Insurance FAQs

Fast Facts

Insurance FAQs

Our EVOKE rehab centers accept most health insurance plans. Learn about how your policy works when it comes to addiction treatment coverage.

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We know that when searching for a treatment center for yourself or a loved one, you are not a health insurance expert. Keeping up with the basics can be challenging, because the ins and outs of insurance policies change – meaning what is and isn’t covered – as state and federal policy makers update or replace laws and regulations. We keep up to speed on the latest developments to eliminate confusion and get you on the path to wellness. During the insurance verification and admissions process, we will explain exactly how your insurance policy works when it comes to covering your treatment stay.

Frequently asked questions

We've put together a quick list of essential facts you need to know:

HMO refers to a Health Maintenance Organization and PPO refers to a Preferred Provider Organization. Both HMO and PPO plans set up networks of providers for your health care needs. People with HMOs generally need a referral from a primary care physician for specialty treatment, whereas people with PPOs do not. HMOs typically have smaller networks, lower deductibles and co-pays, while PPOs have larger networks and higher copays and deductibles. HMOs are growing less and less common every year. Most employer-provided insurance plans are PPOs.
Insurance providers enter into contracts with groups of doctors, hospitals, urgent care facilities, and treatment centers to create a network. The basic concept of a network is that insurance companies negotiate fixed rates for specific services with a group of health care providers – your network – and encourage you to use those providers. Out-of-Network providers are any health care providers who do not have a contract with your insurance company. In-Network deductibles and co-pays are typically less expensive than Out-Of-Network deductibles and co-pays
A deductible is the annual dollar amount you pay for health care services before your insurance benefits begin covering your costs. For example, if you have a $1,000 deductible, you pay the first $1,000 required for a service. Your insurance company pays whatever percentage of expenses specified by your plan after you pay the initial $1,000. Monthly premiums and co-pays do not count toward your annual deductible.
Coinsurance refers to the provisions in your plan for covering costs for a specific service after you meet your annual deductible. You’ll see numbers like 90/10, 80/20, or 70/30 in reference to coinsurance. These numbers are simple: for example, if you have an 80/20 coinsurance plan, your insurance company pays 80% of the cost for a service after you meet your deductible, and you pay 20% of the cost for that service after you meet your deductible.
A copay is a predetermined, fixed dollar amount you pay for a specific health care service. Your copay amount varies depending on your policy and the service you receive. For instance, if you have a $40 copay for a mental health office visit, you pay the $40 – typically at the time of service – and your insurance company pays the rest.

What is the Difference Between In-Network and Out-of-Network?

In-network health care providers have contracted with your insurance company to accept certain negotiated and discounted rates. You will typically pay less with an in-network provider. Out-of-network providers have not agreed to the discounted rates. The best way to check is to call Evoke Wellness directly for us to verify the provider’s network status. Clients often face a constellation of challenges related to their substance use that can affect their ability to participate in and benefit from treatment. With the help of our experts, we can organize and prioritize the challenges and effectively help you begin a journey of recovery.

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Our addiction treatment specialists are standing by for your call. We will conduct a confidential assessment and create a personalized plan of action for your or a loved one’s recovery.

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