Insurance coverage basics
Federal law requires health insurance providers to treat mental health and substance abuse benefits equally with medical and surgical care. Inpatient detox, residential treatment, PHP, IOP, and MAT are typically covered under employer-sponsored plans, marketplace coverage, Medicaid, and Medicare.
Common Insurance Providers
Facilities in our referral network work with leading private and public insurance plans across the country, including:
Medicaid
How Medicaid covers substance use disorder treatment, including medications for opioid use disorder, the IMD exclusion, and Section 1115 waivers.
Medicare
What Medicare Part A, Part B, Part C, and Part D cover for addiction treatment, the 190-day limit, the opioid treatment program benefit, and 2026 costs.
TRICARE
What TRICARE covers for substance use disorder treatment, how referrals and prior authorization work, and costs across Prime and Select.
Aetna
What Aetna plans typically cover for detox, rehab, IOP, and outpatient addiction care, how precertification and medical necessity work, and your parity rights.
Ambetter
What Ambetter (Centene) marketplace plans typically cover for detox, rehab, IOP, and outpatient addiction care, and how prior authorization works.
Anthem
What Anthem plans typically cover for detox, rehab, IOP, and outpatient addiction care, how authorization works, and what to verify before you travel.
Blue Cross Blue Shield
How Blue Cross Blue Shield plans handle behavioral health and substance use disorder coverage, prior authorization, treatment centers, and your parity rights.
CareFirst
What CareFirst plans typically cover for detox, rehab, IOP, and outpatient addiction care, how authorization works, and what to verify before you travel.
Carelon Behavioral Health
How Carelon Behavioral Health manages substance use benefits, prior auth, networks, and what to verify on your ID card before rehab.
Centene
What Centene plans typically cover for detox, rehab, IOP, and outpatient addiction care, how authorization works, and what to verify before you travel.
Cigna and Evernorth
How Cigna's Evernorth Behavioral Health manages rehab coverage: precertification, medical necessity criteria, coaching programs, and parity.
Florida Blue
What Florida Blue plans typically cover for detox, rehab, IOP, and outpatient addiction care, how authorization works, and what to verify before you travel.
Highmark
What Highmark plans typically cover for detox, rehab, IOP, and outpatient addiction care, how authorization works, and what to verify before you travel.
Humana
How Humana covers behavioral health and substance use treatment across commercial, Medicare Advantage, and Medicaid plans, including prior authorization.
Kaiser Permanente
How Kaiser Permanente plans typically handle substance use benefits, referrals inside an integrated system, and what to verify before out-of-network rehab.
Magellan
What Magellan plans typically cover for detox, rehab, IOP, and outpatient addiction care, how authorization works, and what to verify before you travel.
Molina Healthcare
What Molina Healthcare plans typically cover for detox, rehab, and outpatient addiction care, plus prior auth and network checks.
Optum Behavioral Health
How Optum Behavioral Health manages rehab coverage: prior authorization, LOCUS and ASAM criteria, levels of care, and your appeal rights.
Oscar Health
What Oscar Health plans cover for detox, rehab, IOP, and outpatient addiction care, how the Care Team and prior authorization work, and your parity rights.
Quartz
What Quartz Health Plan covers for detox, rehab, IOP, and outpatient addiction care, and how its Behavioral Health Care Management and prior authorization work.
UnitedHealthcare
How UnitedHealthcare and Optum Behavioral Health manage rehab coverage: prior authorization, medical necessity review, LOCUS and ASAM criteria, and parity.
Medicaid, state-funded care, and no insurance
Medicaid covers addiction treatment in every state, but the rules, plan names, and covered services differ. Start with how Medicaid covers rehab and the Medicaid rehab guide for your state. If you have no coverage at all, read about state-funded rehab and free rehab options, or browse every insurance and cost guide.
How Benefit Verification Works
When you call (800) 653-9376, our specialists can verify your benefits directly with your carrier. We will determine:
- Whether your plan requires pre-authorization or clinical necessity reviews
- Your deductible, copays, and out-of-pocket maximums
- In-network vs. out-of-network facility coverage
- Covered lengths of stay for detox and residential rehabilitation