HMC HealthWorks is a healthcare management company that has over 1 million participants. HMC takes a different approach to healthcare in an effort to keep costs low for both its clients and members by tailoring plans to their specific needs. This can include reducing costs for addiction treatment programs related to substance abuse/drug abuse. The HMC program offers chronic care management, behavioral health, wellness, EAP/Work Life programs, and Pharmacy Benefit Management. With a focus on utilization management, HMC generates critical insight to continually improve healthcare management for clients, including for substance abuse treatment programs.

HMC HealthWorks’ objective is to manage rising healthcare costs and ensure that members receive the most effective, highest quality behavioral healthcare services in the most appropriate environment (such as at an addiction treatment center and through inpatient and outpatient treatment programs).

What Does HMC HealthWorks Cover?

HMC HealthWorks might cover the following behavioral health services:

  • Detox
  • Inpatient Rehab
  • Outpatient Rehab
  • Medication-Assisted Treatment

In addition, HMC Insurance generally covers most types of addictions, including:

HMC HealthWorks Addiction Treatment Options & Cost

With thousands of providers specializing in substance use disorder treatment, members are able to find a program that meets their individual needs with ease. Most HMC HealthWorks plans offer addiction treatment options, these plans typically cover both inpatient and outpatient care. The cost of treatment for the member will be determined by the individual plan; however, most are subject to deductible and/or copay.

Does HMC HealthWorks Cover Co-Occurring Disorder Treatment?

Yes, depending on your level of coverage, addiction treatment and treatment of depression and anxiety could be covered under mental or behavioral health services.

Does HMC HealthWorks Cover Medication-Assisted Treatment?

Yes, there are a few plans in their network that cover medication-assisted treatment.

Where is HMC HealthWorks Available?

HMC HealthWorks primarily has a network of rehab providers in Florida, Arizona, and California.

Does HMC HealthWorks Insurance Coverage Include Out-of-Network Providers?

HMC HealthWorks does not cover out-of-network providers unless the member was in need of emergency treatment. Typically HMC HealthWorks requires members to choose a provider or addiction treatment facility from their extensive list of preferred providers. However, they are aware that these providers might not be accepting new patients. Therefore, in emergency situations, their members might seek treatment with out-of-network providers, in which case they allow single-case agreements to cover the member’s treatment services with little out-of-pocket costs.

Inpatient Substance Abuse Treatment Coverage

Most HMC HealthWorks plans cover inpatient treatment. These plans are created with members in mind and the payors and employer programs work to keep costs low for members. Typically inpatient treatment services will have out-of-pocket costs for the member. These out-of-pocket costs will apply to the member’s deductible. For members with higher-level plans, they might only be required to pay a copay for inpatient treatment services.

Commonly covered services by HMC HealthWorks include but are not limited to;

  • Screenings and Assessments
  • Psychiatric Evaluations
  • Detoxification
  • Inpatient Rehab Stay/Residential Addiction Treatment
  • Individual Therapies
  • Medical Examination and Treatment
  • Aftercare Services

To determine your inpatient treatment coverage, contact our rehab advisors. We are here to help you maximize your plan’s benefits and minimize your out-of-cost expenses.

Outpatient Treatment Coverage

HMC HealthWorks covers outpatient addiction treatment services. With thousands of outpatient treatment facilities, therapists, and psychologists within the preferred provider program, members are able to obtain outpatient treatment with little to no out-of-pocket costs. Most HMC HealthWorks plans require members to pay a copay for outpatient treatment services.

Commonly covered outpatient services by HMC HealthWorks include:

  • Partial Hospitalization (PHP)
  • Intensive Outpatient (IOP)
  • Individual Therapy
  • Group Therapy
  • Psychiatric Evaluations and Management
  • Screenings and Assessments
  • Medical Examinations and Treatment
  • Aftercare Services

To determine your out-of-pocket costs for outpatient treatment insurance coverage, or to find out if you are eligible for HMC HealthWorks member benefits, contact our rehab advisors.

HMC HealthWorks Addiction Resources for Drug and Alcohol Rehab

HMC HealthWorks offers 24/7 Crisis Assessment & Triage by Licensed Clinicians. Members are able to speak to a clinician, day or night, when suffering from addiction and/or mental health problems. This will help them get emergency services when they are needed.

Appointment Assistance at HMC HealthWorks also helps its members to obtain appointments and schedule admission into treatment centers during an overwhelming time without having to contact numerous providers themselves. Benefits, Eligibility, and Referral Information also aids members in obtaining the addiction treatment needed and knowing their out-of-pocket costs ahead of time. This can make the entire treatment process much more efficient. The Clinical Utilization Management team at HMC HealthWorks’ objective is to obtain Higher Levels of Care for its members to ensure they receive the appropriate treatment.

With an extensive Provider Network, HMC HealthWorks makes it easy for its members to obtain addiction treatment.

How To Determine Your HMC HealthWorks Substance Abuse Benefits

To find out if HMC HealthWorks might help to lower the cost of addiction treatment, contact our rehab advisors. We are here to help you maximize your plan’s benefits and minimize your out-of-cost expenses.