Insurance and Outpatient Admission

 

Insurance Coverage for IOP

 

Most insurance plans cover IOPs under behavioral health services, but coverage varies based on policy terms and medical necessity.

 

Employer-sponsored and ACA marketplace plans must comply with the Mental Health Parity and Addiction Equity Act (MHPAEA), ensuring mental health benefits are comparable to medical benefits.

 

Medicaid and Medicare may cover IOPs, but eligibility requirements differ by State Programs.

Cost-sharing elements like deductibles, copayments, and coinsurance affect out-of-pocket expenses.

 

Admission Process

Verification of Insurance: Marula Rehab offers free insurance verification to determine coverage.

Eligibility Assessment: Providers assess medical necessity based on clinical guidelines like those from the American Society of Addiction Medicine (ASAM).

 

Preauthorization: Some insurers require prior approval before covering IOP treatment.

 

Payment Options: If insurance doesn’t fully cover treatment, Marula Rehab may offer sliding fee scales or payment assistance.

 

Non-Insured: Marula Rehab Finance Managment is available to assist participants who are uninsured or under insured by assisting in the Completion of a Medicaid Application, and additionally, offers a sliding scale fee reduction to assist in defraying the cost of treatment and services.

 

 

Note: Marula Rehab Telehealth Intensive Outpatient Treatment does not prescribe prescription medications and participants who seek prescription treatment to aid in sobriety from Substance Abuse Addiction may need to seek the advice of their primary physician.