Nirvana Recovery AZ

Does GEHA Insurance Cover Drug Rehab in Arizona? Short Answer is Yes

Graphic illustrating the question 'Does GEHA Insurance Cover Drug Rehab in Arizona?' with the short answer 'Yes,' highlighting insurance coverage for rehab services.

Yes, Nirvana Recovery, a drug rehab facility in Phoenix, Arizona, is equipped to provide personalized substance abuse treatment plans that accept GEHA insurance coverage. We offer inpatient and outpatient programs, ensuring you receive the level of care that best suits your needs.

GEHA offers multiple plans, including the High Option, Standard Option, HDHP (High Deductible Health Plan), Elevate, and Elevate Plus. Each plan has specific provisions for covering drug rehab, whether you are dealing with heroin addictionmeth addictionfentanyl addiction, or any other drug addiction. 

GEHA logo in bold purple letters, representing Government Employees Health Association, a provider of health and dental plans for federal employees and retirees.

Does Nirvana Recovery accept GEHA insurance in Arizona?

Yes, Nirvana Recovery, a drug rehab facility in Phoenix, Arizona, is equipped to provide personalized substance abuse treatment plans that accept GEHA insurance coverage. We offer inpatient and outpatient programs, ensuring you receive the level of care that best suits your needs.

GEHA offers multiple plans, including the High Option, Standard Option, HDHP (High Deductible Health Plan), Elevate, and Elevate Plus. 

How Can I Verify My GEHA Insurance Coverage for Drug Rehab at Nirvana Recovery?

Steps to Verify Your GEHA Insurance Coverage at Nirvana Recovery

1. Visit the Nirvana Recovery Website

Navigate to the “Verify Insurance” section on the Nirvana Recovery website.

2. Complete the Insurance Verification Form

Nirvana Recovery’s insurance verification form, used to check if GEHA insurance is accepted for treatment in Arizona by entering provider, policyholder, and patient details.
  • Insurance Information:
    • Insurance Provider: Select “GEHA” from the list.
    • Member ID: Enter your GEHA member identification number.
GEHA insurance card sample displaying member ID, plan type, provider network, deductible info, and CVS Caremark pharmacy benefits, used for verifying insurance coverage.
  • Policy Holder’s Name and Date of Birth: Provide the full name and birth date of the policyholder.
  • Your Information:
    • Name and Contact Details: Fill in your first and last name, email address, and phone number.
    • Treatment Seeker: Indicate whether you or someone else is seeking treatment.
  • Patient Information (if different from the policyholder):
    • Name and Date of Birth: Provide the patient’s full name and birth date.
  • Referral Source:
    • Mention how you heard about Nirvana Recovery

3. Submit the Form

  • After filling out all required fields, click the “Submit” button.

4. Await Confirmation

  • The admissions team at Nirvana Recovery will review your information, contact GEHA to verify coverage, and inform you about the extent of your benefits and any out-of-pocket costs.

Additional Support

If you prefer direct assistance, you can call Nirvana Recovery at (480) 764-2335. Our team is ready to help you navigate the insurance verification process and answer any questions about treatment options.

Pre-Authorization: Some GEHA plans may require prior authorization for substance abuse treatments. We can assist in obtaining the necessary approvals to ensure a smooth admission process.

By following these steps, you can efficiently verify your GEHA insurance coverage and take a significant step toward recovery with the support of Nirvana Recovery.

What Is Included in GEHA Insurance Drug Rehab Coverage In Arizona

GEHA insurance in Arizona provides comprehensive support for both inpatient and outpatient care. However, coverage details, copayments, and requirements vary depending on the specific plan you are enrolled in. It’s crucial for members to understand their plan’s benefits and to follow necessary procedures, such as obtaining precertification, to ensure they receive the full extent of their coverage.

Table showing GEHA insurance coverage for mental health and substance abuse services in Arizona, including coinsurance rates and pre-authorization requirements for inpatient and outpatient care.

1. Inpatient Treatment in Arizona

This is residential treatment for substance abuse, where you receive 24-hour care.

  • High Option Plan: You’re responsible for $100 daily, up to $500 total per stay. GEHA pays the rest directly to the facility
  • Standard Option Plan: Your cost is $150 per day, up to $750 total per stay. GEHA covers the remaining amount.
  • HDHP Plan: After meeting your annual deductible, you pay 20% of the allowed amount. GEHA pays 80% directly to the provider.
  • Elevate Plus Plan: Once you’ve met your deductible, you pay a flat $500 per admission. GEHA covers all other costs.
  • Elevate Plan: After meeting your deductible, you’re responsible for $1,000 per admission. GEHA pays the remainder.

2. Outpatient Treatment in Arizona

These are regular visits to a drug rehab without overnight stays.

  • High Option Plan: After meeting your deductible, you pay $20 per visit. GEHA covers the rest.
  • Standard Option Plan: After meeting your deductible, you pay $30 per visit, and GEHA pays the remaining amount.
  • HDHP Plan: Once you’ve met your deductible, you pay 20% of the allowed amount per visit. GEHA covers 80%.
  • Elevate Plus Plan: After you meet your deductible, you pay $25 per visit, and GEHA covers the rest.
  • Elevate Plan: Your cost is $50 per visit after meeting your deductible. GEHA pays the remainder.

