PEIA insurance can help you get the help that you deserve for addiction and mental health treatment. Our addiction counselors will walk you through your benefits so you don’t have to worry about reaching out to your insurance provider.

With the highest quality of resources and support, you’ll find that a life of long-term sobriety becomes possible.

Does PEIA Insurance Cover Addiction and Mental Health Treatment?

peia insurance coverage for addiction treatment

PEIA insurance covers mental health and substance abuse treatment. With PEIA insurance, you’ll be able to receive high-quality care at a significantly lower cost. 

Our recovery center offers a variety of evidence-based methods when it comes to treatment. These evidence-based methods include a combination of unique therapies. Therapy will help you develop a toolkit of skills that will help you cope with stress and temptations. 

We offer many therapeutic services such as:

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) uses behavioral therapies to promote the discussion of emotions and thoughts. CBT emphasizes the idea that thinking negatively will result in bad habits, undesirable feelings, and ultimately bad behavior. 

Thoughts, behaviors, and emotions and how they are connected is the central focus of cognitive behavioral therapy. During a CBT session, a therapist will act as a mentor to recognize and work through thoughts, feelings, and behaviors relating to addiction.

Contingency Management (CM)

CM is another evidence-based therapy that has helped countless recovering individuals. CM can be used in treating alcohol, opioids, marijuana, and stimulants addiction

Reinforcing sobriety is the main goal. This therapy provides the recovering individual a material reward for positive behavior, such as maintaining sobriety. 

Rewards vary, but often include: 

  • Voucher-based reinforcement. The program rewards the recovering individual with a voucher when tested negative for drug testing. They can be exchanged for different items of value at our recovery center. 
  • Prize incentives. Different price incentives may also be offered instead of vouchers. 
  • Natural happenings. These are natural rewards as the recovering individual progresses through their sobriety journey. These rewards are shown through improvement in relationships with one’s partner, friends, or family. Your physical health will benefit alongside your mental health too. 

Motivational Interviewing (MI)

Motivational interviewing is a method used to address destructive behavior. MI is a patient-centered model of counseling. In other words, the patient’s wants are prioritized, not what the therapist thinks is best for them. 

MI is a fairly simple process that includes the following steps: 

  • Engaging: Talking about issues, concerns, and hopes, and establishing a trusting relationship with the recovering individual.
  • Focusing: Addressing the patterns and habits the individual wants to change the most.
  • Evoking: Heightening the sense of the importance of change, confidence that change can occur, and readiness for change.
  • Planning: Creating a set of realistic steps that the recovering individual can use to make the necessary changes. 

Family Therapy

Addiction affects not only the person in treatment but the family as a whole. Family therapy aims to help the rest of the family heal as well. Loved ones are able to participate in healthy discussions that are geared towards working through any present issues. Family members are given the opportunity to express their thoughts and emotions in a constructive manner. 

Group Therapy

This form of psychotherapy involves a group of individuals that are all working towards recovery. Therefore, every person in the group can relate to each other as they have been through similar struggles. This provides a very supportive environment and allows for individuals to feel more ease with expressing themselves. 

Music and Art Therapy

These forms of therapy are geared towards focusing on an individuals creativity. The idea is that by focusing on a different outlet, the individual will have a way to refocus their energy in a constructive manner. 

What Insurance Terms are Useful to Know?

As you move along the recovery process, it’s helpful to become acquainted with the terms you’ll be hearing. General PEIA insurance terms include:

Premium

This is the payment you regularly make for your insurance plan that keeps your plan active. 

Out-of-Pocket Maximum

This is the absolute most you’ll have to pay for covered services within the coverage year. After these costs are taken care of through deductibles, copayments, and coinsurance, your insurance provider will cover the remaining costs.

Policy Effective Date

This is when your policy begins. In other words, this is when you will be able to use your benefits. You’ll get access to your benefits, you plan should highlight what those will be. 

Deductible

A deductible is a cost that must be paid out of pocket for covered medical services. Your insurance provider will cover the rest of the cost. 

