Seeking treatment for alcohol or drug abuse is a huge step that requires courage and dedication. It takes a strong and resilient individual to undergo addiction treatment, and we commend you for that.

After making this decision, you might be wondering how you will pay for your recovery. Many health insurance plans cover these expenses so you can focus on getting better.

Custom Design Benefits (CDB) allows you to access a network of doctors at lower prices or for free. The percentage of costs you must cover depends on your chosen insurance plan.

In this article, we explore Custom Design Benefits insurance for alcohol and drug rehab. We also explain the extent of its coverage for treatments recommended by doctors.

What Is Custom Design Benefits Insurance?

Custom Design Benefits Insurance is an insurance provider for employers and their staff. If you have CDB, your boss has provided you access to affordable healthcare providers. CDB is self-funded, which allows you to control your spending on medical services.

It’s important to choose the most suitable plan:

• Self-funded health plans: With self-funded health plans, your employer directly funds your insurance plan instead of paying insurance premiums.
• Flexible plan designs: Employers may choose among flexible plans for their workforce.
• Specialized network access: With this insurance plan, you can access a network of healthcare providers that can be expanded.
• Mental health and addiction treatment plans: These plans give you access to therapy, counseling, and substance use treatment options.
• Wellness programs: Focuses on preventive care and chronic disease management, improving employees’ overall well-being.

However you choose to approach your recovery, do it with kindness and patience. With these insurance plans, you grant yourself the resources to make the best treatment decisions.

Types of Rehab Covered by Custom Design Benefits

You may wonder if CDB insurance covers the specific treatment plan your doctor recommends. Below, you can review all treatment plans included in CDB coverage in detail.

Inpatient Rehab Coverage

Inpatient rehab provides a highly supportive environment for treating substance abuse. It includes living at a treatment facility and attending daily therapy sessions for managing addiction.

With CDB, you have access to medical care, therapy sessions, and medication during your rehab stay. When you choose a rehab program, it won’t hurt to check if the facility is in the CDB network. It can save you from unnecessary costs.

Most rehab treatments require pre-approval, which is called “pre-authorization.” This process requires that you provide a recommendation from your doctor to do the treatment. CDB must also approve any additional treatments down the line.

Outpatient Rehab Coverage

Outpatient rehab includes individual, group, and family therapy sessions for struggling individuals. This treatment allows for more flexibility since patients do not have to stay full-time in a facility.

To qualify for outpatient rehab coverage, CDB requires the following:

• Medical necessity: A healthcare provider has determined that you require outpatient rehabilitation.
• Medical assessment: You have undergone a medical evaluation to determine the level of outpatient support required for your condition.
• In-network facility treatment: The best chance of avoiding extra costs is to seek treatment in an in-network facility.
• Stability demonstration: You must prove your ability to live safely at home while attending recommended therapy sessions frequently.
• Constant progress: To maintain your insurance coverage, you must demonstrate progress and effort toward achieving sobriety.

Detoxification Services

Detoxification is the first step in recovery. Detox helps clear your body of harmful substances. It requires medical supervision in treatment centers to avoid health complications and manage withdrawals.

Your doctor will evaluate your medical state and recommend the most suitable detox treatment among the following:

• Medication-assisted treatment (MAT): Your doctors administer FDA-approved medication to ease withdrawal symptoms.
• Medically supervised withdrawal: This personalized approach is suitable for people who require extra care and assistance when experiencing recovery difficulties.
• Inpatient detoxification: If you are experiencing severe withdrawals, your doctor may advise you to remain in a facility.
• Outpatient detoxing: If your doctor allows it, you may be eligible for obtaining treatment without staying at a facility.

Now that we’ve reviewed the treatment options let’s see how they fall under CDB insurance coverage.

Does Custom Design Benefits Cover Alcohol Rehab?

Custom Design Benefits insurance covers treatment for alcohol abuse in inpatient and outpatient environments. It takes care of the costs of MAT, medical detoxification, and counseling to support your recovery journey.

