Does Community Care Behavioral Health Cover Drug Rehab in Pennsylvania?

Does Community Care Behavioral Health Cover Drug Rehab?

Community Care Behavioral Health Organization, which is also commonly referred to as Community Care, Community Care Behavioral Health, or CCBH, is the largest not-for-profit managed care organization for behavioral health in the United States.

Community Care Behavioral Health, as its name implies, focuses on behavioral healthcare services, a category that includes drug rehab and other forms of treatment related to substance abuse and addiction. Part of the UPMC Health System, Community Care Behavioral Health serves policyholders across Pennsylvania and in parts of New York.

For policyholders who seek treatment for themselves or for a covered family member in Pennsylvania, Community Care will fund a variety of services that are associated with drug rehab. Of course, the specific types and levels of treatment that you or your loved one may be eligible to receive through your Community Care policy will be determined by a variety of factors, including the specific needs of the individual who needs care and the parameters of your specific policy.

To learn about the types and levels of addiction-related treatment services that are covered under your Community Care Behavioral Health Organization policy, please contact White Deer Run at your earliest convenience. Friendly and knowledgeable members of our team are available 24/7 to answer all of your insurance questions.

What Types of Drug Rehab Does Community Care Behavioral Health Cover?

Determining the specific types and levels of care that are covered by your Community Care policy will require a close examination of your policy’s details. As noted in the previous section, we are happy to assist you in that endeavor. In the interim, the following are examples of drug rehab and related types of care that may be covered by an insurance policy that was issued through Community Care Behavioral Health:

  • Detoxification
  • Inpatient treatment for mental health disorders
  • Inpatient treatment for a substance use disorder
  • Treatment in a partial hospitalization program (IOP) for a mental health disorder and/or substance use disorder
  • Treatment in an intensive outpatient program (IOP) for a mental health disorder and/or substance use disorder
  • Traditional outpatient services for a mental health disorder and/or substance use disorder

Virtually all care for a substance use disorder (which is the clinical term for addiction) or a related mental health disorder will need to be authorized by Community Care Behavioral Health prior to the start of treatment. Also, your policy may include limits on the amount of money that Community Care will contribute toward your treatment, and may also limit the amount of time that you can remain in treatment and still have your care funded by your insurance.

The variances and limitations in your insurance policy may be influenced by several factors, including but not limited to the type of policy that you possess and the current needs and treatment history of the individual who is receiving care. To determine what addiction treatment services at White Deer Run are covered under your Community Care Behavioral Health policy, please contact us and have your insurance policy information with you. One of our team members will be happy to identify and access all benefits that you are eligible to receive through your Community Care policy.

How Much of the Cost of Drug Rehab is Covered by Community Care Behavioral Health?

Getting a complete understanding of the financial aspect of your treatment at White Deer Run, or of the treatment of a family member who is covered by your Community Care policy, involves three components:

  • Identifying the specific needs of the individual, which allows our experts to decide which types and levels of care are best suited to meeting those needs and preparing the individual for long-term success
  • Confirming which types and levels of services are authorized under your Community Care policy
  • Determining financial limits, co-pays, or length of care limitations in your Community Care policy

Once you know what kind of treatment you or your loved one needs, what kinds of treatment your Community Care policy will cover, and what limitations Community Care will place upon that coverage, then you will have an accurate picture of what percentage of the total cost of drug rehab will be covered by Community Care Behavioral Health, and what percentage you may be responsible for paying.

It is also important to understand that the process of getting and retaining authorization from Community Care Behavioral Health or any other insurance provider typically involves ongoing updates from the treatment provider to the insurer to document the needs and progress of the individual who is receiving care. This process is known as utilization review.

At White Deer Run, we have professionals on our team who have significant experience with the utilization review process, and we are prepared to advocate on your behalf or on behalf of your loved one in order to secure the best possible care.

What Can I Do if Community Care Behavioral Health Doesn’t Cover All of My Drug Rehab Needs?

Once we have made the determinations outlined in the previous section, we will be able to address your financial obligations in an informed manner. It is not uncommon for individuals who have a Community Care Behavioral Health policy or who are insured via other providers to be responsible for paying for a portion of their care.

We understand that worries about paying for care unfortunately prevent some people from seeking treatment for substance abuse or a related concern, and we encourage you not to let such concerns stop you from continuing your efforts. At White Deer Run, we are dedicated to working with all who contact us to find treatment opportunities that meet their financial situations. Depending upon your unique situation, we may be able to help you secure alternative means for funding treatment beyond what your Community Care policy provides, or we may be able to refer you to a treatment provider that is better suited to providing you with the care that you need.

Regardless of your final decision, contacting White Deer Run will allow our experts to help you develop a full understanding of the financial implications of receiving care, and can guide you toward the treatment option that is best for you and your family.

How Can I Confirm My Community Care Behavioral Health Benefits?

Answers to all of your insurance questions, including confirming the benefits to which you are entitled under your policy with Community Care Behavioral Health Organization, are as close as a phone call away. If you have your Community Care insurance card or a copy of your policy at hand when you call White Deer Run, the experienced professional with whom you speak will be able to get you the information that you need in order to make the optimal treatment decisions for yourself or your loved one.

We are available to take your call 24 hours a day, seven days a week, and we are happy to be of service to you and your family.

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