The federal Mental Health Parity & Addiction Equity Act of 1996 and the Affordable Care Act of 2010 ensure that all US insurance providers must offer the same level of benefits for behavioral health issues like addiction as they do for medical and surgical issues — including addiction treatment.
MHN’s behavioral health plan covers medically necessary behavioral health treatment, including addiction treatment. That may include sessions with therapists or psychiatrists, IOP (intensive outpatient treatment for addiction), residential addiction treatment, and addiction treatment aftercare. The details of your particular plan are laid out in the Summary Plan Description or Evidence of Coverage, including who is eligible, what services are covered, what services require pre-authorization, benefit exclusions and limitations, and what your costs will be.
Acqua Recovery is an in-network provider for MHNet. That means our program has been reviewed and approved by MHNet to provide care for its members. That process also includes contract negotiations that set the price for treatment paid by MHNet and its clients at the most affordable rate possible. In addition, our contract is the foundation of a collaborative working relationship with MHNet, which means we can act as your advocate with your provider to verify your benefits and get your claim approved.
In addition, when you choose a provider that is not in network with MHNet, you have to pay all claims up front and then work to get paid back later on. With an in-network provider like Acqua Recovery, you can realize your cost savings up front.
You can review your MHNet benefits by logging in to the MHN member site and navigating to “Benefits.” Or, simply provide your plan information to the Acqua Recovery team and we can check your benefits for you. It’s something we do every day, and we can make the process easier for you.
Although all plans are different, you must usually start with receiving a diagnosis from your primary care physician, who must be authorized by MHNet. If your PCP believes you need treatment, they will advise MHNet by filling out a prior authorization form spelling out the form of treatment they believe will be the most beneficial. From there, you can choose a facility — either on your own or with the help of MHNet. Simply call the facility and tell them you’re with MHNet, and they’ll take it from there.
Most MHNet customers must pay a deductible of $2500 or more every year. In addition, if your plan does not cover the full cost of treatment you may be required to pay a copay. When you verify your benefits, you find out your full copay up front. However, in most cases you do not have to pay it under after you receive treatment.