Ask the insurer to identify the member, policy type, effective date, termination date if one is listed, and whether substance use disorder benefits are administered by the same company shown on the card. Some plans use a separate behavioral health administrator. If so, obtain that administrator's contact information and repeat the verification there.
Next, ask whether the plan distinguishes among detoxification settings or service categories. Use the insurer's own terms and codes rather than substituting the phrase medical detox for every answer. Living Longer Recovery should not be described as offering medical detox based on the verified public record. California DHCS records on file identify Living Longer Recovery, Inc., record number 330022BP, at 68257 Calle Azteca, Desert Hot Springs, CA 92240, with residential drug and alcohol detox, a 14-person capacity, co-ed adults, and incidental medical services. Those records do not establish current availability, individual fit, admission, staffing, schedule, medication, insurance participation, room type, or outcome.
- Is the policy active now, and is it expected to remain active during the proposed dates?
- Is there a separate behavioral health or substance use benefits administrator?
- What exact benefit category would the insurer use for the service being considered?