State RegulationsOH specificDifficulty 2/5
A Toledo health insuring corporation's contract covers treatment programs for alcohol and drug abuse. A member asks whether this is a basic service because the treatment is medically necessary. Under ORC 1751.01, alcohol and drug abuse treatment is:
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
ORC 1751.01(B) classifies alcohol and drug abuse treatment as a supplemental health care service. The tier is set by statute, not by medical necessity: the basic tier of ORC 1751.01(A) is a closed list, and the specialty tier of ORC 1751.01(C) is a separate definition.
Why the other options are wrong
- A) Wrong: the basic tier in ORC 1751.01(A) is defined by statute and does not include alcohol and drug abuse treatment; medical necessity does not change the tier.
- C) Wrong: the specialty tier is a separate definition in ORC 1751.01(C); substance abuse treatment sits in the supplemental tier.
- D) Wrong: ORC 1751.01(B) expressly places alcohol and drug abuse treatment in the supplemental tier, so it is a recognized service category.
Memory hook
Recovery care is supplemental — (B), not basic.