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Neighborhood Health Plan of Rhode Island Insurance Coverage for Drug and Alcohol Rehab

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Plan Types

Neighborhood Health Plan of Rhode Island Plan Types

Like most health insurance plans, Neighborhood Health Plan of Rhode Island offers several different plan options, and coverage depends on the type of plan that you have. All Neighborhood commercial plans for individuals and families provide services, including:2

  • No-cost preventative care.
  • Behavioral health services, hospital care, and emergency services.
  • Access to a network of providers, hospitals, and pharmacies.
  • Prescription drug coverage.
  • Wellness programs.

Each plan type is offered at two levels:2

Bronze Plans

Innovation: This lowest-priced, high deductible plan requires a copay for primary care visits and behavioral health outpatient visits.

Economy: The lowest-priced health savings account-qualified plan has high deductibles but the lowest monthly premiums.

Silver Plans

Community: The lowest-priced plan and Health Savings Account-qualified plan at this level offers a high level of coverage once the deductible, which is dependent on income, has been met.

Value: This plan offers a traditional copay plan design. Copays are charged for services like primary care visits, specialty care visits, behavioral health outpatient services, and prescription medications. Deductible and other cost-sharing amounts are dependent on income.

Gold Plans

Plus: The lowest-priced gold plan has lower copays for certain services like primary care visits, specialty care visits, urgent care, behavioral health outpatient services, and prescription drugs in specific tiers.

Essential: This gold plan provides a traditional copay plan with low copays for services like primary care visits, specialty care visits, urgent care, behavioral health outpatient services, and prescription medicines in specific tiers.

Medicaid Plans

Access: This plan, for eligible families, children, pregnant women, and children with special health care needs, offers a large provider network, check-ups, routine immunizations, doctor visits, prescription medications, hospital care, behavioral health services, emergency services, and more.

Trust: This plan is identical to the Access plan but is designed for eligible adults with disabilities or eligible adults who do not have dependent children.

Medicare-Medicaid Plan

Integrity: Among the benefits included for eligible subscribers are hospital stays, including inpatient, outpatient, and mental health needs.

Coverage

Neighborhood Health Plan of Rhode Island is a not-for-profit health maintenance organization (HMO) insurance company. Through its provider network, Neighborhood provides its members access to healthcare services, including behavioral health providers for substance use disorders.1

Mental and behavioral health services, including inpatient and outpatient treatment for substance use may be partially or fully covered by Neighborhood plans.3 To understand the specifics of your particular Neighborhood plan, you can call the number on the back of your card, or you can verify your insurance here.

Does Neighborhood Health Plan of Rhode Island Cover Drug and Alcohol Rehab?

Alcohol and substance use support services and treatment are covered through Neighborhood. You can find in-network addiction care specialists by using the company’s behavioral health benefit portal.

There are many different levels of care in addiction treatment. Your primary care physician or mental healthcare provider and an addiction care specialist can work with you to determine the best level of care for your needs. It’s important to note that Neighborhood covers medically necessary services. Thus, substance use treatment—or parts of it—may require preauthorization before it’s covered.4

What Addiction Treatment Does Neighborhood Health Plan of Rhode Island Cover?

Your Neighborhood insurance policy may cover a variety of addiction services. Some of the programs and services that may be covered by your Neighborhood Health Plan of Rhode Island include:4

  • Detoxification. As part of the inpatient and community-based behavioral health and substance use services offered by Neighborhood, medically managed detox may be covered—and the first step in a more comprehensive treatment plan. Detox helps your body rid itself of substances in a safe, supervised environment that keeps you as comfortable as possible as you experience withdrawal.
  • Inpatient care. Inpatient care or residential treatment may require preauthorization and involves you living at the treatment facility for the duration of treatment while you receive 24/7 support. Inpatient care removes you from everyday stressors and potential triggers and allows you to focus completely on your recovery, which includes learning coping skills necessary to help you avoid relapse.
  • Outpatient treatment. There are several levels of outpatient treatment, including standard outpatient treatment, intensive outpatient programs (IOPs), and partial hospitalization programs (PHPs). Preauthorization may be required for outpatient treatment as well. Outpatient programs differ in intensity and level of support but allow you to return home or to a sober living environment after treatment, which takes place at regularly scheduled times and may include psychoeducation, behavioral therapies, mutual-help groups, and more.
  • Medications for addiction treatment. Your healthcare provider may recommend that you take medication to support your recovery, and this medication may be partially or fully covered by your Neighborhood plan.

How to Check Your Neighborhood Health Plan of Rhode Island Benefits

It’s important to understand your benefits so that you know what your out-of-pockets costs entail and other details regarding duration, covered therapies and interventions, and more. As a policy holder with an online account, you can access your coverage, approved medications, plan information, and in-network provider directory.

Is Mental Health and Co-Occurring Disorder Treatment Covered Under Neighborhood Health Plan of Rhode Island?

Many mental health disorders co-occur with substance use disorder. In fact, it’s not uncommon for an individual with a substance use disorder to also have other mental health disorders, such as anxiety disorders, depression, or bipolar disorder, for instance. Treating the disorders simultaneously is most effective, according to research.5

Services to diagnose and treat co-occurring mental health and substance use disorders may be fully or at least partially covered by your Neighborhood plan.4

What To Do if My Policy Does Not Cover an Inpatient Rehab Program

Cost or lack of coverage should never prevent you from seeking addiction treatment. Besides using insurance to pay for all or some of your care, there are other ways to pay. You can also pay cash or use credit cards to pay for your treatment. Some facilities offer payment plans, sliding scale fees, and scholarships for eligible individuals. If you’re not sure how to pay for treatment, talk to the facility directly and inquire about your options. You may also want to see if you qualify for state-funded rehab, which offers free or low-cost care.

Next Steps

If you’re ready to get started with treatment, American Addiction Centers (AAC) can help. Call to speak to an admissions navigator, who can listen to your needs and complete a pre-screening, answer your questions, explain your options and costs, verify your insurance coverage, and help you begin your recovery journey.

Our Treatment Centers

AAC has treatment centers across the United States. In Rhode Island, AAC operates AdCare Rhode Island, a 59-bed inpatient drug and alcohol treatment center in North Kingstown, and an outpatient drug and alcohol addiction program in Warwick. Both facilities provide evidence-based therapies and industry-best treatment, including treatment for co-occurring disorders.

Sources
  1. Neighborhood Health Plan of Rhode Island. (2023). Company profile.
  2. Neighborhood Health Plan of Rhode Island. (n.d.). Become a Member.
  3. Neighborhood Health Plan of Rhode Island. (2024). 2024 plan summary.
  4. Neighborhood Health Plan of Rhode Island (2020). Certificate of coverage.
  5. National Institute of Mental Health. (2024, Jun 30). Substance use and co-occurring mental disorders.
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Rehabs That May Accept Neighborhood Health Plan of Rhode Island Insurance

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