Rehabs that Accept GHI Insurance

What makes your insurer decide what level of addiction care you need? They sometimes approve inpatient rehab programs (residential programs) but approve intensive outpatient programs or partial hospitalization programs for others who need care.

All insurance policies, including GHI and Emblem Health, consider numerous factors before covering treatment. When you call Ingrained with your insurance data, our staff member will ask you a few additional questions.

We’ll need to share your lived experiences with drug and alcohol use with Emblem Health. That requires having a quick discussion with you about your need for addiction treatment. Remember, we share a common goal: to get treatment covered at our drug and alcohol rehab center.

The questions we ask can be difficult to discuss. But rest assured, they are necessary to help leverage your insurance benefits.

The better we understand where you are right now, the better we can explain your need for outpatient treatment vs. inpatient treatment to the insurer.

Questions our insurance specialists may ask can include:

Did you try inpatient and residential programs or an outpatient treatment facility? How long-lasting was the sobriety? What led to a relapse?

These questions reveal two important things. First, you have demonstrated a willingness to go to a drug and alcohol rehab center seeking treatment. Second, understanding the level of care and its effectiveness helps decide the appropriate level of care – inpatient or outpatient treatment.

For example, imagine you went to a partial hospitalization program for alcohol treatment. After you left the rehab center, you stayed sober for five months before a relapse into alcohol abuse. This scenario may suggest that you require a higher intensity treatment setting this time, like a residential behavioral health treatment program that will be more comprehensive.

Are you currently using alcohol or drugs? What is your drug of choice? How often and how much do you use?

We need to design a program that meets you where you are right now; the insurance company must decide whether they’ll approve outpatient or inpatient treatment. Giving them a clear picture of your current treatment center needs will help them move forward and cover treatment.

Consider a person who has an active addiction to methamphetamine, someone who injects high doses several times daily using a shared needle. The insurance company will weigh the cost of inpatient and residential programs versus the cost of an overdose or possibly high physical health costs due to infections after sharing needles.

In that case, they may approve inpatient programs over outpatient treatment to lessen the chances of other possible health complications that could result from the person’s drug and alcohol addiction.

How has substance abuse impacted your life? What makes you seek treatment now? Have you engaged in self-harm or considered suicide to end your struggles? Do you require other mental health services to cover co-occurring disorders?

These questions give us an idea about your current mental state and place you in the safest rehab center. These questions are especially important when deciding to approve behavioral health inpatient programs, in an intensive setting.

Ingrained Recovery, like many reputable rehab centers, provides dual diagnosis and mental health treatment services in addition to treating substance use disorders. Our addiction treatment services address the internal turmoil along with providing drug or alcohol addiction treatment.

Imagine a young adult who wants to use their insurance benefits for substance abuse treatment. They call drug and alcohol rehab centers with no luck. They finally reach Ingrained Recovery, who asks these questions, learning that the client is cutting and using heroin from street dealers.

Recognizing the imminent danger and the probable presence of a mental illness, the admissions rep works with Emblem Health to approve an emergency admission and immediate medical detoxification at our inpatient treatment center.

Where do you currently live? Who do you live with? Is it a sober environment? Are you safe from physical harm at night?

These last questions can rule out an intensive outpatient program in favor of a residential rehab facility. Emblem Health Insurance plans may look at someone with insecure or unsafe housing as a high priority for addiction treatment.

For instance, you might consider a young adult whose parents kicked them out of the house at 19. The person has lived in their car for over a year, with an ever-increasing reliance on illicit drugs to cope with the pain of being ousted by their loved ones.

They were assaulted and robbed several times while living in the car. The local shelters have no available spots. This person is not a likely candidate for outpatient programs, as they have little chance of sobriety outside of rehab centers.