Health Net Rehab Coverage

Yes. Depending on the plan you have, you’ll have differing levels of coverage. For example, PPO plans and HOM plans may cover a wide variety of costs. Medi-Cal covers no-ride costs to therapy and substance use treatment visits, and you can access substance use disorder (SUD) treatment through Health Net Medi-Cal’s Behavioral Health Services. Call 1-800-675-6110 (TTY:711) for more information.

Health Net also has Medicare plans that cover drug and alcohol rehab. In addition to those, you can get coverage through your employer or by purchasing an individual or family plan. Health Net offers HMO and PPO plans, each of which is different. Check your individual plan’s member benefits to learn about your coverage.

Absolutely, you can check your benefits on the Solution Based Treatment website. Or, you can log into your account at provider.healthnet.com. From there, select Patient Information. Under Benefits, you’ll click on “Schedule of Benefits” to see your specific member benefits. You can also contact Health Net directly.

Yes. Health Net has a variety of plans, and they cover outpatient treatment. Exactly which provider you can see and how much coverage you’ll receive will vary based on your plan. For example, the Platinum 90 Ambetter HMO plan covers outpatient substance use disorder treatment for $15 per office visit.

Yes. The specific coverage and benefits for your plan may vary, so it’s important to reach out to Health Net or review your member benefits before selecting a provider. For instance, the Platinum 90 Ambetter HMO plan covers inpatient mental/behavioral health or substance use disorder treatment at a cost of $225 for up to five days. You may need a pre-authorization for care.

Not necessarily. Whether or not your care will be covered with an out-of-network provider will depend on your plan with Health Net. Check your member benefits to determine if out-of-network coverage is provided. Many times, out-of-network coverage pays less and requires a pre-authorization. For example, the Platinum 90 Ambetter PPO plan covers up to 50% of the cost of out-of-network inpatient or outpatient care, but you may need pre-authorization depending on the services you’re interested in.

Health Net insurance benefits aren’t subject to annual dollar limits. However, you should verify that there aren’t limits on the number of visits you can have to a specific treatment facility or provider prior to starting treatment.

If Health Net doesn’t cover all your expenses related to SUD treatment, you will need to cover your costs out of pocket. To avoid having to pay out of pocket, you will need to choose from rehabs that take Health Net or be prepared to cover the costs with cash, a credit card, or other forms of financing.

With a Health Net HMO, you can expect to pay less in monthly premiums. You will also pay less out of pocket when you go to see a medical provider. However, you will not have as much flexibility to see who you’d like, and your providers will need to be in-network. On the other hand, Health Net’s PPO has higher monthly premiums but better flexibility. Some out-of-network coverage is also provided.

It may be possible to get a single case agreement with Health Net depending on your insurance plan.  You do have a right to request continuity of care with some exceptions. Typically, Health Net covers these services for up to 12 months. Reach out to member services or check your member benefits to see if your plan allows a single-case agreement.

*Solution Based Treatment accepts many different types of insurance from patients all over the United States. We also offer Day Treatment (PHP) and outpatient programs for those in the following locales: Temecula, CA, Murrieta, CA, Menifee, CA, Wildomar, CA, French Valley, CA, Lake Elsinore, CA, Canyon Lake, CA, French Valley, CA, Corona, CA, Vista, CA, Escondido, CA, San Marcos, CA and Fallbrook, CA.