that you can make informed decisions about your care.

The Different Types of Rehab Treatment That Univera Plans May Cover

If you have a Univera plan that covers rehab treatment, it's important to understand what types of treatment may be covered. Univera plans may cover both inpatient and outpatient rehab treatment.

Inpatient Rehab Treatment

Inpatient rehab treatment typically involves staying at a residential facility for a period of time while receiving intensive therapy and medical care.

Outpatient Rehab Treatment

Outpatient rehab treatment, on the other hand, allows patients to live at home while receiving therapy and medical care during scheduled appointments.

Range of Therapies Covered

Univera plans may also cover a range of therapies as part of rehab treatment, including:

  • Behavioral therapy
  • Individual counseling
  • Group therapy
  • Medication-assisted treatment

It's important to review your specific plan to understand what types of therapies are covered.

It's worth noting that not all rehab facilities accept insurance, so it's important to verify coverage with both your insurance provider and the facility before starting treatment. Additionally, some Univera plans may require pre-authorization or a referral from a healthcare provider before covering rehab treatment.

How to Determine Whether a Specific Rehab Facility is Covered by Your Univera Plan

If you are considering a specific rehab facility for treatment, it's important to verify whether it is covered by your Univera plan. Here are some steps you can take to determine whether a specific rehab facility is covered:

  1. Contact Univera: The best way to determine whether a specific rehab facility is covered by your plan is to contact Univera directly. You can find the phone number on the back of your insurance card or visit their website for more information.
  2. Provide Information: When you contact Univera, be prepared to provide information about the rehab facility, such as its name and location. You may also need to provide information about your specific plan.
  3. Ask Questions: Don't be afraid to ask questions when speaking with a representative from Univera. For example, you may want to ask about any limitations on coverage or whether pre-authorization is required.
  4. Contact the Rehab Facility: It's also a good idea to contact the rehab facility directly and ask if they accept your Univera plan. They may be able to provide more detailed information about what services are covered and any out-of-pocket costs that you may incur.

By taking these steps, you can ensure that you have all of the information needed to make an informed decision about where to receive rehab treatment. Remember, seeking help for addiction takes courage and strength, and having access to quality care can make all the difference in achieving lasting recovery.

How to Get Pre-Authorization for Rehab Treatment Through Univera

If your Univera plan requires pre-authorization for rehab treatment, it's important to understand the process for obtaining this authorization. Here are the steps you can take to get pre-authorization:

  1. Contact Your Healthcare Provider: The first step in getting pre-authorization is to speak with your healthcare provider. They will be able to provide you with information about what type of treatment is necessary and whether it requires pre-authorization.
  2. Submit a Request: Once you have determined that pre-authorization is required, you will need to submit a request to Univera. You can do this by contacting their customer service department or by submitting a request through their online portal.
  3. Provide Information: When submitting your request, be prepared to provide information about the rehab facility you plan on attending and the type of treatment that is needed. You may also need to provide information about your healthcare provider and any previous treatment received.
  4. Wait for Approval: After submitting your request, you will need to wait for approval from Univera. This process can take several days, so it's important to submit your request as soon as possible.
  5. Receive Confirmation: Once your request has been approved, you will receive confirmation from Univera that the treatment is covered under your plan.

It's important to note that even if pre-authorization is not required under your specific plan, it's always a good idea to verify coverage with Univera before beginning treatment. By taking these steps, you can ensure that you have all of the information needed to make an informed decision about where to receive rehab treatment and avoid any unexpected out-of-pocket expenses.

Other Addiction Treatment Options Covered by Univera

In addition to inpatient and outpatient rehab treatment, Univera plans may also cover medication-assisted treatment (MAT).

MAT is a type of addiction treatment that involves the use of medication, in combination with behavioral therapy and counseling, to help individuals overcome addiction.

MAT can be an effective option for individuals who are struggling with addiction to opioids or alcohol. The medications used as part of MAT work by reducing cravings and withdrawal symptoms, making it easier for individuals to stay in recovery.

It's important to note that not all medications used as part of MAT are covered by all Univera plans. It's important to review your specific plan to understand what medications are covered and any limitations on coverage.

If you are considering MAT as a treatment option, it's important to speak with your healthcare provider about whether it is right for you. They can provide more information about the different medications used as part of MAT and how they work.

