Looking at insurance options is often the first step that families take when someone they love needs drug or alcohol rehab. Cambia Health Solutions, formerly known as The Regence Group, is a nonprofit healthcare company that serves as the parent organization of multiple health insurance platforms.

Coverage for addiction treatment is included on most plans, but coverage levels may vary depending on policy type. How much can a patient expect Cambia Health Solutions to pay toward drug and alcohol treatment?

Does Cambia Health Solutions Cover Drug And Alcohol Detox?

Insurance policies under the Cambia Health Solutions label will likely cover the cost of detox either partially or in full.

Drug and alcohol detox is only the first stage of addiction treatment. When a physical dependency is present, withholding drugs and alcohol will cause withdrawal symptoms such as:

  • Nausea
  • Vomiting
  • Anxiety
  • Shaking
  • Insomnia
  • Sweating
  • Seizures

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Professional detox programs allow medical staff to manage withdrawal symptoms and keep patients safe and as comfortable as possible.

Does Cambia Health Solutions Cover Inpatient Rehab?

Cambia Health Solutions most likely covers inpatient rehab. A residential addiction treatment program is a live-in situation that allows a person with an addiction to receive round-the-clock support as they go through the healing process. Patients live with other individuals who are in treatment, and they are immersed in an environment that is both therapeutic and safe.

While Cambia Health Solutions may cover inpatient treatment, they may not pay the entire amount. Out-of-pocket amounts depend on the policy and the treatment center. The insured can expect to be responsible for a copayment or coinsurance fee. Cambia Health Solutions typically pays a larger portion of treatment at in-network providers than out-of-network.

Regence Plans

Regence focuses on four states:

  • Washington
  • Utah
  • Oregon
  • Idaho

The policy details may change based on the location.

In Washington, Regence offers Bronze, Silver and Gold plans, each broken into categories such as:

  • Health saving account
  • Essential
  • Deduction amount
  • Additional service such as dental and vision

For example, the Bronze HSA 5000 Individual and Family Network tells the insured that this plan:

  • Works with a health savings account
  • Has a $5,000 deductible
  • Is available to both individuals and families

All the Regence plans follow a similar pattern for drug and alcohol coverage, based on metal level. The plans for all four states include:

  • Bronze: 10 to 30 percent coinsurance
  • Silver: 20 to 30 percent coinsurance
  • Gold: 20 percent coinsurance

None of the Regence plans cover out-of-network facilities or require preauthorization of care.

Asuris Plans

Asuris plans use the same structure to indicate out-of-pocket costs. Asuris offers the same coverage per metal level as Regence plans. The metal levels include:

  • Bronze: 10 to 30 percent coinsurance
  • Silver: 20 to 30 percent coinsurance
  • Gold: 20 percent coinsurance

As with the Regence plans, Asuris does not pay for out-of-network facilities or require preauthorization for care.

BridgeSpan Policies

BridgeSpan is likely to have very similar coverage as Regence and Asuris. The BridgeSpan market includes four states:

  • Washington
  • Oregon
  • Utah
  • Idaho

BridgeSpan may not serve every county within these states, however. BridgeSpan exclusively offers EPO plans. EPO means BridgeSpan will only pay for in-network treatment, with the exception that Idaho residents may be able to get BridgeSpan to cover 10 percent of the cost for out-of-network services.

Most of the brands under Cambia Health Solutions offer Medicare Supplemental insurance, as well. Those policies are personalized for the individual based on age, health and Medicare coverage. They will likely pay at least part of an addiction treatment bill, as well.

Does Cambia Health Solutions Cover Outpatient Rehab?

The Cambia Health Solutions companies that provide health insurance policies cover outpatient drug and alcohol rehab services. Each plan offers the same coverage for both inpatient and outpatient treatment.

For example, if someone has Regence Bronze HSA 5000 EPO Individual and Family Network insurance, the plan will pay 70 percent of the bill for either inpatient or outpatient care. The insured is responsible for a 30 percent coinsurance fee, and Regence pays the rest.

A similar structure applies for those with the Asuris Gold 1000 EPO Individual and Family Network policy. Asuris pays 80 percent and the insured pays 20 percent.

The same is likely true for the Medicare Supplement plans. There may be some variance in how much each Cambia Health Solutions company pays based on the specific policy, though.

Does Cambia Health Solutions Cover Medication-Assisted Treatment?

Many treatment centers offer medication-assisted treatment programs. MAT combines therapy with medications such as Suboxone (buprenorphine, naloxone) to reduce cravings and prevent withdrawal for those who are addicted to alcohol or opioids, like heroin or prescription painkillers (codeine, oxycodone). A person could take methadone to prevent heroin withdrawal and then slowly reduce the methadone dosage over time.

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MAT is also available for alcohol addiction. Detoxing from alcohol can be life-threatening, and MAT minimizes this risk and improves treatment outcomes.

Most insurance providers like Cambia Health Solutions cover medication-assisted treatment. How much coverage is available will depend on the policy.

Does Cambia Health Solutions Cover Sober Living Houses?

Sober living houses provide those who have completed an inpatient rehab program with a safe, sober environment as they transition back to independent life. Cambia Health Solutions may cover outpatient care in full minus the coinsurance fee. It is likely Cambia will cover aftercare, as well, including in-network sober living houses.

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

Cambia Health Solutions offers a network of healthcare providers for its members. Cambia partners with local treatment facilities to reduce the cost of drug and alcohol rehab. An in-network treatment facility has a pricing agreement with Cambia. As the name suggests, a facility that is not part of that network is called out-of-network.

How To Find Drug And Alcohol Rehab Centers That Accept Cambia Health Solutions

  1. Contact Addiction Campuses for an immediate verification of benefits. Addiction Campuses can answer questions about insurance and addiction treatment and perform a no-obligation verification of insurance benefits on your behalf.
  2. Contact the insurance provider by using the phone number on the back of the insurance card or by visiting the provider’s website. A representative will be able to match you to an in-network drug and alcohol rehab center.
  3. Call the treatment center you or your loved one is interested in. The treatment center’s admissions team can answer questions about covered services.