Coverage Explanation
Provider Type
- Participating Physician Groups (PPG)
- Ancillary
- Hospitals
Health Net covers Medicare reimbursable acute care (detoxification) services for alcohol and drug abuse. Services include diagnosis, medical evaluation, treatment, detoxification services, and referral services for further assistance. Coverage for acute care does not have a maximum number of admissions and must be provided even if the problem is determined to be chronic.
Medicare Advantage (MA) also cover alcohol and drug or substance abuse rehabilitation in inpatient and outpatient substance abuse facilities that are Medicare-certified. This includes institutional charges for inpatient substance abuse treatment programs and institutional and professional charges for day care substance abuse treatment programs. Refer to the member's Evidence of Coverage (EOC).