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  • Optima Health Insurance is a company in the state of Virginia that provides a wide-range of insurance products. They offer individual plans as well as coverage options for employers and people on Medicare/Medicaid. 

    Their insurance plans can cover behavioral health services like addiction treatment. 

    Find Alcohol And Drug Rehab Centers That Accept Your Health Insurance

    How To Determine Optima Health Benefits For Substance Abuse Treatment

    Each insurance plan has a different approach to covering alcohol and drug addiction recovery programs. Here are the fastest ways to determine covered services for treatment: 

    • read the details of your Optima Health Plan on optimahealth.com 
    • contact the insurance company and ask about member services
    • ask for a referral from your primary care physician (PCP) for an in-network provider
    • reach out to a treatment center an ask about insurance validation 

    Does Optima Health Insurance Cover Detoxification Programs?

    Optima Health Insurance can cover the cost of a detox program if it’s determined to be medically necessary. In a detox program, your treatment plan provider may offer medical support to help people with substance use disorder safely get through withdrawal. 

    Learn more about Medical Drug & Alcohol Detox Programs

    Does Optima Health Insurance Cover Inpatient Drug Or Alcohol Rehab?

    Residential treatment programs offer a holistic/wellness approach to addiction rehab. They include 24-hour access to treatments and supportive staff. These rehabilitation services are often covered by insurance

    Learn more about Inpatient Rehab Programs

    Does Optima Health Insurance Cover Outpatient Programs?

    Outpatient treatment plans allow individuals to schedule addiction treatment or office visits around other activities such as work, school, and personal responsibilities. 

    These treatment services allow people to continue to maintain their social support network from loved ones or family members. Health insurance often covers outpatient services

    Learn more about Outpatient Rehab Programs

    Does Optima Health Insurance Cover Intensive Outpatient Treatment?

    An intensive outpatient program (IOP) meets three days each week and offers a blended level of care for addiction recovery. These programs can be covered by health insurance. Outpatient programs are ideal for people in need of follow-up care after inpatient treatment. 

    Learn more about Intensive Outpatient Programs

    Does Optima Health Insurance Cover Partial Hospitalization Programs?

    A partial hospitalization program (PHP) provides the most comprehensive type of outpatient services. The goal of a PHP is to offer treatments similar to a residential program, but in an outpatient treatment center. 

    The cost of this type of treatment can be managed by health insurance coverage from Optima

    Learn more about Partial Hospitalization Programs

    Does Optima Health Insurance Cover Methadone Or Suboxone Treatment?

    Your health coverage from Optima may cover medications like methadone and Suboxone to help people struggling with opioid addiction. Check your policy to see if there is a prescription drug list or formulary detailed in your plan. 

    These medications do not replace the addictive substance, but rather work to reduce cravings, dependence, and withdrawal. Health insurance plans may cover this type of treatment.  

    Learn more about Opioid Addiction Treatment Programs

    Does Optima Health Insurance Cover Medication-Assisted Treatment For Alcohol Addiction?

    Alcohol rehab programs often include a level of medication-assisted treatment. Also known as MAT, this type of treatment uses a combination of therapy and medications to address severe alcohol addiction. Health insurance from Optima may cover this type of treatment

    Learn more about Medication-Assisted Treatment Programs

    Where Are Optima Health Insurance Plans Available?

    Optima Health Insurance offers plans for residents of the state of Virginia. This insurance provider creates plans available publicly for individuals and their families. They also create plans for companies who need to provide coverage for their employees in the state of Virginia. 

    Types Of Optima Health Insurance Plans

    Optima Health provides health insurance plans that can help with the cost of addiction treatment. These programs are both available privately and on the ACA marketplace. 

    They also offer HMO and PPO plans, as well plans for self-employed individuals, companies, and Medicare/Medicaid. 

    OptimaFit Direct

    This plan covers Charlottesville, Halifax, Hampton Roads, Harrisonburg, Mecklenburg, Richmond, and Rockingham. Coverage may also extend to the surrounding areas. 

    It covers most providers except those associated with the University of Virginia Health System and Mary Washington Healthcare. 

    OptimaFit Select

    This program relies on local doctors and facilities to help people get the healthcare services they need. This coverage option applies to Charlottesville, Rockingham, and could also cover other areas. The select network includes a specific list of accepted health care providers. 

    Other Plans 

    The other plans available from Optima Health Insurance might also help with the cost of behavioral health treatment. These programs can be for self-employed individuals, employees, and other types of coverage such as employee assistance programs. 

    Verify Your Insurance Coverage

    Insurance coverage is complex and it can be hard to know if addiction treatment is covered. You’ll likely have to wait for pre-authorization and other factors to determine the exact cost of treatment.

    What you have to pay for an addiction treatment program depends on the level of health insurance you have and if you’re dealing with in-network or out-of-network providers. 

    Your plan’s copayments, coinsurance fees, deductibles, and what treatment centers it has in-network can also contribute to your maximum out-of-pocket costs at a treatment facility. 

    To verify your insurance coverage, please contact Ark Behavioral Health today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.
    Sources

    Optima Health - Frequently Asked Questions | Members
    Substance Abuse and Mental Health Services Administration - Find Treatment

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