CarePlus Insurance Coverage

Did you know that about 1 in 3 adults in the country had either a mental illness or substance abuse disorder in 2021? And a majority of these people didn’t get the right treatment because it was too costly.

High out-of-pocket expenses, copays, and prescription costs make treatment expensive. But with types of insurance such as CarePlus Medicare, patients get to spend less.

As a Miami-based health insurer, CarePlus caters to people in certain regions of Florida. These regions include North Florida, South Florida, Orlando Area, Treasure and Space Coasts, and Tampa Bay Area. As discussed in this guide, you can get partial or full CarePlus coverage for mental health and substance abuse treatment.

How it Works

The law requires insurance companies to offer coverage for mental health and addiction treatment. You can find this mandate in the Mental Health Parity and Addiction Equity Act of 2008.

CarePlus Medicare Advantage plans offer discounts and benefits for eligible treatments. You can enjoy these offerings with a referral from your physician.

The insurance company seeks to make healthcare services more affordable for members. They are also in partnership with Magellan Healthcare Inc. Through this partnership, they manage to improve communication between medical providers.

To enjoy CarePlus benefits, find an institution that accepts CarePlus insurance. Doing this will cut the costs of the treatments. It gives you peace of mind while allowing you to focus on recovering.

The amount of coverage will vary depending on the deductible and plan requirements. It also varies with the location of the mental health treatment facility and substance abuse treatment center.

Eligible Treatment Services

CarePlus Health allows its members to enjoy partial or full coverage. The insurance plans apply to different substance abuse treatments.

Eligible treatment services include preventative screenings, behavioral counseling, and inpatient/outpatient hospital services. Others include prescription drugs and medically-assisted detox.

Note that CarePlus’s insurance options have a limited range. So, they may not cover treatment costs from all rehab providers or centers.

For mental health conditions, Medicare insurance covers bipolar disorder, schizophrenia, anxiety, and depression. Refer to the fine print of the insurance plan for more details on its exclusions or limits.

Comprehensive Wellness Centers offer treatment for substance abuse and mental health problems with CarePlus. For substance abuse, the coverage spans four types of treatment. They include dual diagnosis treatment, residential treatment, partial hospitalization and intensive outpatient.

The dual diagnosis addiction treatment touches on both addiction and mental illness. Consequently, the residential treatment is suitable for people suffering from severe substance use disorders. It offers 24-hour supervision and support, allowing patients to get sober.

Inpatient and Outpatient Programs

The partial hospitalization program covers holistic treatment options, case management with professionals, and group sessions, among others. It features individualized plans to help in recovery. The intensive outpatient treatment program allows patients to receive support and help from home.

For mental illness, Comprehensive Wellness Centers have inpatient and outpatient programs. The CWC inpatient mental health facilities spread across Florida facilitate inpatient treatment.

The centers also offer the outpatient program in two levels, partial hospitalization and intensive outpatient. Each of them targets patients’ specific needs for recovery.

CarePlus Medicare for Inpatient Treatment

The patient may need inpatient treatment depending on the condition. In the case of addiction or substance abuse, the treatment will take place in a rehab center. And for a severe mental health condition, it may take place in a psychiatric ward.

Either way, this intensive treatment helps the patient overcome their condition. It offers round-the-clock care and supervision needed for recovery.

The amount of coverage CarePlus Health members can use for inpatient treatment varies. Also, the insurer expects the patient to seek treatment from accredited facilities. Their inpatient program should accept CarePlus Health plans.

CarePlus Medicare for Outpatient Treatment

Recovery from a mental health condition or addiction may need outpatient treatment too. For this treatment, the patient will need regular appointments. They’ll see a psychiatrist, doctor, or counselor.

These sessions are important after completing an inpatient treatment program. They are crucial for long-term mental health and addiction recovery.

Attending an outpatient program is also another aftercare option that patients can consider. It involves spending time at a counseling facility or joining support groups.

CarePlus Health members can enjoy outpatient services at reduced costs or for free. Co-payments are either optional or mandatory. It depends on the location, treatment level, and plan.

To enjoy these benefits, the outpatient program provider should accept CarePlus insurance. Checking with the facility or provider can help confirm this information. The same applies to speaking with a CarePlus representative.

Prescription Drugs Covered Under the Plan

Prescription drugs can help treat drug and alcohol addiction and mental health conditions. Patients are less likely to relapse when they combine behavioral therapy with medications.

CarePlus recognizes the effectiveness of prescription drugs for mental health and addiction recovery. As such, their insurance plans offer coverage for prescription drugs. But, the amount of coverage depends on the types of drugs.

Refer to CarePlus’ Prescription Drug Guides for further explanations on this coverage. The guide is available online for the convenience of all members.

Using Your CarePlus Plan To Pay For Rehab or Psychiatric Admission

You can use your CarePlus plan to pay for psychiatric admission or rehab. But certain factors come into play when you do this.

First, you have to check if the plan needs evidence of medical necessity. You should also check if you need a doctor’s approval for the treatment.

Your doctor can determine whether you need to go to the rehab or psychiatric ward. A clinical assessment will help confirm that you need the treatment. After this assessment, they will issue some paperwork that you need to submit to your insurer.

The insurer has to acknowledge that the treatment is necessary. With this acknowledgment, you can make use of the insurance benefits.

The rehab center or psychiatric hospital should accept your insurance plan. It is the only way to pay for the treatment with CarePlus insurance.

What to Do if There Are Issues With the Coverage

Issues related to billing and paperwork can arise when seeking addiction or mental health treatment. When this happens, reach out to the customer support team of your insurer.

The support team can help you understand the limits and exclusions of the coverage. They can also help you with any other issues with the plan.

Navigating the healthcare system is, at times, confusing. So, you may want to reach out to a treatment specialist once in a while for help. As you do this, give all the details.

Take Advantage of CarePlus Medicare Today

CarePlus Medicare for substance abuse and mental health treatment can help cut costs. But you have to understand the coverage limits to make the process seamless. You also need to find a facility or provider that accepts CarePlus Health plans.

That’s where Comprehensive Wellness Centers come in. We help people with substance abuse or mental health problems to find the right treatment. Our partnership with CarePlus allows patients to cover addiction treatment, mental health care, and support services with CarePlus insurance.

We strive to keep our services comprehensive, recovery-focused, and integrated. They all revolve around inpatient and outpatient care. To begin a new chapter in your life, get help from CWC in South Florida today.

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