Determining how to pay for treatment can be one of the biggest obstacles to accessing professional help for an addiction. MHN is one of many insurance providers to offer coverage for drug and alcohol rehab.

About MHN

MHN is the mental health arm of the Health Net insurance company. MHN is focused exclusively on providing mental and behavioral health services, which includes substance abuse treatment coverage. Benefits offered by MHN include:

  • Outpatient treatment and assessment with licensed counselors, psychologists or psychiatrists
  • Inpatient diagnostics and treatment
  • Other levels of care, including partial hospitalization, residential treatment programs and intensive outpatient options

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MHN’s insurance benefits can be accessed through two main insurance platforms:

  • Health Insurance Marketplace – people who have enrolled in Health Net through one of the state Exchange platforms can access behavioral health benefits, including drug and alcohol abuse treatment, through MHN’s Essential Health Benefits.
  • Medicare Supplemental Insurance – MHN offers mental health and substance abuse treatment coverage for those who purchase its Medicare supplemental package.

Coverage levels may vary based on the company administering the benefits. For instance, medicaid has more restrictive coverages and referral policies than plans obtained through the exchanges.

MHN Government Services

MHN also has an insurance arm that is responsible for providing mental health and drug and alcohol treatment coverage to active military service members and members of the National Guard and Army Reserve, as well as their families and veterans. These programs include:

  • Short-term non-medical counseling
  • Inpatient drug and alcohol addiction treatment
  • Outpatient drug and alcohol addiction treatment

MHN Government Services is administered in conjunction with TRICARE health insurance, which is available to all retired and active military, Guard and Reserve service members and their families.

Does MHN Cover Drug And Alcohol Detox?

The medical supervision required for drug and alcohol detox is covered as part of an inpatient or partial hospitalization program. However, prescription medications that are administered during detox are subject to the subscriber’s prescription medication coverage. The subscriber may receive two separate bills: one for the clinician’s services and one for the medications that are administered.

Detoxification is often the first step in treating a drug or alcohol addiction. However, it is rarely conducted as a standalone procedure. During detox, medical staff monitor a patient’s heart rate, breathing and body temperature and administer any medications to help with nausea, vomiting or seizures that may result from withdrawal.

Does MHN Cover Inpatient Rehab?

Inpatient rehab, also known as residential addiction treatment, offers patients an opportunity to live in a secure group setting while participating in daily therapy and recovery activities. Residing in a safe, controlled environment allows patients to focus on their recovery without the distractions of the outside world.

MHN covers inpatient drug rehab at the inpatient hospitalization coverage levels of the subscriber’s Health Net policy, as long as:

  • The patient receives prior authorization for inpatient treatment
  • Inpatient treatment is deemed medically necessary by a referring physician
  • The inpatient facility is part of the MHN network

If any of these requirements are not met, inpatient rehab may not be covered.

Does MHN Cover Outpatient Rehab?

MHN covers outpatient rehabilitation. Outpatient rehabilitation conducted in an outpatient facility may require prior authorization from MHN or a referral. Coinsurance and deductible amounts are determined by the subscriber’s specific plan.

Outpatient rehab refers to treatment services provided while the patient lives at home. In some cases, outpatient treatment consists of individual sessions with a certified mental health counselor, psychologist or psychiatrist. Other times, it may include partial hospitalization where the patient spends their days in a treatment facility and returns home at night. Outpatient rehab also includes intensive outpatient treatment at a specialized outpatient rehab facility.

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Does MHN Cover Medication-Assisted Treatment?

MHN does not cover nor administer prescription drug benefits. Any medication-assisted treatment, including the use of Suboxone (buprenorphine and naloxone), methadone, naltrexone or any other FDA-approved medications, is subject to pharmacy coverages that are administered by Health Net. Co-insurance and deductible amounts are determined by the subscriber’s particular insurance plan.

Medication-assisted treatment (MAT) refers to the use of behavioral therapy along with prescription medications to help decrease the likelihood of a relapse. Some medications cause illness in the user if they consume alcohol or drugs, while others block the pleasurable effects of the substance. All MAT programs are administered by a qualified medical professional and may be included as part of inpatient or outpatient treatment plans.

Does MHN Cover Sober Living Houses?

Group living environments such as sober living houses, where patients are given opportunities to adjust to daily life in the safety of a sober environment, may be covered under MHN insurances. Coverages, limits, copays and deductibles vary based on the Health Net insurance plan, but a variety of in-network residential facilities can provide care and treatment.

Sober living houses are sometimes included as part of the inpatient rehab experience and can be prescribed by the inpatient facility. They will generally conduct any prior authorizations and establish medical necessity before a patient checks in.

In-Network Coverage Vs. Out-Of-Network Coverage

Some MHN plans do not provide coverage for out-of-network providers. Even if the subscriber’s plan does allow for treatment at out-of-network facilities, there are distinct advantages to selecting an in-network treatment facility or program for addiction recovery.

In-network providers have agreed to a contracted price for services they render. In-network providers will only bill the patient for their copayment or deductible amount. Out-of-network providers may bill the patient the full fee for services, without any contract discounts. MHN pays benefits based on maximum allowable amounts, and the patient is responsible for the remaining costs.

Even if it appears that the desired treatment center is not a part of the MHN network of providers, contact the center and request a verification of insurance benefits. Many times, information that appears online or in provider directories is outdated.

The desired facility may also be able to negotiate with an insurance company on the patient’s behalf for coverage at an in-network rate due to the specialization of the care providers, the distance from the patient’s home or the patient’s personal access to other in-network treatment centers.