CONFIDENTIAL EVALUATION
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Medica’s Addiction Treatment Coverage

There are two coverage plans available through Medica in North Dakota: Medica Individual Choice and Altru Prime. Medica Individual Choice covers most of North Dakota (all counties except Burke, Divide, McKenzie, and Mountrail) and gives you access to a large number of providers, including many behavioral health and addiction treatment centers. On the other hand, Altru Prime covers only northeastern Dakota, but it has better coverage of services in that area. Depending on availability, both of these insurance plans may cover substance abuse services under their Behavioral Health/ Substance Abuse Service coverage.

Medica Behavioral Health has a network of providers where you can get mental health and/or substance abuse help. To find out which specific providers are covered, you will need to contact Medica.

Outpatient medication management services are available once you obtain an annual certification. This certification allows you to see any network provider without any other prior authorization. For more intensive care, you will need to contact Medica for prior authorization.

For those who receive coverage, the substance abuse services covered by Medica providers are:

  • Assessment
  • Individual treatment planning
  • Outpatient and residential substance abuse programs

Additionally, for behavioral health services, Medica may cover:

  • Individual, family, and group therapy
  • Psychiatric evaluation and medication management
  • Hospitalization when necessary

Depending on the type of insurance your employer has with Medica, you may be covered for substance abuse treatment through them as well.

Other Options Available

Many major cities have multiple treatment centers that take Medicaid and Medicare insurance. While there is not a definite benefit Medicare offers for addiction treatment, it can still be covered. Medicare is able to cover substance abuse treatment when it is determined to be necessary and reasonable. North Dakota and other states have the option to provide payment plans or discounts to patients. This is dependent on the needs of the patient. Additionally, the state may provide funding to low-income individuals.

It is recommended that those with insurance that is not Medica, Medicare, or Medicaid check with their insurance provider to see what can be covered by them. If insurance is provided by your employer you can contact the HR department of the company. Your Human Resources representative will assist you in figuring out what your insurance plan can cover. If you are uneasy about having a discussion with HR we are happy to assist you with getting more information about your insurance plan and what it covers for you.

How to Find Coverage

The information about addiction treatment can usually be found in the mental or behavioral health page on the website of your insurance provider. Unfortunatley, it can be hard to find information on insurance websites. After calling us, out addiction consultants will be happy to help you locate the best rehab facility for you as well as insurance to assit you in planning your treatment.

Fortunately, there are a variety of treatment centers in the state that offer sliding scale fees and other kinds of financial assistance. A sliding fee scale gives those with a smaller income the ability to have a lower cost for treatment. Additionally, the state may offer grants that can help cover treatment costs. With all of these options available, do not let the cost of treatment stop you from getting the help you need.

We’re ready to help you, whether you have insurance or not. We have compassionate and experienced specialists that are happy to answer the questions you may have. Call us at 701-380-5836 to get more informaiton.

How We Can Help

Medica Individual Choice or Altru Prime are two Medica insurance plan options available in North Dakota that can possibly cover your addiction treatment. If your employer provides you with Medica insurance you may also be covered. On the other hand, if you have Medicare or Medicaid insurance you still have the ability to be covered. Both Medicare and Medicaid offer coverage for addiction rehab if treatment has been defined as both necessary and reasonable. For other insurance types, look into their website to find additional information about the coverage you have. You can typically find this information in the mental and behavioral health section of your providers website.

Do not lose hope! Whether you have insurance or not treatment is still available to you. Insurance can be complicated, but do not let it prevent you from changing your life for the better. We would love to assist you in finding the right financial plan to suit your needs. Give us a call at 701-380-5836 to get assistance today!