Young Adult Mental Health & Substance Abuse Treatment Centers

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Using Mental Health Insurance for
Our Services

Behavioral and mental health services are essential
health benefits.

Mental Health & Substance Abuse Coverage

At Newport Institute, we know that treatment financing can make all the difference in receiving quality treatment. You may not know that the following treatment is covered by insurance plans:

  • Behavioral health treatment, such as psychotherapy and counseling
  • Residential or inpatient behavioral and mental health services
  • Substance use disorder (commonly known as substance abuse) treatment

Our Dedication to Securing the Highest-Quality Treatment

At Newport Institute, we take great pride in the fact that we have a full-time, in-house team dedicated to supporting our families through the mental health and substance abuse insurance coverage and financing process. In order to secure sufficient insurance coverage, we will most likely need to conduct a series of clinical reviews and any requested doctor-to-doctor calls with the insurance company. While other facilities may charge for this service, we feel it is our responsibility to assist families with what can be a complex process in order to receive the highest-quality treatment.

Here are the primary ways that young adults and families pay for treatment at Newport Institute:

Does insurance cover treatment costs at Newport Institute?

Insurance often covers a majority of treatment costs. Newport Institute is In-Network with major insurance companies, and we also have extensive experience working with out-of-network payers to negotiate Single Case Agreements that provide coverage for the young adults in our care. 

What if my insurance doesn’t cover my full treatment plan?

Some young adults or families choose a private pay option, which means that they cover all treatment costs without using mental health insurance. Private pay is a viable option for those who feel comfortable using their own resources rather than using behavioral healthcare coverage from an insurance company. Treatment is a worthwhile endeavor that provides the foundation for a new life—and ultimately, it saves time, money, and energy, and promotes quality of life and peace of mind. And connecting you to the help you need, when you need it, is Newport’s top priority.

What can I expect
when I call?

What can I expect
when I call?

We’re here 24 hours a day, 7 days a week. Your call is always confidential, and there’s no pressure to commit to treatment until you’re ready. Our fundamental priority is to help you.

855-895-4468

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Verify Insurance

Frequently Asked Questions

Here are some of the most common questions young adults and families ask about insurance coverage for treatment at Newport.

  • How much will I have to pay out of pocket?
  • How many days of treatment will insurance pay for?
  • If Newport isn’t In-Network with my insurance, can my treatment still be covered?
  • Will I get a bill from Newport?
  • Do you take Medicaid?

Our dedicated Admissions team can answer all these questions and more, according to your specific situation and insurance options. Call us at 855-895-4468, anytime.

What factors determine how much treatment will cost?

When you are considering whether a loved one or family member will enter treatment, remember that you will be making a lifetime investment in positive transformation and wellness. Addiction and untreated mental health issues are challenging—and they’re not going to go away by themselves. For an individual who may be embarking on their path as an adult, and who may not have developed the tools and infrastructure to face the complexities of day-to-day life, untreated mental health issues can become overwhelming. Your commitment to lifelong recovery will yield invaluable results and ultimately become fundamentally life changing.

Here are some of the things that influence treatment costs:

  • The individual’s clinical diagnosis
  • The recommended length of stay in treatment
  • Whether the situation requires specialized services
  • The individual’s mental health insurance coverage or preferred payment options

We work with most major insurance providers to optimize access to care for young adults and families.

Anthem
BCBS
Empire
First Choice
Carelon Logo
Shasta Admin Resize 2
Health Net
ComPsych
GEHA
Humana
Regence Washington
Dean Health Plan
Quartz
Regency Utah
Carolina Behavioral Health Alliance

We’re continuing to expand our partnerships with insurance carriers both in and out of network. The below selection represents some of our most popular mental health insurance provider plans.

