Multiplan Insurance (PHCS)

Multiplan is a facilitator of preferred provider organization (PPO) networks operating in certain areas of the United States. Multiplan isn’t a company that directly provides insurance to members. Instead, members access Multiplan health insurance services through an administrator of a health plan or the payer of medical bills. Multiplan offers discounted rates on providers and they also connect people with nearly a million PPO healthcare providers not only in the southwest but also in Wisconsin and other states throughout the country.

Multiplan also offers services for government and commercial healthcare programs. When someone has insurance through one of the insurance payers and carriers that work with Multiplan, their coverage is considered part of the Multiplan network.

With a PPO there is typically more flexibility as compared to health maintenance organization (HMO) plans, and there are fewer restrictions on seeing providers outside of the network. While a PPO may cover the costs of non-network services and providers, they will usually do so at a lower rate.

Does Multiplan Cover Drug and Alcohol Detox?

The insurance plans that are part of Multiplan’s network will cover a broad range of services. The provision of drug and alcohol detox and addiction treatment was also significantly expanded by most insurance companies following the enactment of the Affordable Care Act. The Affordable Care Act requires Marketplace insurance plans to cover mental health and substance abuse treatment as essential health care services.

If someone has insurance through companies that are part of the Multiplan network, they may have coverage not only for drug and alcohol detox but other types of addiction treatment including:

  • Inpatient residential addiction treatment
  • Intensive outpatient treatment
  • Individual outpatient treatment including medication management and individual therapy

Benefits Offered from Multiplan for Addiction Treatment

While Multiplan isn’t a health insurance provider, the company creates a network of health insurance programs and products. Then, direct insurance carriers can use the Multiplan network to provide PPO coverage to their customers. By contracting with Multiplan, the insurance carriers have access to a greater provider network.

In terms of mental health care and addiction treatment, how much coverage you may be eligible for depends on your network, your plan and the state you live in.  

With PPO health insurance, you will often have the ability to work with the provider you choose without a referral, although they may need to be in-network to pay lower out-of-pocket costs.

If you do have a network through Multiplan, you can’t contact them to learn more about your coverage. Instead, you need to contact The Recovery Village Ridgefield and we can help you, or you can directly contact the benefits administrator for your health insurance plan. Then, you can learn more about the exact level of coverage available to you for addiction treatment.

Will Multiplan Cover My Entire Stay for Addiction Treatment?

Since Multiplan isn’t a direct health insurance provider, they don’t cover any of the stay for addiction treatment. However, addiction treatment centers that are part of their network may be covered if your plan is part of Multiplan. Where you live and your plan determines how much of addiction treatment is covered and what you’re responsible to pay out-of-pocket.

Most insurance plans cover some or all of the cost of addiction treatment, and The Recovery Village Ridgefield works with many of the primary insurance providers in the country.

Find Out More About What My Multiplan Insurance Plan Covers

If you would like to learn more about your insurance coverage for addiction treatment, contact our admissions specialists at The Recovery Village Ridgefield. Our admissions team can check with your insurance company and create a list of covered services. We can also coordinate with your insurance company on your behalf. Contact us to learn more.

Sources:

Medical Mutual. “HMO vs. PPO Insurance Plans.” Accessed March 5, 2019.