Seeking Treatment Through a Tufts Insurance Plan

Insurance is a vital financial resource for anyone with serious substance problems. It allows you to cover at least part of your costs while receiving the help you need. However, not all insurance providers are the same. Some providers cover a broad array of addiction-related services. Others only cover certain kinds of services. Knowledge of the coverage available under your specific provider is essential.

One potential option for health insurance is Tufts. This Massachusetts-based provider covers a wide range of services for its policyholders. That includes extensive services for the treatment of alcohol- and drug-related problems. Keep reading to learn the key details of the coverage offered through Tufts insurance for rehab.

What is Tufts Insurance

Tufts insurance is formally known as Tufts Health Plan. Formed in the late 1970s by members of Tufts University School of Medicine, it operates on a non-profit basis. In addition to serving Massachusetts residents, the organization provides policies for residents of Rhode Island and Connecticut. It also offers coverage to people in other states through national network plans.

More than 100 hospitals and 51,000 treatment providers offer in-network coverage through Tufts. The organization currently serves well over 1,000,000 people. Tufts offers a variety of plans for its members. The list of available options includes:

  • Coverage sponsored by your employer
  • Individual coverage
  • Medicare coverage
  • Medicaid coverage
  • Combined Medicare and Medicaid coverage

Tufts not only provides health insurance. It also advocates for change in the health insurance industry. Specific issues the organization focuses on include:

  • Wider access to healthcare services
  • Affordable insurance coverage
  • Prevention and wellness efforts

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Tufts Insurance for Behavioral Health

Will Tufts cover drug and alcohol treatment? Yes. The organization places an emphasis on providing help for people with substance problems. It places the same emphasis on helping people with other kinds of mental health conditions. Both of these issues are covered through Tufts’ Behavioral Health Department.

Common Features of Tufts Healthcare Policies

Tufts offers multiple kinds of behavioral health plans to its members. Your options include:

  • A health maintenance organization or HMO plan
  • A preferred provider organization or PPO plan
  • An exclusive provider organization or EPO plan
  • A point of service or POS plan

The organization also offers tiered plans. These plans provide you with full access to Tufts’ provider network. However, providers are grouped in levels or tiers. Each tier contains services of a certain value. In addition, there is Tufts Premier, a plan designed for small groups and individuals.

All of these plans share Tufts’ core commitment to treatment accessibility. This means that each of them covers certain core services. However, despite their common features, there are differences between available policies. The biggest differences are in the EPO and POS plans. If you have one of these plans, your inpatient or outpatient rehab treatment may not be covered.

 Features of In-Network Tufts Treatment Centers

In-network treatment centers that accept Tufts insurance for rehab typically provide a number of services. Examples of these core services include:

  • Standard outpatient care
  • Intensive outpatient care
  • Partial hospitalization
  • Residential care

Standard outpatient care provides adults with eight hours or less of weekly treatment. It provides teenagers with treatment five hours or less per week. In intensive outpatient care, adults and teens receive between nine and 19 hours of weekly treatment. Partial hospitalization is also an outpatient option. It provides adults and teens with 20 hours or more of treatment per week. Residential care provides 24/7 support in a live-in environment.

Tufts Insurance for Rehab

Medication-Assisted Treatment With Tufts Coverage

Medication-assisted treatment, or MAT, is the term for a combined form of addiction treatment. It features both medication and some kind of psychotherapy or counseling. The goal of MAT is not just to address addiction itself. The approach also seeks to put your treatment in the context of all aspects of your life.

MAT is typically intended to help people affected by opioid addiction. Three medications are used for this purpose:

  • Methadone
  • Suboxone or other buprenorphine products
  • Vivitrol or other naltrexone products

Suboxone and methadone are opioid medications. In MAT, they do not serve as a substitute “high.” Instead, they help you halt your uncontrolled opioid use by easing the effects of withdrawal. Vivitrol is an opioid blocker. It reinforces sobriety once opioids are out of your system. MAT psychotherapy helps you establish a long-term pattern of sobriety.