Aetna
Anthem Blue Cross Blue Shield of California
Anthem Blue Cross Blue Shield of Connecticut
Anthem Blue Cross Blue Shield of Maine
Anthem Blue Cross Blue Shield of New Hampshire
Blue Cross Blue Shield of Georgia
Blue Cross Blue Shield of Illinois
Blue Cross Blue Shield of Indiana
Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Minnesota
Blue Cross Blue Shield of Rhode Island
Blue Cross Blue Shield of Texas
Blue Cross Blue Shield of Virginia
Beacon Health Options
Blue Shield of California
CareFirst Blue Cross Blue Shield of Maryland

Carolina Behavioral Health Alliance
CIGNA
ComPsych
Empire Blue Cross Blue Shield of New York
First Choice Health Network
First Health
HealthNet/Managed Health Network
HighMark Blue Cross Blue Shield
Independence Blue Cross of Pennsylvania
Kaiser MidAtlantic
Kaiser Northern California
Kaiser of Washington
Magellan
Premera Blue Cross Blue Shield
Quartz
Regence Blue Cross Blue Shield of Utah
Regence Blue Shield of Washington
Shasta Administrative Services

Insurance Terms

Insurance Verification

If you’re interested in exploring the possibility of treatment at Newport Institute for you or your loved one’s mental health, behavioral health, or substance abuse issues, we can begin the insurance verification process immediately. Furthermore, we are happy to obtain your insurance policy information and seek verification on your behalf. You can also expedite this process by completing the insurance verification form. There is no obligation to either Newport Institute or to your insurance provider. We will generally get back to you with verification results and a comprehensive assessment of your insurance benefits coverage within 24 hours.

Clinical Review and Insurance Substantiation

Clinical reviews take place on an ongoing basis, depending on the individual’s specific case and insurance company. We will also file appeals for any denials and bill the insurance company directly. Our team of insurance review experts assist families with this process every step of the way. While other facilities charge for this service, we feel it is our responsibility to help you and your family receive the highest-quality treatment.

Coinsurance

Coinsurance is the percentage of treatment costs, after the deductible, that your mental health insurance policy will not cover. You are responsible for this amount.

Allowed Amount

The allowed amount is the daily rate that the insurance company feels is appropriate for the services rendered. The allowed amount may be exactly what you are invoiced for services, or it may be less. It is important to note that, for out-of-network services, the rehab insurance coverage amount percentage applies to the allowed amount, and is not necessarily reflective of invoiced amounts or cost of services rendered.

Copay

A copay is a regular fixed cost that you pay for certain services. For example, many people pay a small copay each time they visit a doctor. This contributes to your overall plan and is part of your cost agreement with the insurance company. Some insurance plans do not require copays.

Premium

A premium is the amount that people pay at regular intervals to their insurance companies for their coverage. This is the individual’s contribution to their policy, and in some cases, employers may also contribute to the premium. Premiums are determined by what kind of coverage a person has, such as an HMO or PPO plan.

Policy Effective Date

This is the date when your mental health insurance company begins to help pay for your healthcare costs. You must enroll in a health insurance plan either during the open enrollment period, usually offered for a set amount of time once a year, or during a “special enrollment period.” Special enrollment periods begin after a qualifying event, such as marriage, the start of a new job, the birth of a baby, or the loss of healthcare coverage, and usually last for about 90 days. Your policy effective date is determined after you’ve enrolled, and usually falls a few weeks or months after your initial enrollment date.

Insurance Plan Types

Newport Institute works with an array of insurance plans providing coverage for mental health treatment. Plan types break down into three categories: those with In-Network benefits, those with out-of-network benefits, and those that typically don’t offer out-of-network benefits. Plan types that typically offer out-of-network benefits are Preferred Provider Organization (PPO) and Point-of-Service (POS) plans. Plan types that typically don’t offer out-of-network benefits are Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. The bottom line: We pride ourselves on being able to work with most major insurance payers, to help young adults and families receive the best treatment possible, as soon as possible.

Coverage Amount

The coverage amount is the percentage of treatment costs, after the deductible, that your mental health insurance policy will cover.

Pre-Certification

The majority of insurance providers require pre-certification, or authorization, prior to entering the program and continuously throughout treatment. We will guide you through this process as well. Consequently, if your policy has this stipulation, we will provide you with support and direction on how best to proceed. If you don’t see your insurance provider in the list above, that does not mean that we cannot work with them—it might simply mean that we haven’t worked with them previously.

