Addiction Treatment

APS Health Insurance Coverage for Heroin Addiction Treatment

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Last updated: 04/2/2019
Author: Medical Review

Reading Time: 3 minutes

You know that heroin addiction is no joke. People quickly transition from casual use to the development of tolerance to using increasing amounts to a state of dependence followed by full-blown addiction. Once your body is dependent upon the drug to function, the threat of withdrawal alone can be enough to keep you using. It can feel like a cycle that is impossible to break.

But, you have to break the cycle because you face the threat of overdose and death. Between 2001 and 2014, the National Institute on Drug Abuse reports, there has been a six-fold increase in the total number of heroin related overdose deaths. As you continue to use, you risk becoming another statistic. You need professional, structured treatment to assist you in recovery.

But, can you count on your APS health insurance to provide you with the coverage that you need to seek treatment? Yes. With decades of experience providing topnotch insurance, APS provides coverage for substance abuse treatment, even for heroin, at the same level that it provides it for other, similar medical and surgical undertakings. Depending on the state in which you live and your specific policy, the coverage will vary, but the following should provide you with general information.

What Types of Rehab Will APS Insurance Cover?

There are a few different types of treatment for heroin addiction, but the two primary types of treatment are inpatient and outpatient programs.

Inpatient care is defined by the residential nature of the care; you live at the facility while being treated. This means that you attend therapy and take you meds at the same place where you eat and sleep. The major benefit of inpatient care is that it separates you from the social and environmental triggers that keep you returning to heroin use. There are multiple models of inpatient care and the National Institute on Drug Abuse identifies:

  • Therapeutic communities
  • Recovery housing
  • Shorter-term residential treatment

Outpatient care is defined by its non-residential format. Instead of living at the facility, you attend frequent, often daily, treatment at the facility and then are free to go back to living your daily life. This is a great approach for people who have children they are responsible for or jobs they cannot take leave from. This is also the less expensive approach.

When you consult with a doctor about your heroin addiction he or she should be able to recommend an approach that will work in your particular situation. In general, APS covers both types of care. However, there are a few exceptions.

Is My APS Coverage Strictly Local or Can I Seek Treatment Out of State?

When looking at inpatient care, you may find yourself interested in out of state programs. But, does APS cover care at one of these distant programs?

Typically, coverage is restricted to in-network providers who have a contract with APS. The shared contract ensures low pricing. In-network providers are primarily local.

You are still, however, more than welcome to check your policy and determine the level of coverage you can expect if you attend an out of state program. You may choose to simply pay the difference between the total cost and the coverage provided.

What Treatment Lengths Are Covered by APS HEalth Insurance?

Heroin addiction, as you know, is an incredibly difficult addiction to break and heroin addicts often require a longer stay in rehab than the average individual. Although APS will cover whatever is deemed medically necessary, that usually only extends to a 28-30 day program with both a detox and short-term treatment component.

If you need treatment that extends beyond this, you may not have coverage. When determining your length of stay, you need to study your policy and communicate with the potential treatment center.

How Our Helpline Works

For those seeking addiction treatment for themselves or a loved one, the helpline is a private and convenient solution.

Calls to any general helpline (non-facility specific 1-8XX numbers) for your visit will be answered by American Addiction Centers (AAC).

We are standing by 24/7 to discuss your treatment options. Our representatives work solely for AAC and will discuss whether an AAC facility may be an option for you. Our helpline is offered at no cost to you and with no obligation to enter into treatment. Neither nor AAC receives any commission or other fee that is dependent upon which treatment provider a visitor may ultimately choose.

For more information on AAC’s commitment to ethical marketing and treatment practices, or to learn more about how to select a treatment provider, visit our About AAC page. If you wish to explore additional treatment options or connect with a specific rehab center, you can browse top-rated listings or visit SAMHSA.

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