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When it comes to finding addiction or mental health residential treatment for yourself or a loved one, the last thing you probably want to think about is how you are going to pay for it. On that note, we here at the Phoenix Recovery Center want to make it clear that insurance insecurity should never supersede the need to get help as soon as possible. Yes, financial aspects are a reality of the recovery system, but the first step is reaching out for help and getting yourself or a loved one safe. Moreover, financial and insurance concerns can be best navigated with professional help. 

The good news is Medicare does cover both inpatient and outpatient mental health care, and The Phoenix Recovery Center is compliant with Medicare insurance. However, coverage is based on the type of insurance of each individual, so make sure to check with your Medicare provider to know for sure what is covered.

Professionals Can Provide Financial Advice

By reaching out to an addiction and/or mental health professional you can ensure that you are taking the first step toward getting the help you or a loved one needs. Assessment professionals are trained to be able to quickly navigate finance and insurance options while also ensuring that an individual gets the kind of immediate care if necessary. It is also important to note that if you have trouble getting answers or if you are speaking to someone that is not availing you of any options, please keep trying. There are professionals that want to get you the help that is right for you. 

Here’s the truth, The Phoenix Recovery Center is not right for everyone. We may not be the right fit for an individual’s specific physical or psychological needs. In full disclosure, we may also not be able to accommodate someone financially. However, if we cannot accommodate you, we can direct you to the right next place to look. We believe in what we do here at The Phoenix Recovery Center, but our primary goal is to help people recover. If that means that we must direct you somewhere else, we still feel that we are honoring our mission. 

Understanding Medicare and Residential Treatment Options

Now that the necessity of connecting with a professional has been established, we can discuss various Medicare and residential (inpatient) treatment options. Medicare’s official website states, “Medicare Part A (Hospital Insurance) covers mental health care services you get when you’re admitted as a hospital patient. Medicare Part B (Medical Insurance) covers the services you get from a doctor or other health care provider while you’re in the hospital.”

To break this down, there are two aspects of Medicare that, when combined, cover a relative portion of care when admitted to an inpatient program. The following are some very specific aspects of how Medicare will cover residential treatment per “each benefit period”:

  • There is a $1,600 deductible
  • No daily cost for the first 60 days
  • The copayment cost is $400 per day from day 61 to day 90
  • After 91 days, something called “lifetime reserve days” takes effect. There is a maximum of 60 of these reserve days, and each reserve day has an $800 copayment per day
  • All costs are incurred after all of the lifetime reserve days are used

A few other aspects of Medicare to understand is that all of those numbers only apply to each “benefit period,” and, according to Medicare directly, “There’s no limit to the number of benefit periods you can have, whether you’re getting mental health care in a general or psychiatric hospital.” Lastly, Medicare defines “mental health care” as all services that “diagnose and treat people with mental health disorders.”

Stopping Insurance Insecurities From Getting in the Way of Residential Treatment

If all of that feels like a lot, that is understandable. Sometimes systems like Medicare communicate in a way that can feel overwhelming. This is especially unfortunate because it can stop individuals from getting the mental health care they need and deserve.

Ultimately, what individuals with Medicare should take away from all of that information is that they have a right to inpatient and residential mental health care according to the guidelines. There is no reason to let insurance insecurity stop you from getting yourself or a loved one into recovery. 

How The Phoenix Recovery Center Can Help

Our mission has always been to empower our clients and their families as they navigate their life in treatment and, eventually, in long-term recovery. However, before we can start that empowerment process, someone has to reach out. If you feel like you are ready to reach out, we are ready to take your hand.

When reaching out about mental health care, it is important to understand how your insurance may be able to cover some or all of your treatment. However, here at the Phoenix Recovery Center, we understand how overwhelming and often confusing it can be to deal directly with insurance companies. That is why we have professionals available to better explain to you your insurance and treatment options. For those that have Medicare, there are very specific details regarding residential treatment and what other recovery options they cover. Don’t let insurance insecurities get in the way of recovery. For more information on how Medicare may cover residential treatment, please reach out to the Phoenix Recovery Center today at (801) 438-3185.

The Phoenix Recovery Center
489 W. South Jordan Pkwy
Suite 400
South Jordan, UT