Providence Insurance Coverage for Rehab and Detox

Does Providence Cover Detox or Rehab?

Providence insurance offers rehab coverage as is required under the Affordable Care Act. Rehab & detox coverage under your Providence health plan can include the following in-network substance abuse treatment services.⁸ The specific substance abuse coverage provided by Providence will vary depending on your specific insurance plan and the state in which you live.

How to Check your Providence Substance Abuse Coverage

Your Providence drug rehab insurance coverage depends on your plan and the state where you live. If you have questions about your plan’s out-of-state coverage, the Providence health plan network, deductibles, covered services, or anything else, you can visit Providence’s own website or call their customer service line directly.

Again, each insurance plan varies in rehab services covered, deductibles, and other out-of-pocket costs. Some have a set cost for these services while other plans require you to pay a percentage of the total cost of services after your deductible has been met. This is why it is important that you check with Providence directly to better understand your rehab coverage and how to use it to pay for rehab. 

How to Find Providence Rehab Centers

As a nationwide provider of rehab, American Addiction Centers (AAC) works with insurance providers like Providence to help people in need access addiction treatment services.

If you have questions about your Providence substance abuse treatment coverage or how to pay for rehab you can call our confidential detox hotline and speak with a member of our team.

Types of Providence Health Plans

Providence offers several healthcare plans in Washington and Oregon, and there are differences in each state. In Washington, for example, 2 different classifications of plans are available for individuals and families: Columbia plans and Providence Cascade plans.² 

Providence Columbia Plans

With a Columbia plan, you must choose an in-network provider for your rehab services to be covered by Providence. ³ Using an out-of-network rehab center could result in more out-of-pocket costs than anticipated. The plan requires you to choose a medical home from Providence’s list of approved providers. The medical home is where you receive your primary care with in-network providers. If you require a specialty service, like detox or rehab, you must receive a referral from your medical home provider.³

There are 3 different levels to choose from:

• The Columbia 1500 Gold plan has a $1,500 deductible and out-of-pocket costs are capped at $8,200 per calendar year.⁴
• Columbia 4500 Silver plan has a deductible of $4,500 with a maximum out-of-pocket cost of $8,550.⁵
• The Columbia 8550 Bronze plan is the last of the 3 Columbia plan options. With this plan, the deductible and the out-of-pocket maximum are both $8,550.⁶

Providence Cascade Plans

Cascade plans are similar to Columbia plans in that you are still required to use in-network providers and you need a referral for specialty services such as rehab or detox.⁷ Unlike Columbia plans, they provide cost-sharing products that include deductibles, coinsurance, and copays.⁷ One of the major differences between the 2 plans is the deductibles and maximum out-of-pocket costs.

 The 3 plans under the Cascade umbrella are:

• The Cascade Gold plan has an annual deductible is $500 and an out-of-pocket cost cap of $5,250.⁸
• With the Cascade Silver plan, you can expect a higher deductible and out-of-pocket costs. The deductible is $2,000, and maximum out-of-pocket costs are $8,200.⁹
• The Cascade Bronze plan has the highest deductible at $6,000 and a maximum out-of-pocket cost of $8,550.¹⁰

Providence Health Plan also offers Medicare Advantage plans. Medicare is a government-sourced insurance program serving people 65 years and older and people who meet certain criteria.¹¹