AvMed In-Network (HMO) Provider for Florida

In-Network (HMO) Provider for Addiction Treatment

Friday, July 3, 2020 | By Cooper Samp

Coalition Recovery is an in-network provider with AvMed. Through these in-network contracts, we have been able to serve the greater population of Florida. Therefore, whether you have an in-network policy (HMO, out-of-network-policy (PPO), you can ensure the most cost effective treatment by attending an in-network facility.

The cost of treatment with an AvMed policy at Coalition Recovery may only be your deductible.* Call our admission specialists to learn how much treatment will be for you and your AvMed insurance policy.

AvMed

Formerly Aviation Medicine, AvMed started in 1969 as a niche healthcare insurance coverage provider for the growing air travel industry in Miami, Florida. Today, AvMed provides commercial, private and Medicare health coverage to more than 380,000 Floridians in over 30 counties throughout the state.

AvMed is one of Florida’s oldest and largest not-for-profit health plans. AvMed’s mission is to promote greater health and motivate its members to live a healthier life. With a membership of more than 340,000, AvMed supplies Medicare Advantage coverage in Broward and Miami-Dade counties, Individual and family coverage in South Florida, Orlando, Gainesville and Jacksonville and employer group plans in more than 30 counties throughout the state of Florida.

AvMed offers members a local plan with customized service without the limitations usually connected with regional health insurance. Members have access to a broad service provider network and care management options.

AvMed is a local medical insurance provider that mainly runs in South Florida and Central Florida. AvMed plans have great protection within its geographic footprint, but do not have as strong of a statewide or nationwide network. AvMed plans tend to be amongst the lowest price plans available.

AvMed provides 3 various networks, consisting of a PPO, POS, and HMO choice.

AvMed insurance covers drug abuse and mental health treatment, though the level and type of protection will differ from one plan to another.

If you have AvMed health insurance and you need treatment for addiction, confirm your benefits and learn more about payment alternatives with Coalition Recovery.

Kinds Of Treatment Options AvMed Health Insurance Typically Covers

Many health insurance plans, consisting of AvMed, cover drug abuse treatment.

Inpatient/residential occurs in settings where you stay overnight for durations of a few days to a number of months.

The types of treatment covered and the level of coverage will depend on your plan. Types of rehab that may be covered include:.

Inpatient/residential

This takes place in settings where you remain overnight for periods of a few days to several months. Inpatient rehab can be hospital-based, or it might occur in residential centers. Treatment often consists of medical care, private and group therapy, 12-step meetings, drug education, and recreational activities.

Partial hospitalization

PHP might be run in connection with inpatient healthcare facility rehabilitation programs. For some individuals,  PHP works as the preliminary point of treatment; in other cases, it represents a step-down program for those having currently completed an inpatient or residential program. Partial hospitalization programs (PHPs) are typically similar to inpatient programs, offering several hours a day of groups and other types of therapy. The major distinction around PHPs and inpatient treatment is that you return home or to a sober living residence at night. Some partial programs might satisfy 4 or 5 days a week, while some satisfy 7 days each week. Coalition Recovery offers room and board for customers in its PHPs.

Intensive outpatient programs (IOP), 

IOP typically meets 2-3 hours per day, 2-4 days weekly. Like partial hospitalization, an IOP can be the very first type of treatment someone receives, or it can be a step down from either partial hospitalization or an inpatient or residential program. Coalition Recovery offers room and board for customers in its IOPs who are not local residents.

Conventional outpatient treatment

Usually consists of individualized or group therapy sessions with a counselor, generally held once weekly, though you might go more than once each week. Outpatient treatment is normally a follow-up to inpatient treatment, partial hospitalization, or an IOP treatment program.

After reading these explanations, you may be wondering which kind of program is the best fit for you. A few of the factors used to identify the ideal rehabilitation setting for somebody consist of:

  • Withdrawal-associated threats.
  • General physical health.
  • Mental health.
  • Preparedness to begin the recovery process.
  • Prospective for relapse.
  • Home environment.

Abruptly giving up substances, such as alcohol or benzodiazepines, can set off seizures throughout withdrawal. Often, if you have been using these drugs for a couple of months or more, you will require medical management of your withdrawal prior to you start treatment. A medical detox can be performed in a freestanding detox or an inpatient program. After detox, it is recommended that you transition into an official treatment program.

Kinds Of Addictions Covered

Lots of rehab programs deal with all types of substance dependency, and AvMed plans normally cover the full variety, consisting of dependencies to:

  • Heroin
  • Alcohol
  • Benzodiazepines, such as Xanax and Klonopin
  • Opioid painkillers, such as oxycodone and hydrocodone
  • Methamphetamine
  • Cannabis
  • Other prescription drugs, such as Adderall or Ambien
  • Cocaine

What Does AvMed Health Insurance Specifically Pay For?

AvMed coverage varies from one plan to another; nevertheless, AvMed plans with rehab protection typically cover the basic services of treatment, that include:.

Intake evaluations.

  • Psychosocial assessments
  • Detox treatment
  • Medications
  • Medical and psychiatric examinations
  • Treatment, both group and private

Will My Employer Find Out?

Your treatment center is not permitted to inform someone outside the center that you are a client. The confidentiality of your health information is protected by law. As a result, providers go to great lengths to protect what is known as your PHI, or protected health information. Your PHI consists of details such as physical or mental health conditions you might have, health care services offered to you, and payment for health care services.

Subsequently, you can look for drug rehabilitation without being concerned that your company will find that you are getting drug abuse treatment.

Am I Covered for Addiction Treatment?

We’ll be able to inform you if your service provider is in network with Coalition Recovery. This indicates your treatment may be FREE depending on your policy, copay, and deductible.

What if My Service provider Is Out of Network?

Many insurance policies motivate you to see in-network providers. In-network providers normally have negotiated prices for services and benefits for plan members. Your out-of-pocket costs may be greater if you see an out-of-network service provider than if you see an in-network service provider.

Just How Much Will I Pay Out of Pocket?

Whether you go to an out-of-network or in-network provider, you will generally need to pay a deductible, co-pay, and/or coinsurance. Your AvMed policy might have a set deductible, which is the amount that you need to cover out of pocket for covered services prior to your insurance protection begins to take effect. In addition, you may have a copay, which is a flat quantity you pay each time you get a service. Coinsurance is a percentage of the cost of a covered service that you pay.

For numerous drug rehabilitation programs, you will likewise have to get preauthorization from AvMed, where they will make a decision about whether your care is medically essential. Preauthorization might or may not be required for outpatient services. In some cases, you will be required to get preauthorization within 48 hours of admission, however in other cases, it might be needed prior to you being admitted.

This process may sound complicated and hard, but one of our admissions navigators can assist you comprehend your specific benefits and what to expect in regards to your out-of-pocket expenses and the steps necessary to start treatment.

How Do I Get Started?

Coalition Recovery can confirm your AvMed insurance benefits and let you know what may be covered. After identifying your benefits, we can then assist you discover the right treatment service provider for your particular requirements. Rest assured that your call is classified and there will be no pressure placed on you. You can call us today at 888-707-2873 to speak with an admissions navigator or inspect your benefits utilizing the form on this page.

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