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Addicts, families can get insurance information from state agency

Stephen Huba
| Monday, Aug. 14, 2017, 5:18 p.m.

The Pennsylvania Insurance Department wants opioid addicts and their families to be better informed about the range of insurance coverage options for substance abuse treatment.

The state agency has released a brochure titled, “Substance Use Disorder and Your Insurance Coverage,” which outlines coverage options under the Affordable Care Act, employer-provided health insurance, and government programs such as Medicaid and Medicare.

The brochure outlines how the source of health care coverage determines what treatment coverage options a person has, or whether the treatment is covered at all.

Although the information was already online, the agency first made the brochure available on Aug. 3 at a meeting on the opioid crisis held by the Diocese of Greensburg at Our Lady of Grace Parish in Greensburg.

“We chose to release the information at the Diocese of Greensburg meeting in order to provide an additional resource to people who may be looking for help for themselves or a loved one,” said department spokeswoman Ali Fogarty.

The brochure notes that insurance plans that have Substance Abuse Disorder coverage must offer the same level of benefits as they do for medical or surgical treatment – a concept known as parity.

Services that are subject to parity rules and must be covered at the same level as medical or surgical benefits include: the number of outpatient visits; out-of-pocket costs, such as co-pays, deductibles and co-insurance; prior authorization requirements; the provider network for out-of-network services; and the criteria used to determine medical necessity.

Dave Buono, consumer liaison for the Insurance Department, will give a presentation on insurance coverage at 7 p.m. Wednesday at St. Thomas More University Parish in Indiana – the last of seven Summer Diocesan Drug Education and Prayer Service Evenings with Bishop Edward C. Malesic.

The brochure can be found on the Pennsylvania Insurance Department website .

Stephen Huba is a Tribune-Review staff writer. Reach him at 724-850-1280, shuba@tribweb.com or via Twitter @shuba_trib.

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