Arizona Complete Health is a major insurance provider in Arizona that offers different types of health plans. These include Medicaid (AHCCCS) and Medicare Advantage plans.

For people struggling with addiction or mental health issues, understanding what treatment services are covered can be confusing. Insurance coverage for rehab services can depend on the type of plan, medical necessity, and whether the treatment facility is in the insurance network.

Granite Mountain Behavioral Healthcare works with Arizona Complete Health to help patients access treatment. We’ll help you determine what level of coverage applies to your situation, help you determine payment options, and incorporate it all into your personalized treatment plan. Our job is to support your journey, and helping you figure out how to pay for it is just another part of that journey.

Types of Rehab Services Covered by Arizona Complete Health

Arizona Complete Health covers a range of behavioral health and substance abuse services. Coverage varies by plan type, but generally includes treatment at different levels of care.

• Detoxification: Medically supervised withdrawal management, typically covered for 3-7 days (depending on medical necessity).
• Residential Treatment: 24-hour care in a structured environment
• Partial Hospitalization (PHP): Structured treatment that allows individuals to return home at night.
• Intensive Outpatient (IOP): Treatment several times per week, at a level between inpatient and outpatient.
• Standard Outpatient: Weekly treatment and medication management (when appropriate).
• Medication-Assisted Treatment: FDA-approved medications for addiction, such as buprenorphine or naltrexone, monitored by medical professionals.

For AHCCCS (Medicaid) members, most of these services are covered with little or no out-of-pocket cost when deemed medically necessary. Marketplace and Medicare Advantage plans may require copayments, coinsurance, or meeting a deductible first. Of course, coverage may vary according to individual coverage and level of coverage.

Potential Coverage Limitations for Rehab Services

There are some important limitations to be aware of when seeking out insurance coverage for drug rehab and/or mental health support services:

• Network Restrictions: Services may only fully cover when provided by facilities in the provider’s treatment network.
• Prior Authorization: Most inpatient and some outpatient services require approval before treatment starts.
• Medical Necessity: Treatment must be deemed necessary based on clinical criteria, although qualifications and criteria may vary by insurer.
• Duration Limits: Coverage may be limited to a specific number of treatment days or therapy sessions.

Granite Mountain Behavioral Healthcare offers treatment programs that can be covered by Arizona Complete Health. We work directly with insurance companies to maximize benefits for people seeking coverage, so they can receive the fullest extent of benefits available to them.

Why it’s Important to Seek Insurance Coverage for Rehab

You may be hesitant to engage with insurance around coverage for rehab services, something that may already seem scary or intimidating. But insurance companies want to support your health. From a practical point of view, they’re interested in helping you prevent future health crises and have an incentive in helping you heal from conditions before they start affecting your life for the long term.

Understanding your specific benefits helps you make informed decisions about treatment options. Arizona Complete Health insurance offers comprehensive coverage for substance use and mental health treatment. You may be surprised to learn just how many treatment options are within your budget — and how easy it is to receive support for treatment that can help.

The National Institute on Drug Abuse reports that patients who use insurance benefits for addiction treatment are more likely to complete their programs. According to SAMHSA’s 2023 National Survey on Drug Use and Health, individuals who received insurance-covered treatment showed 32% higher rates of sustained recovery at one year compared to those without coverage.

Granite Mountain Behavioral Healthcare works with Arizona Complete Health to maximize insurance benefits and minimize out-of-pocket costs. Our team handles insurance verification, preauthorization, and ongoing coverage reviews. Treatment programs at Granite Mountain are designed for effective, evidence-based care that speaks to individual needs.

FAQs About Rehab Coverage in Arizona

Does Arizona Complete Health cover both mental health and substance use treatment?

Yes, Arizona Complete Health covers both mental health and substance use treatment services as required by federal parity laws. However, specific coverage depends on your plan type.

How do I know if my treatment is considered “medically necessary”?

Medical necessity is determined based on clinical assessments, diagnosis, severity of symptoms, and treatment history. It is eventually evaluated by Arizona Complete Health’s clinical review team.

What if I need more treatment days than initially approved?

Your treatment team can request additional days by submitting updated clinical information showing continued medical necessity for the level of care.

What if I need to switch treatment formats?

Needing to switch treatment formats (such as stepping down to a less intensive form of treatment after completion of a program) does not mean coverage necessarily has to end. Communication with the insurance company and treatment facility can help facilitate continued coverage as you move to the next level of care.

Get Help Today at Granite Mountain Behavioral Healthcare

Granite Mountain can help you navigate Arizona Complete Health insurance coverage for addiction and mental health treatment. Our admissions team will verify your benefits, explain your coverage, and help with the authorization process.

Contact us today to start the process. Our experienced staff understands how to work with Arizona Complete Health to access the care you need.