Copayment

A copayment is a cost you may pay before you receive a medical service. For instance, let’s say you need to pay $2,000 for inpatient treatment at a treatment center. Your health insurance plan may pay half of that price, and then require a $500 copayment to cover the rest. 

Determining Monthly Premiums with PEIA Insurance

Active Employees

If you are an active employee of a State agency, college, university or county board of education, most of your health insurance premium is taken care of by your employer. 

The amount of your contribution is determined by your salary, the type of coverage you choose, your tobacco-use status, whether you’ve completed an Advance Directive/Living Will affidavit as well as your participation in the Improve Your Score program. 

If you are an active employee of a local government agency, your employer will set your health insurance premium contribution level. You may take care of costs ranging from 0% to 100% of the premium that PEIA charges to your employer. 

Retired Employees 

Premiums for retired employees are decided based on a number of factors, such as retirement date.Premiums for most retired employees are deducted from their annuity on a monthly basis. Some retired employees pay premium costs directly to PEIA each month.

How Do We Determine Your Benefits?

When we go through PEIA insurance, we’ll help you get the most out of your benefits. Our goal is to provide you the highest quality of treatment while also getting the most out of your PEIA insurance plan. 

We go through a simple two-step process. The steps are as follows:

Step 1: Confirming Your PEIA Insurance Benefits 

We’ll start with a complimentary and thorough evaluation of your insurance benefits. TDuring this step, we’ll reach out to your provider and see what kind of benefits are included in your PEIA insurance plan. 

Step 2: Verifying Addiction and Dual-Diagnosis Benefits of Your PEIA Insurance Plan

After the in-depth evaluation, we’ll let you know:

  • How much of the cost your insurance company will cover
  • What level of care you’ll be covered for
  • The amount of time you’ll be covered for residential care (30-120 days, etc.)
  • How much you will be expected to pay out-of-pocket for a treatment program

The Opioid Crisis in West Virginia and How PEIA Insurance Can Help

West Virginia is one of the many communities nationwide that’s struggling with prescription and illicit opiate drug misuse. This misuse results in an escalation of addictions, overdoses and deaths. Since 2010, West Virginia has undergone an average of 600 overdose deaths per year. 

PEIA insurance recognizes this issue. If you or a loved one is struggling with opioid addiction, our recovery center can help you get the benefits and help that you need. 

Coverage for Opioid Therapy with PEIA Insurance

PEIA can cover varying levels of care, from outpatient treatment to residential treatment. Depending on your needs, one level of care may be suited for you over another. PEIA insurance helps take care of detoxification, stabilization, and any medical complication costs.

Residential treatment is when an individual resides at our recovery center while undergoing treatment sessions. Residential treatment is the highest level of care. Individuals will take part in a daily, customized routine that targets addiction as well as any other co-occurring disorders. 

PEIA will also cover outpatient treatment if an individual’s plan meets certain qualifications. Outpatient treatment is a more flexible form of care. PEIA insurance coverage takes care of all the different types of outpatient programs. Standard outpatient treatment is the least intensive form of care. Other programs, such as intensive outpatient care, consist of scheduled treatment sessions several days per week. 

Begin Your Road to Recovery with Harmony Ridge Today!

Here at Harmony Ridge, our goal is to make the onboarding process as smooth as possible. Insurance shouldn’t stop you from getting the help that you deserve. We’re here to guide from the first phone call all the way through the end.

No matter what stage of addiction you’re in, we’re here to be a part of your journey. At the end of the tunnel, there can always be a light found.

We’re here to help you not just through insurance coverage and benefits, but everything else you may need as well. We offer many additional services such as:

  • Group therapy
  • Individual therapy
  • Family therapy
  • Psychotherapy 
  • Medical appointments
  • Wellness and fitness activities
  • Family program participation
  • Nutritional assessment
  • Spiritual care
  • Educational and experiential workshops

If you have any questions, comments, or concerns, please don’t hesitate to reach out to us here. We’re ready to take your call!