Are you looking for rehab in Virginia that takes UPMC insurance? Novara Recovery Center provides complete addiction treatment that your UPMC plan covers.
It can be confusing to understand health insurance plans. Fortunately, any UPMC insurance plan will pay for at least a portion of your addiction treatment expenses. Being in-network with UPMC means Novara Recovery Center will accept most (if not all) benefits of your plan.
But remember, not all UPMC plans are the same. UPMC provides numerous varieties of insurance plans with varying degrees of coverage, deductibles, and copays. So, the real specifics of your plan are what determine the degree of your UPMC rehab coverage. Let’s pause for a moment before getting into the details and talking about what drug or alcohol rehab is.
Struggling with drug or alcohol use can feel isolating, but you don’t have to face it alone. Drug and alcohol rehab services help people get treatment, counseling, and support. They guide you to reduce or stop using substances.
The goal is also to equip you with the skills and confidence to rebuild your life. Through behavioral therapy, you’ll learn how to manage cravings, cope with triggers, and create healthier habits.
UPMC Insurance is a health insurance company. It is offered through the UPMC Health Plan. UPMC Insurance is connected to the University of Pittsburgh Medical Center (UPMC). UPMC Health Plan provides a wide range of coverage options to support your health, both physical and mental.
As a participant in the Affordable Care Act (ACA) marketplace, the insurer covers many services. These include Employee Assistance Programs, Group Health Insurance, Medicare Plans, and Special Needs Plans. UPMC Health Plan offers coverage through programs like CHIP (Children’s Health Insurance Program), Medical Assistance, and Workers’ Compensation. This ensures that people of all ages can access quality healthcare.
Yes, UPMC insurance covers drug rehab and alcohol treatment. UPMC Health Plan offers complete behavioral healthcare services as part of the Affordable Care Act (ACA). This includes addiction treatment and mental health coverage.
Coverage varies based on the specific UPMC insurance plan, medical necessity, and utilization review process. Patients should check their insurance benefits. This helps them know what treatment centers and therapy options their plan covers.
UPMC Insurance offers coverage for many proven addiction treatment programs. This ensures you get the support you need during your recovery journey. Here’s a look at the types of rehab programs covered under UPMC Insurance:
Detoxification (Medical Detox)
Medical detox is an important first step. It helps you safely handle withdrawal symptoms. This process allows your body to adjust to life without substances.
This is very important because serious withdrawal can harm your health. This is especially true if you have opioid use disorders or are addicted to alcohol.
Medical detox provides the care and support needed for people with drug dependency. It helps them through this tough time. With the help of skilled specialists, you will receive the therapy you need. This will help you prepare for the next steps in recovery and stabilize.
Inpatient Treatment (Residential Rehab)
An inpatient rehab program means staying at a treatment facility where you can get the therapy and care you need. You’ll be admitted, stay there throughout your treatment, and then leave when you’re ready.
Outpatient Treatment (Flexible Recovery Options)
If you need treatment but have work, school, or home duties, outpatient rehab can help. It lets you keep your daily schedule while getting the professional help you need. You’ll attend therapy sessions a few hours a week and learn about how to deal without substance use, but return home afterward. Depending on your circumstances, you can enroll in:
Thanks to the Affordable Care Act (ACA), your insurance must cover treatment for substance use disorders. This is part of the essential health benefits they provide. Make sure to read your policy carefully. Check what services are covered and what steps you need to take for that coverage.
For example, your policy may require you to submit documentation that the treatment is medically needed. You may be required to obtain pre-authorization in most cases as well prior to your treatment.
Choose a rehab center that is in your insurance provider’s network. This will help you get the most coverage and lower out-of-pocket costs.
Going out of network may mean your insurance won’t cover it. You might pay much more out of pocket. Some services may not be covered at all.
Verification of Benefits
Review your insurance coverage for addiction treatment first to determine if your UPMC mental healthcare plan covers rehab. You can accomplish this by contacting UPMC. If you are already a member, please call member services at 1-844-220-4785 (TTY: 711). They are available five days a week, from Monday to Friday, between 8 a.m. and 6 p.m. EST.
UPMC also offers an Interactive Voice Response system that you can access any time, day or night, by calling 1-866-406-8762. You can use it to check on things like:
Think of your deductible as the amount you need to pay for healthcare on your own before UPMC starts contributing. Let’s say your plan has a $1,500 deductible. That means you’ll need to cover the first $1,500 of your medical bills.
Once you’ve paid that $1,500, UPMC will start helping with the costs based on what your specific plan covers. Co-payments or Co-insurance are any shared costs you’re responsible for during treatment. Out-of-Pocket Maximums mean that when you reach this limit, UPMC Health Plan may pay for all your care for the rest of the plan year.
Finally, take the time to select a rehab facility that’s covered under your UPMC Health Plan. You can:
If you are unsure where to start, feel free to ask for help. The admission team at Novara Recovery Center is here to support you every step of the way.
Choosing UPMC Insurance for substance abuse treatment or mental health issues has many benefits. This includes help for conditions like depression, anxiety, and PTSD.
With UPMC insurance for rehab, you get access to a vast network of in-network treatment centers. Throughout the United States, the networks encompass almost 1.4 million healthcare providers and 6,400 health facilities. They also feature a retail pharmacy network comprising national chains, regional chains, and independent pharmacies.
They provide different inpatient programs, outpatient counseling, and drug detox insurance options. These options can be adjusted to fit your needs.
All plans let you customize your coverage. You can choose different deductibles, copays, and premiums. This helps fit your budget and health needs.
