What Is AvMed Health Insurance?

AvMed is a health insurance company that provides a range of health coverage options for individuals, families, and businesses. AvMed Health Plans is based in Florida and serves members in numerous counties, including Miami-Dade, Broward, Palm Beach, and Orange. The company offers various health insurance plans, including individual and family plans, employer-sponsored plans, and Medicare Advantage plans.

Typically, AvMed Health Insurance covers a variety of healthcare services, such as doctor visits, hospital stays, prescription medications, preventive care, and more. Like other health insurance providers, AvMed aims to help individuals access quality healthcare while managing the costs associated with medical services.

It's important for individuals considering AvMed health insurance to review the specific details of the plans offered, including coverage for behavioral health services. This may include coverage for mental health and substance abuse treatment, depending on the plan.

Types of AvMed Health Plans

There are numerous AvMed plans and coverage. Plans and coverage options offered by AvMed are quite diverse. In addition to catastrophic coverage, Entrust, Engage, and Empower plans at the bronze, silver, and gold tiers are available through the marketplace. Every tier offers a variety of AvMed health plan options at varying monthly premiums. The higher tiers will generally result in lower out-of-pocket expenses but higher monthly premiums.³

Additionally, AvMed provides Point-of-Service (POS) plans that combine aspects of HMO (Health Maintenance Organizations) and PPO. Apart from your primary care physician, you may also qualify for benefits that are not part of the network. AvMed offers HMO plans as well. With an HMO, however, you have fewer provider options, and you are unlikely to obtain coverage outside of the network. However, this plan is less expensive in terms of monthly premiums and out-of-pocket costs.

When conducting an AvMed provider search for coverage, you can use the AvMed provider directory to find addiction treatment services through an AvMed provider list.

AvMed Medicare Plans

AvMed is a provider of Medicare Advantage plans. Medicare Advantage fully replaces original Medicare, and with AvMed, you get additional benefits like dental and vision care, as well as the SilverSneakers fitness program.⁴

So, can you use AvMed insurance for addiction treatment? You certainly can! Your plan and the provider you select will determine the specifics and the amount of coverage. If your insurance doesn't pay for the entire amount, there are ways to assist you with the payment.

Does AvMed Cover Rehab for Drugs and Alcohol?

Yes, AvMed does cover rehab or addiction treatment. All long-term health insurance plans are required by the Affordable Care Act (ACA) to offer at least some coverage for addiction treatment and mental health. It is regarded as a vital health advantage.¹

Through Optum, AvMed provides benefits for behavioral health. You can browse mental health resources, contact a provider to help you get the treatment you need, and access a hotline for substance abuse disorders on the Optum website.²

You can call the toll-free number provided by Optum to speak with a certified clinician who will assess your case and assist you in developing the best possible care plan. Your state of residence, whether the facility is in-network or out-of-network, the duration of your stay, and the level of your insurance plan can all have a significant impact on the amount of coverage you have.

The price of treating drug and alcohol addiction varies from person to person and is also contingent upon the type of rehab facility chosen, the kind of program participated in, and the particular services rendered.

What to Do If AvMed Doesn’t Cover the Total Cost of Rehab

Your AvMed insurance plan may not cover the full cost of your rehab program. There may be costs that the insurance program pays for, but you will still have to pay for things out of pocket. Fortunately, there are other options if these are out of your price range. For example, some programs provide scholarships, or you may be eligible for a loan intended expressly to cover your medical expenses. You may also be able to set up a payment plan with the facility.

AvMed Rehab Coverage

Your AvMed medical insurance plan may cover the following levels of addiction treatment:

• Medical Detox: It is frequently uncomfortable, excruciating, or even lethal to detox from narcotics and alcohol. In these circumstances, you may need assistance. With the help of medical detox, where you will have round-the-clock medical supervision, you can safely taper off narcotics and alcohol. You can also be given medication to help with your withdrawal symptoms. Find local detox facilities now.
• Residential/Inpatient Care: Inpatient and residential treatment centers provide drug and alcohol therapy while you are a resident of the facility. Most inpatient treatments range between 15 to 90 days, depending on the program you're in and your unique needs.
• Partial Hospitalization Program (PHP): Following their session hours at the facility, clients participating in partial hospitalization programs are permitted to return home.
• Intensive Outpatient Program (IOP): Although less intensive than PHP, intensive outpatient addiction treatment entails attending programs a few evenings a week. Customers can live at home and work during the day thanks to this.
• Outpatient Treatment: After completing an inpatient program, patients frequently go to an outpatient facility for continued assistance. In these programs, clients live at home and attend therapy and counseling sessions at a treatment center for ten to twelve hours each week.
• Sober Living: Also known as halfway houses, rehabilitation residences, or transitional living arrangements, sober living homes provide a halfway house alternative for those who have finished a treatment program before going back to their own homes.
• Aftercare: Any continuation or follow-up therapy for substance misuse that takes place following an initial rehab program is referred to as aftercare. Relapse prevention techniques and preservation of recovery are among the objectives of aftercare.

Finding Rehabs That Accept AvMed

When choosing a treatment center, we recommend finding AvMed providers that use evidence-based practices. Credentials are important when searching for drug and alcohol treatment. While some AvMed plans cover only in-network providers, others give limited coverage for out-of-network providers. If you are unsure if your plan covers out-of-network addiction treatment, you should speak with the insurer directly.

Fortunately, Banyan Treatment Centers accepts AvMed insurance for rehab. Your AvMed plan may cover some or all our following services:

• Medical detox
• Inpatient treatment
• Residential care
• Partial hospitalization treatment
• Intensive outpatient treatment
• Outpatient services
• Telehealth rehab programs
• Eating disorder treatment
• Veterans and military rehab programs

Check Your AvMed Drug Rehab Coverage

You can use the insurance verification form below to verify your AvMed insurance benefits if you intend to seek addiction treatment or if you're just interested in learning more about your options. If you still have questions, we invite you to visit our page on insurance for drug and alcohol rehab, where we address topics including deductibles, out-of-pocket maximums, and other fundamental health insurance issues.

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You may also get in touch with qualified experts who can help verify your insurance for recovery and put you in touch with the best rehab facilities by calling our 24/7 addiction helpline. To get started, get in touch with Banyan right now.

Sources:

1. Healthcare.gov - Mental health & substance abuse coverage
2. AvMed - AvMed Benefits and Programs
3. AvMed - Health Plans
4. AvMed - Medicare Plans