If this information overwhelms you, remember to talk with your insurance provider. They will guide you through each insurance option so you can focus solely on improving overall health.

Does Custom Design Benefits Cover Drug Rehab?

Custom Design Benefits insurance also covers treatment for drug abuse through individual and group insurance plans. The coverage extends to treating addiction to drugs such as opioids, stimulants, depressants, and hallucinogens.

Depending on your CDB plan, there might be restrictions on the length and intensity of treatment. Check these details in your policy or with an insurance representative.

After we’ve discussed paying for services, we will advise you on finding the program that fits your coverage.

Custom Design Benefits and Substance Abuse Programs

Custom Design Benefits insurance is eligible for substance abuse programs. These programs support your continuous recovery and sobriety. CDB collaborates with recovery providers who support initiatives that provide quality care for treating your diagnosis.

Here is a list of CDB-supported treatment programs that aim to sustain your recovery:

• Employee Assistance Programs (EAPs): EAPs provide confidential care and support for battling substance abuse.
• Relapse prevention programs: They give you access to therapists and group meetings to prevent relapsing.
• Peer support networks: They connect members with similar struggles and for mutual support in recovery.
• Telemedicine services: They offer virtual therapy sessions for continuous support in the comfort of your home.

As you can see, there are many different types of treatment programs to choose from. 

Custom Design Benefits Insurance Coverage for Rehab: What to Know

Navigating CDB insurance coverage requires understanding critical factors to choose the proper treatment and avoid unexpected costs.

Let’s discuss these factors.

Pre-Authorization Requirements

You will need additional authorization for specific treatments despite having CDB insurance. Usually, providing documentation from your doctor is enough to pass pre-authorization. Also, the insurance provider might require information about your previous health conditions and rehab stays.

Sometimes, your insurance can deny you pre-authorization. While this might be concerning, many people experience it at some point in their recovery.

In most cases, denials happen due to missing paperwork, which you can easily resolve and begin treatment. You might have to pay out-of-pocket for the treatment and receive reimbursement after the documentation has cleared.

Coverage Limits and Duration

Custom Design Benefits have limits on the duration and frequency of treatments and sessions. Generally, insurance covers rehab stays for up to 90 days per year. Therapy sessions range from 20 to 40 annually, depending on your doctor’s advice.

Network vs. Out-of-Network Facilities

The main difference between network and out-of-network facilities is their coverage level. This can have a large impact on the extra costs you must pay on top of your insurance.

If you choose treatment in a network facility, you’ll likely have fewer costs. This is because the company has already negotiated lower rates for you. At the same time, out-of-network facilities come with unexpected costs of higher deductibles and additional services.

Key Takeaways

• While the insurance process can seem daunting at first, take it one step at a time and receive the support you need.
• Custom Design Benefits Insurance will save you from unnecessary spending on treatment programs.
• With the right coverage, you can focus on your recovery commitment without worrying about finances.

Frequently Asked Questions

Does Custom Design Benefits require a referral for rehab coverage?

Yes, Custom Design Benefits requires a referral for rehab coverage. Your doctor provides it by recommending a comprehensive treatment plan tailored to your condition. If you need additional treatment, your doctor must also advise on it.

Can Custom Design Benefits cover rehab treatment more than once?

Yes, Custom Design Benefits can cover rehab treatment more than once if you provide the appropriate doctor’s recommendation. Just be aware of your insurance policy’s time limits for rehab stays.

Does Custom Design Benefits cover family therapy for addiction recovery?

Yes, Custom Design Benefits covers family therapy, which is an essential part of recovery. Family therapy helps rebuild the bonds broken by addiction and strengthens your support system.

How much of the rehab cost does Custom Design Benefits cover?

Custom Design Benefits insurance covers a portion of your treatment costs, depending on the insurance plan. Typically, in-network treatments cover 70-80% of the total, while the rest is up to you to pay out-of-pocket.