They also offer state-customized products. For example, UPMC offers full plans for Pennsylvania Medicaid members. These plans include prescription drugs, dental care, vision, and other medical needs.
In addition to other options, they provide Medicare Advantage plans. These plans replace Original Medicare. They offer extra benefits and make out-of-pocket costs easier to predict. However, the network of healthcare providers you can choose from might be limited.
UPMC insurance is a real lifesaver in terms of keeping medical care affordable. UPMC Memorial provides free care to help with your medical costs. This is available if your income is at or below 300% of the Federal Poverty Level. They also have charity care programs that provide reduced or free care for those who qualify.
Programs like charity care and financial aid are usually only for patients living in UPMC’s main service areas. These areas include Pennsylvania, New York, Maryland, West Virginia, and Ohio. If you’re not certain whether or not you qualify, it’s always best to call UPMC for confirmation.
If your budget is still too tight, consider exploring alternative options like ACA subsidies. There are many ways to get the help you need. Don’t be shy about asking questions and exploring your options.
We know that cost is a major factor for most people when seeking treatment for drug & alcohol abuse in Virginia. Novara Recovery Center works with most major insurance plans to help cover up to 100% of the costs associated with treatment at our program. To find out your personal options for treatment, get a free verification of insurance benefits right now by clicking the button below.
UPMC Health Plan, like other health insurance companies, usually pays for different types of rehab. However, there are some rules and restrictions you should know about. These limitations depend on the exact health plan you have and the specific type of rehab you need.
If you pick a rehab provider that is not in-network, UPMC might only pay part of the costs. Some services may not be covered at all based on your plan’s network rules.
If you need help for drug or alcohol problems or other mental health issues, you may need “prior authorization.” This is especially true for longer stays or specialized care. This includes staying at a luxury rehab center or joining a customized intensive outpatient program (IOP).
Your health insurance company, like UPMC, must check your treatment plan. They need to approve it before covering the costs. This usually means your doctor will send proof that you need the treatment. It is a medical necessity.
Not every therapy choice or private rehab center might be fully covered. The UPMC Health Plan may limit the number of rehab visits or sessions that are covered.
These limits depend on the type of therapy, like physical or occupational. They also depend on the level of care needed and if the treatment is considered medically necessary. After a certain number of sessions, additional visits may require approval.
Here’s how to use your UPMC Health Plan to seek treatment for drug and alcohol use disorders and any co-occurring mental health disorders:
Start by looking at your insurance documentation. Check your UPMC Health Plan benefits guide or confirmation letter. This will help you see what services are included in your policy.
Pay particular attention to addiction treatment services, treatments including outpatient and inpatient rehab, detox services, counseling, and therapy. Take the time to clarify details like the number of rehab sessions you’ll receive and the duration of your inpatient stay. This proactive move helps you avoid unexpected costs and ensures there are no surprises along the way.
UPMC Health Plan has a wide network of trusted rehab centers and addiction treatment providers.
To find a list of in-network facilities and providers, visit their online directory. You can also call customer service using the number on the back of your insurance card. Selecting an in-network physician guarantees the lowest out-of-pocket expenses and the greatest degree of coverage.
Some rehab services need pre-authorization to be covered. This includes luxury inpatient rehab, peer support services, and holistic therapies.
Pre-authorization is the process of getting approval from your insurer before starting treatment. Before you begin any therapy, call UPMC Health Plan and get pre-authorized. You will likely need to produce a statement from your doctor or treatment provider on the medical need for the therapy.
Your therapy provider may need to show documents that prove you need rehab. This includes your diagnosis, treatment plan, and how the treatment will help you. After you submit your pre-authorization, UPMC will analyze it and tell you whether it is approved. If your request is refused, you may file a claims appeal or explore other rehab payment alternatives.
Before you start treatment, make sure you know your out-of-pocket costs, copays, deductibles, and coinsurance. This will help you plan for treatment expenses and avoid surprises. Call UPMC Health Plan to find out what your out-of-pocket responsibilities are for addiction treatment. Be sure to ask about available UPMC financial assistance programs or options to help with costs.
Also, inquire about co-pays and deductibles. Depending on your plan, you may have to pay a certain amount per treatment session or service. Knowing these costs upfront will help you plan for rehab.
Novara Recovery Center aims to make it easier to get treatment for substance misuse and mental health issues. We provide personalized, patient-focused care in a safe, modern, and inviting environment, customized to meet your unique needs.
We offer many treatment options. These include detox placement, inpatient services, and flexible outpatient programs. We will support you through every step of your journey.
We work with UPMC Health Plans and many top insurance companies. We also offer free insurance verification services. Your journey to healing can commence right now.
Reach out to us to confirm your UPMC Health Plan benefits and take that vital initial step toward recovery. Visit us at 2815 Old Lee Hwy Floor 2, Fairfax, VA 22031. Call us at (703) 705-7870 or email us at info@novararecoverycenter.com.
Written By:
Mental Health Writer
Geoffrey Andaria is a seasoned writer and editor specializing in mental health content. With a B.A. in English and Journalism, he possesses a solid foundation in crafting freelance articles and conducting research. Geoffrey has also completed courses in social work. He dedicates himself to providing valuable and informative content for individuals impacted by mental health challenges and addiction.
Medically Reviewed By:
Expert Contributor
Dr. Williams is currently a board member for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, located in Philadelphia, Pennsylvania.
He possesses a Ph.D. in Clinical Psychology from Union Institute and University, located in Cincinnati, Ohio. He holds a license to offer addiction counseling in both New Jersey and Connecticut. Additionally, he has submitted an application to become a licensed psychologist in New Jersey.
