Watching someone you love battle with addiction can make you feel overwhelmed and helpless. Struggling with addiction yourself can feel hopeless and may elicit crippling shame that drives you into hiding.

Addiction thrives in isolation. It thrives in secrecy. It thrives in darkness. Only when you bring addiction to the light can it begin to heal, allowing true recovery to spring forth.

When you’re ready to reach out for help, worries may come to mind: Will my Coventry Health Care insurance plan help with drug rehab? How much will this cost me? Will Coventry pay for treatment for my child or loved one?

We’ll help you make sense of your Coventry insurance for rehab by explaining:

  • Governmental statistics on substance abuse in the U.S.
  • Coventry coverage for adults with Substance Use Disorder (SUD).
  • Coventry coverage for children with substance abuse issues.
  • Prior authorization requirements associated with Coventry insurance.
  • Out-of-pocket expenses and what to expect.
  • Where you can turn for help in choosing the best drug rehab for you.

Government Statistics

The Center for Disease Control (CDC) reports that, starting at age 12, 10% of teenagers acknowledge their use of unlawful substances over the past month. Reports from SAMHSA, the governmental agency monitoring addiction trends in the U.S., shows that:

  • 20 million people meet the qualifications for Substance Use Disorder (SUD)
  • This is equivalent to 1 of every 12 people in the U.S.
  • 7.7 million individuals meet the qualifications for a co-occurring mental health diagnosis, in addition to SUD

A statistic reported by reveals that 1 of every 15 people taking non-prescription opioid pain relievers will experiment with heroin within ten years of this pain medication abuse.

Considering this data, you are likely to face a situation impacted by addiction at some point in you lifetime, in fact, 1 in 3 individuals is impacted by addiction either directly or indirectly. It can be helpful to know exactly what your Coventry insurance will cover for drug and/or alcohol services should you or a loved one need help.

Coventry Insurance for Drug Rehab Offers Coverage for Adults

In 2013, Coventry Health Care was bought by Aetna. ranking it the third biggest health care benefits company in the U.S., with more than 22 million contracted medical professionals around the world. This joining of forces allows Coventry to offer even more support to those seeking recovery from addiction.

Because addiction is medically recognized as a brain disease, its interventions are now covered by insurance providers. Coventry believes in a holistic approach treating the body, mind and spirit in the healing process, as well as addressing co-occurring disorders including mental illness or other physical health problems.

Coventry addresses each patient’s situation on a case-by-case basis, and they are only willing to cover interventions that have been scientifically proven to be effective.

With variations based on the specific plan you have, Coventry coverage typically includes, in part or in full:

  • Prevention
  • Detoxification
  • 45 days of intensive inpatient treatment per year, with a common range of 28 to 90 days
  • Individual, group and family therapy
  • Medications
  • Partial hospitalization
  • Management of co-occurring disorders or dual diagnosis
  • Outpatient services
  • Follow-up programs
  • Case management

Coventry aims to support recovery in a variety of ways. Through its Medicare policies for addiction, Coventry is willing to cover inpatient rehab for a total of 190 days at pre-arranged facilities over the person’s lifetime.

Coventry will consider additional coverage for treatment addressing more than just the primary diagnosis of SUD, if a co-existing diagnosis requires further attention.

If ruled medically beneficial, Coventry will consider covering more luxury-type aspects of care, including residential treatment with:

  • Health and fitness centers
  • Elaborate food options
  • Housekeeping
  • Private rooms and living quarters

Coventry Insurance, in some cases, will also cover the following holistic interventions:

  • Massage therapy
  • Acupuncture
  • Spa therapy
  • Equine therapy
  • Aromatherapy

Coventry offers commendable employee assistance through your workplace if you have a group plan, as well.

Coventry Rehab Insurance Coverage for Children

Coverage for children with substance abuse issues can be similar to coverage for adults. Covered services for children, in some cases up to the age of 21, may include:

  • Relapse or drug use prevention
  • Drug detoxification
  • Inpatient treatment
  • Individual, group and family therapy
  • Medications used during treatment
  • “Day treatment” during the school days
  • Management of co-occurring issues and dual diagnosis
  • Outpatient services, including cognitive behavioral therapy and drug counseling
  • Follow-up programs and aftercare services
  • Case management

It is important to speak with your insurance company to find out exactly what your plan covers when it comes to children with substance abuse issues.

Prior Authorization Requirements for Addiction Treatment

Prior authorization refers to when an insurance provider agrees to honor the requested interventions based on the recommendations of medical and therapeutic professionals. The recommendation is given to the insurance provider following a thorough assessment of the patient to identify his/her needs.

Most substance abuse services require prior authorization. You will need to find out from your insurance provider which addiction rehabilitation services need prior insurance authorization.

Out-of-pocket Expenses that May Arise

These expenses typically include:

  • Deductibles
  • Co-payments
  • Additional charges

Some of the pluses of having a Coventry Health Care plan is that they usually have little to no deductible, with a specific cap placed on services covered for the calendar year. Typically, outpatient drug rehab programs are fully covered.

Coventry offers you a “flexible spending account,” which can help you when you need it most. This account holds a minimum of $130 per year towards the parts of care that aren’t covered by your insurance. This amount can be used for co-payments or alternative therapies not included in your particular plan.

Where to Turn For Support

We at understand how overwhelming sifting through all of this information can be. This is why we offer you a free national helpline, available 24 hours a day, 7 days a week.

Our licensed therapists are here to answer your questions, help you explore treatment options, and offer you confidential referrals to the best treatment facilities your insurance will cover. Give us a call, and let us empower you on your road to recovery!