Deductible

Your deductible is an annual amount that you must pay before insurance will begin to cover your expenses. Typically, once the deductible has been satisfied for the year, your mental health insurance policy will start to cover a percentage of the total treatment costs, called the coverage amount.

Maximum Out of Pocket (MOOP)

The MOOP is a limit on your policy set by your insurance company. Once the total amount of coinsurance paid equals the MOOP, the insurance policy typically covers 100 percent of the “allowed amount.” Sometimes, the deductible applies toward the MOOP, which can help you meet that limit faster.

Balance Billing

Balance billing is a practice in which an out-of-network treatment provider invoices the person who will be receiving treatment for the difference between what the insurance company paid and the actual cost of treatment. Newport Institute does not balance bill. What this effectively means is that we work to ensure maximum coverage by in- and out-of-network insurance providers, and once we collectively understand the mental health insurance coverage options, our Admissions Specialists will work hand in hand with the family or individual to affirm the final cost of treatment. With some treatment centers, you’ll receive an invoice for a balance due after treatment, but Newport Institute does not support this practice. There will be no surprises.

Primary Insurance Subscriber

This is the person whose name is on the insurance card. Many young adults in treatment qualify for coverage under their family’s insurance plan. Under the Affordable Care Act, young adults 26 years of age and under are entitled to their parents’ health insurance policies, which, through the exchanges, are required to provide mental health benefits.

Out-of-Pocket Expenses

Your out-of-pocket cost is the amount of money you must pay each time you visit a doctor or receive inpatient, outpatient, or other therapeutic treatments. These costs are usually due at the time treatment begins, but you may also be able to pay them a little at a time with payment plans. Out-of-pocket expenses include deductibles, copays, and co-insurance.

Managed Care

This blanket term is used to describe the primary system through which healthcare services are provided in the United States. An insurance company directs—i.e., manages—the way you receive treatment, from regular checkups to accidents to major illnesses. Managed Care Organizations (MCOs) include the doctors, hospitals, laboratories, and clinics that make up your network.

Single-Case Agreement

A Single Case Agreement is when a provider, such as Newport Institute, works out a special contract so that out-of-network providers can work with your insurance company on an In-Network basis. Many young people who receive treatment from Newport Institute using insurance coverage do so through a Single Case Agreement, so we have extensive experience working with insurance companies to create Single Case Agreements for young adults with emotional, behavioral, or substance abuse disorders. Our goal is to ensure that your mental health insurance provider makes it possible for you to receive the most comprehensive and highest-quality treatment available.

Insurance Verification

If you’re interested in exploring the possibility of treatment at Newport Institute for you or your loved one’s mental health, behavioral health, or substance abuse issues, we can begin the insurance verification process immediately. Furthermore, we are happy to obtain your insurance policy information and seek verification on your behalf. You can also expedite this process by completing the insurance verification form. There is no obligation to either Newport Institute or to your insurance provider. We will generally get back to you with verification results and a comprehensive assessment of your insurance benefits coverage within 24 hours.

Pre-Certification

The majority of insurance providers require pre-certification, or authorization, prior to entering the program and continuously throughout treatment. We will guide you through this process as well. Consequently, if your policy has this stipulation, we will provide you with support and direction on how best to proceed. If you don’t see your insurance provider in the list above, that does not mean that we cannot work with them—it might simply mean that we haven’t worked with them previously.

Clinical Review and Insurance Substantiation

Clinical reviews take place on an ongoing basis, depending on the individual’s specific case and insurance company. We will also file appeals for any denials and bill the insurance company directly. Our team of insurance review experts assist families with this process on a daily basis. While other facilities may charge for this service, we feel it is our responsibility to help you and your family receive the highest-quality treatment.

Deductible

Your deductible is an annual amount that you must pay before insurance will begin to cover your expenses. Typically, once the deductible has been satisfied for the year, your mental health insurance policy will start to cover a percentage of the total treatment costs, called the coverage amount.

Coinsurance

Coinsurance is the percentage of treatment costs, after the deductible, that your mental health insurance policy will not cover. You are responsible for this amount.