Does Tufts insurance for rehab cover medication-assisted treatment? Yes, it does. For people with the appropriate Tufts plans, MAT coverage is provided when deemed medically necessary. Check your plan for more details on insurance for MAT.

Aftercare Planning With Tufts

Aftercare is also known as continuing care. These umbrella terms refer to recovery assistance you receive after completing your main treatment program. Aftercare of some kind is recommended for everyone who goes through substance rehab. Why? It allows you to stay in touch with resources vital to your ongoing sobriety.

This is crucial given the chronic nature of addiction. Like all chronic illnesses, addiction must be managed over time. If you fail to do so, it can flare up and lead to a relapse back into drug or alcohol use. Aftercare typically involves help from a doctor, addiction specialist or other medical professional. Your aftercare plan may also include enrollment in a mutual self-help group like Alcoholics Anonymous.

Tufts insurance for rehab offers extensive aftercare assistance. The organization refers to this assistance as utilization management. In Tufts utilization management, a care coordinator helps you establish an appropriate aftercare plan. This coordinator also helps ensure that your plan includes all needed long-term services. Check your policy to see if it covers utilization management.

Immediate Placement for Mental Health Treatment

Does Tufts Cover Sober Living

Sober living is an approach that helps you transition from a rehab program back to your everyday life. Instead of going straight home, you live in a home with others dedicated to maintaining their newfound sobriety. While in this home, you do things such as:

  • Interact with your peers
  • Gain needed support for your sobriety efforts
  • Help keep the household functional
  • Spend your days taking care of any offsite responsibilities

Tufts insurance for rehab may include sober living as a form of aftercare. However, in most states, sober living homes do not accept private insurance. They also do not accept state-supported insurance. Check with your policy to see which rules govern your particular location.

Tufts Insurance for Rehab

Making the Most of Your Tufts Healthcare Coverage and Benefits

If you have Tufts insurance, it is important that you make the most of its provided benefits. Otherwise, you could find yourself saddled with unnecessary financial burdens. Take the time to read the details of your policy in regard to substance and mental health treatment. If you need help understanding it, call a Tufts representative for assistance.

You can also seek help from in-network healthcare providers. These providers will let you know what specific services they offer through Tufts coverage. They will also let you know if your specific Tufts plan covers any given rehab service.

Alternative Ways to Pay for Addiction Treatment

Today, most people have insurance plans that cover at least part of the cost of addiction treatment. Some of these plans are provided through an employer. Others are provided through coverage obtained under the federal Affordable Care Act.

However, even with these options available, not everyone has adequate coverage. If you have insurance, your plan may not cover all of your rehab costs. In addition, you may not have insurance at all.

What can you do in these situations? Fortunately, many rehab programs offer alternative options for paying for the cost of treatment. These options typically take the form of installment agreements. Such agreements allow you to pay for your treatment out-of-pocket on a regular schedule. In this way, they make it possible to fit rehab into your budget. If you need to pay in installments, ask your chosen program(s) if they can make suitable arrangements.

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Emerald Isle Health & Recovery: In-Network With Tufts

Do you have Tufts insurance for rehab? Emerald Isle an Arizona-based provider and part of Tufts Health Plan’s national network. If you need or prefer substance treatment in greater Phoenix, we will accept your Tufts coverage.

Emerald Isle is a premier resource for effective substance treatment. Our services support your recovery from problems with alcoholism or serious alcohol abuse. They also support your recovery from opioids, sedatives, stimulants and other widely used addictive drugs. In addition, we have options for treating some of the lesser-known sources of drug addiction.

Our comprehensive slate of programs includes residential treatment. It also includes standard and intensive outpatient care, as well as partial hospitalization. In all cases, we match your program options to the specific details of your unique situation. Emerald Isle is also a provider of dual diagnosis treatment. This treatment supports your recovery from the combination of substance problems and additional mental health issues.

Need more information on using Tufts insurance at Emerald Isle? Call us today. We’ll be happy to answer any questions and help you sort out the terms of your coverage.