How to Find Out if Your Plan Covers Rehab Treatment

If you or a loved one is struggling with addiction, it's important to know that help is available. To find out if your Univera plan covers rehab treatment, you have several options. Firstly, you can review your plan documents to see what's covered. If you're not sure how to do this, don't hesitate to contact Univera directly. They can answer any questions you may have and help you navigate the complicated world of insurance.

It's also a good idea to speak with your healthcare provider or the rehab facility that you are considering to see whether they accept your insurance. Many rehab facilities have staff members who specialize in insurance and can help you figure out what your coverage options are. Remember, you don't have to go through this alone – there are people and resources available to help you every step of the way.

How to File an Appeal if Your Univera Plan Denies Coverage for Rehab Treatment

If your Univera plan denies coverage for rehab treatment, you have the right to appeal the decision. Here are the steps you can take to file an appeal:

  1. Review Your Plan: The first step in filing an appeal is to review your plan documents carefully. Look for information about how to file an appeal and any deadlines that may apply.
  2. Contact Univera: Contact Univera as soon as possible to get more information about why your claim was denied and what steps you can take to appeal the decision.
  3. Gather Information: Before filing an appeal, gather all relevant information about your case, including medical records and any documentation that supports your need for rehab treatment.
  4. Submit Your Appeal: Submit your appeal in writing to Univera's appeals department. Make sure to include all relevant information and documentation.
  5. Wait for a Decision: After submitting your appeal, you will need to wait for a decision from Univera. This process can take several weeks, so be patient.
  6. Consider Additional Options: If your appeal is denied, you may have additional options, such as requesting an external review or contacting the New York State Department of Financial Services.

It's important to remember that filing an appeal can be a complex process, so it's always a good idea to seek guidance from a healthcare professional or legal expert who has experience with insurance appeals. By taking these steps and advocating for yourself or your loved one, you may be able to get the coverage needed for rehab treatment and achieve lasting recovery.

Other Options for Paying for Rehab Treatment

If you or someone you love is struggling with addiction, it can be overwhelming to navigate the complex landscape of rehab treatment. If your Univera plan does not cover rehab treatment or if you have high out-of-pocket costs, don't lose hope. There are still other options for paying for treatment.

Some rehab facilities offer payment plans or sliding scale fees based on income. This means that they'll work with you to create a payment plan that fits your budget. Additionally, you may also be able to apply for scholarships or grants to help cover the cost of treatment. Many organizations offer financial assistance for those who need it most.

Remember, seeking treatment for addiction is an investment in your future. Don't let financial concerns prevent you from getting the help you need. There are resources available to help you overcome this obstacle and get on the path to recovery.

Tips for Choosing a Rehab Facility That is Covered by Your Univera Plan and Meets Your Needs

Choosing a rehab facility can be overwhelming, especially when you're trying to find one that meets your needs and is covered by your Univera plan. Here are some tips to help you make the best decision:

1. Verify Coverage

Before you start researching rehab facilities, it's important to verify whether they are covered by your Univera plan. You can contact Univera directly or check their website for a list of in-network providers.

2. Consider Location

Location is an important factor to consider when choosing a rehab facility. Do you want to stay close to home or go somewhere that's more secluded? Keep in mind that staying close to home may make it easier for loved ones to visit and provide support.

3. Research Treatment Options

Different rehab facilities offer different types of treatment programs, so it's important to research what options are available. Some facilities may focus on specific types of addiction, while others may offer a range of programs.

4. Check Credentials

It's important to choose a rehab facility that is licensed and accredited by reputable organizations such as The Joint Commission or the National Committee for Quality Assurance (NCQA). This ensures that the facility meets high standards for quality care.

5. Read Reviews

Reading reviews from former patients or their loved ones can give you insight into the quality of care provided at a particular rehab facility. Look for patterns in the reviews, such as consistent complaints about staff or facilities.

By following these tips, you can make an informed decision about which rehab facility is right for you and ensure that it is covered by your Univera plan. Remember, seeking help for addiction takes courage and strength, and finding the right treatment program can make all the difference in achieving lasting recovery.

Conclusion

Seeking rehab treatment can be a difficult but important step towards recovery from addiction. If you have Univera insurance, it is important to review your plan to see whether rehab treatment is covered. If it is not covered, there may be other options for paying for treatment. Remember, seeking help is a sign of strength, and there are resources available to help you get the treatment you need.

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