3. Prescription Drug Coverage under GEHA Insurance in Arizona

For medications related to your substance abuse treatment:

  • High and Standard Options: You pay $10 to $90 per prescription, depending on the type of drug. GEHA covers the rest.
  • HDHP, Elevate, and Elevate Plus Plans: After meeting your deductible, you pay 25% to 40% of the allowed amount. GEHA covers the remaining 60% to 75%.

4. Telemedicine Services: For remote consultations in Arizona

Most plans have lower copayments for telemedicine. Some plans like Elevate and Elevate Plus offer $0 copayments after you’ve met your deductible. GEHA pays the provider directly for the service’s total cost beyond your copayment.

Remember, these costs assume you’re using in-network providers. GEHA will handle the billing directly with the provider, so you only need to pay your portion at the time of service. The provider will collect the rest from GEHA.

Does Substance Abuse Treatments In Arizona Require Pre Authorization From GEHA?

It’s important to note that some substance abuse treatments may require prior authorization from GEHA. Precertification ensures that the treatment is medically necessary and helps avoid unexpected costs. If precertification is not obtained, insurance benefits might be reduced, leaving you to cover a more significant portion of the drug treatment costs out-of-pocket.

GEHA coverage page detailing that substance abuse treatments in Arizona, including psychological testing and ECT/TMS, require pre-authorization by contacting UnitedHealthcare.

Pre-authorization is often required for:

  • Acute Inpatient Care: This includes care provided in a hospital setting for substance use and behavioral health disorders.
  • Residential Treatment Centers: Authorization is necessary for stays at residential treatment centers for substance use disorder.
  • Outpatient Services: Certain outpatient services, such as psychological or neuropsychological testing, Electroconvulsive Therapy (ECT), and Transcranial Magnetic Stimulation (TMS), also require prior authorization.

Providers are typically required to call UnitedHealthcare at 877.585.9643 to obtain the necessary authorizations.

How To Claim Arizona GEHA Insurance Coverage For Substance Abuse Treatment?

You generally don’t need to “claim” or seek reimbursement for substance abuse treatment if you’re using in-network providers in Arizona. The claim typically comes into play in two scenarios:

  • If you use an out-of-network provider who doesn’t bill GEHA directly.
  • If you pay for services upfront and need to submit a claim for reimbursement.

In these cases, you would submit a claim to GEHA, and they would reimburse you based on your plan’s out-of-network coverage levels, which are often lower than in-network coverage.

Claims for Substance Use Disorder

If you’re receiving Out-of-network-treatment for mental health, behavioral health, or substance use disorder, you should submit your claims to:

  • EDI Payor ID: 39026
  • Claims Address:
    • UnitedHealthcare Shared Services
    • P.O. Box 30783
    • Salt Lake City, UT 84130-0783

General UnitedHealthcare Choice Plus Claim (All 50 States)

Regardless of your location, if you’re on the UnitedHealthcare Choice Plus plan, use the following information for claim submission:

  • EDI Payer ID: 39026
  • Claims Address:
    • UnitedHealthcare Shared Services
    • P.O. Box 30783
    • Salt Lake City, UT 84130-0783
    • Provider Services Phone: (844) 586-7309

Tips for Filing Your Claims

Double-check that all information on your claims form is accurate, including your details, insurance information, and provider details.

The EDI Payor ID #39026 is used across all the claim types mentioned, ensuring submission consistency.

If you encounter any issues or have questions regarding your claims, reach out to UnitedHealthcare Provider Services at the phone numbers provided for assistance.

Conclusion

Substance abuse treatment is a critical step in the journey to recovery, and understanding how your GEHA insurance can support you in Arizona is key to accessing the care you need. Whether you require inpatient treatment, outpatient services, behavioral health service, medication management, Nirvana Recovery accepts GEHA Insurance, which offers coverage options to help alleviate your financial burden. By taking the time to understand your benefits, obtaining necessary pre-certifications, and working with in-network providers, you can focus on what truly matters: your recovery.

Nirvana Recovery features an extensive selection of specialized treatments for various substance abuse conditions, including:

  • Alcohol Addiction Treatment
  • Methamphetamine (Meth) Addiction Treatment
  • Heroin Addiction Treatment
  • Prescription Drug Addiction Treatment (e.g., opioids, benzodiazepines)
  • Cocaine Addiction Treatment
  • Marijuana Addiction Treatment
  • Fentanyl Addiction Treatment
  • Ecstasy (MDMA) Addiction Treatment
  • Hallucinogen Addiction Treatment
  • Inhalant Addiction Treatment
  • Stimulant Addiction Treatment
  • Synthetic Drug Addiction Treatment (e.g., synthetic marijuana, bath salts)

For more information on substance abuse treatment in Arizona or to explore the services available at Nirvana Recovery, visit Nirvana Recovery AZ.

Frequently Asked Questions

Under GEHA insurance, out-of-pocket costs include deductibles, copayments, and coinsurance. The exact amount varies depending on your specific plan (e.g., High Option, Standard Option, HDHP, Elevate, or Elevate Plus). For instance, inpatient treatment might cost $100 to $1,000 per admission, depending on the plan, and outpatient visits may have copayments ranging from $20 to $50 per session. It’s essential to review your plan details to estimate your expenses accurately.

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Nirvana Recovery