Harvard Pilgrim Health Care insurance plans are offered to individuals and families through Medicare and as student insurance through United Healthcare Student Resources. With services areas in Massachusetts, New Hampshire, Connecticut, and Maine, Harvard Pilgrim Healthcare offers several dozen types of health insurance plans, between Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). These plans offer behavioral and mental health benefits ranging from $1000 copays for each inpatient treatment stay to inpatient care for as low as $500. Depending on individual plan coverage, members of Harvard Pilgrim Health Care have access to several options of intensity and types of addiction treatment when it is most needed.
With the opioid epidemic ravaging entire states, addiction treatment becomes a serious and immediate need for the residents of that state. So behavioral health benefits like those available through Harvard Pilgrim Health Care are especially important in states like New Hampshire, which has the third-highest rate of opioid overdose deaths, as of 2017.1 Also included in states with disturbing trends in rates of opioid overdose death rates is Connecticut. In 2016, the rate of opioid-related overdose deaths in Connecticut was nearly double the national average.2 Massachusetts is another northeastern state hit especially hard by the opioid epidemic, seeing an increase in opioid-related deaths of more than twentyfold from 2012 through 2016, as a result of synthetic opioids like painkillers and fentanyl.3 The overdose death rate for Maine has also been nearly double the national average, at 25.2 deaths per 100,000 people.
Like many regions of the country, entire communities in northeastern states have been decimated by opioid addiction, and each person who struggles with this deadly and chronic illness has individual needs and different levels of care that will work best for their situation.
Those who struggle with substance abuse and addiction may benefit from the added feature of Harvard Pilgrim Health Care’s coordination of care. This program offers extra assistance to members to individualize a treatment program for the unique needs of the member and the specific condition needing treatment. This often involves coordinating social services and community resources, ensuring discharge and aftercare planning, as well as a personal nurse or social worker to assist with transitions between levels of care and community support.
Understanding that some level of supervision and an extra hand to help coordinate the most appropriate treatment can lead to extraordinary care along the road to recovery. Addiction can be very complex, and Harvard Pilgrim Health Care acknowledges this complication with personal care, to work with your physician to assess and structure the entire recovery process while helping to maximize your insurance benefits.
It is always recommended to work with your health insurance provider as much as possible when looking for addiction treatment. The out-of-pocket costs associated with rehab can add up fast, and financial hardships are one of the most common triggers for relapse. In the best efforts to be prepared for your financial responsibilities, it is wise to have a complete understanding of your benefits through Harvard Pilgrim Health Care.
If you choose to use the coordination-of-care benefit, your nurse or social worker will be well versed in every way your insurance plan can work best for your treatment needs. Additionally, any treatment program will be able to verify and discuss the benefits you have and also explain the way their billing works. This will allow you to understand what you may be charged for, separate from the cost of the treatment itself.
Separate charges may be for things like:
Even if your health insurance plan and benefits are not completely sufficient, the help you can receive using them is much more than anything available without insurance benefits, which would be an exorbitant cost to you. No one wants to have to face seeking drug treatment, but immediate action is imperative, and the first thing is to cut through the confusion of your health insurance benefits so that you can begin your path to recovery.
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