As each insurance plan has different restrictions regarding benefit availability, service providers, and medical necessity criteria, we strongly recommend that you contact your insurance carrier to verify your benefit coverage prior to seeking treatment.
Call the toll-free number on your insurance card to check about the behavioral health services, medical services and prescription drug coverage. Make sure you have a clear understanding about what is covered by your plan and if there are any restrictions or exclusions.
Health Plan Contracts
Rogers Memorial Hospital is contracted with many national health plans, including most Aetna, Blue Cross Blue Shield, Cigna, Humana and United Behavioral Health plans. We are also an approved provider for the Ontario Health Insurance Plan (OHIP). Please contact our admissions department for the most current information.
Medicare is accepted for inpatient services. Please note that Wisconsin Medicaid coverage varies depending on your age and if you are enrolled in an HMO. Medicare and/or Medicaid do not cover our residential treatment programs.
Quote of Benefits
Our admissions department staff will work with you to help you get answers concerning insurance coverage for treatment at Rogers. With your permission, an intake specialist will contact your insurance carrier to request a quote of your insurance benefits as part of the screening process. This quote is not a guarantee of coverage; that is why we strongly encourage you to contact your insurance carrier to discuss your plan’s coverage and to refer to your benefit plan handbook regarding what is covered.
To provide coverage for your stay, most insurance carriers require authorization prior to admission. This means that even if Rogers is an in-network provider and you have a quote of benefits for the program, your stay may not be covered unless authorization is obtained. When you arrive for your scheduled admission, we will notify your insurance carrier of your admission to request authorization. The authorization process can take anywhere from 30 minutes to several hours. Some insurance carriers do not have staff available 24 hours a day to complete the authorization. In lieu of waiting for insurance authorization, you may have the option of signing a form stating that you understand that the authorization has not been obtained yet, but wish to proceed with admission, and we will contact your insurance carrier during the next business day following your admission.
During treatment, Rogers has dedicated staff in each program who act as a liaison with insurance carriers and will assist you with addressing your financial questions and concerns. Please note that for some treatment services, such as certain assessments and diagnostic tests, medical services, laboratory services and prescription drugs, you may be billed separately by independent providers. You will receive separate statements from these providers for their services. We will work with your insurance carrier to obtain payment for the behavioral health treatment services you receive from Rogers; however, the hospital cannot guarantee payment of benefits by your insurance carrier. Ultimately, you are responsible for any expenses not covered by your insurance plan.