Maximum Out of Pocket (MOOP)

The MOOP is a limit on your policy set by your insurance company. Once the total amount of coinsurance paid equals the MOOP, the insurance policy typically covers 100 percent of the “allowed amount.” Sometimes, the deductible applies toward the MOOP, which can help you meet that limit faster.

Allowed Amount

The allowed amount is the daily rate that the insurance company feels is appropriate for the services rendered. The allowed amount may be exactly what you are invoiced for services, or it may be less. It is important to note that, for out-of-network services, the rehab insurance coverage amount percentage applies to the allowed amount, and is not necessarily reflective of invoiced amounts or cost of services rendered.

Balance Billing

Balance billing is a practice in which an out-of-network treatment provider invoices the person who will be receiving treatment for the difference between what the insurance company paid and the actual cost of treatment. Newport Institute does not balance bill. What this effectively means is that we work to ensure maximum coverage by in- and out-of-network insurance providers, and once we collectively understand the mental health insurance coverage options, our Admissions Specialists will work hand in hand with the family or individual to affirm the final cost of treatment. With some treatment centers, you’ll receive an invoice for a balance due after treatment, but Newport Institute does not support this practice. There will be no surprises.

Copay

A copay is a regular fixed cost that you pay for certain services. For example, many people pay a small copay each time they visit a doctor. This contributes to your overall plan and is part of your cost agreement with the insurance company. Some insurance plans do not require copays.

Primary Insurance Subscriber

This is the person whose name is on the insurance card. Many young adults in treatment qualify for coverage under their family’s insurance plan. Under the Affordable Care Act, young adults 26 years of age and under are entitled to their parents’ health insurance policies, which, through the exchanges, are required to provide mental health benefits.

Premium

A premium is the amount that people pay at regular intervals to their insurance companies for their coverage. This is the individual’s contribution to their policy, and in some cases, employers may also contribute to the premium. Premiums are determined by what kind of coverage a person has, such as an HMO or PPO plan.

Out-of-Pocket Expenses

Your out-of-pocket cost is the amount of money you must pay each time you visit a doctor or receive inpatient, outpatient, or other therapeutic treatments. These costs are usually due at the time treatment begins, but you may also be able to pay them a little at a time with payment plans. Out-of-pocket expenses include deductibles, copays, and co-insurance.

Policy Effective Date

This is the date when your mental health insurance company begins to help pay for your healthcare costs. You must enroll in a health insurance plan either during the open enrollment period, usually offered for a set amount of time once a year, or during a “special enrollment period.” Special enrollment periods begin after a qualifying event, such as marriage, the start of a new job, the birth of a baby, or the loss of healthcare coverage, and usually last for about 90 days. Your policy effective date is determined after you’ve enrolled, and usually falls a few weeks or months after your initial enrollment date.

Managed Care

This blanket term is used to describe the primary system through which healthcare services are provided in the United States. An insurance company directs—i.e., manages—the way you receive treatment, from regular checkups to accidents to major illnesses. Managed Care Organizations (MCOs) include the doctors, hospitals, laboratories, and clinics that make up your network.

Insurance Plan Types

Newport Institute works with an array of mental health insurance plans. Plan types break down into two categories: those with out-of-network benefits and those without out-of-network benefits. Plan types that typically offer out-of-network benefits are Preferred Provider Organization (PPO) and Point-of-Service (POS) plans. Plan types that typically don’t offer out-of-network benefits are Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. The bottom line: We pride ourselves on being able to work with the majority of major insurance companies, to help young adults receive the best treatment possible, as soon as possible.

Single-Case Agreement

A Single Case Agreement is when a provider, such as Newport Institute, works out a special contract so that out-of-network providers can work with your insurance company on an in-network basis. Many clients who receive treatment from Newport Institute do so within a Single Case Agreement, so we have extensive experience working with insurance companies to create Single Case Agreements for young adults with emotional, behavioral, or substance abuse disorders. Our goal is to ensure that your mental health insurance provider makes it possible for young adults to receive the most comprehensive and highest-quality treatment available.

Coverage Amount

The coverage amount is the percentage of treatment costs, after the deductible, that your mental health insurance policy will cover.

i
Call us at 855-895-4468
or if dialing in from outside the US,
+1-714-798-9320

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All information is confidential.

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