UniCare (Now Wellpoint) Rehab Coverage in West Virginia

Published: 2026-10-26 Updated: 2026-10-26

You still have the old UniCare card in your wallet, or someone told you to call UniCare, and now the paperwork says Wellpoint. It is the same plan — just a new name — and the bigger question underneath it is whether West Virginia Medicaid will cover detox and rehab. The coverage answer is a firm yes on the benefit, and the practical answer runs through your plan and the state's authorization process.

Was UniCare renamed, and does that change my coverage?

It depends on nothing about your treatment — the name changed, the benefits did not. UniCare Health Plan of West Virginia, Inc. became Wellpoint on January 1, 2025. Wellpoint's FAQ says the rebrand did not change coverage, provider access or the cost of premiums, the provider network stayed the same, and members received a new ID card with the Wellpoint logo while keeping the same member ID number. You may still see the UniCare name during the transition, and your old card is not a problem to sort out before you get care.

Does West Virginia Medicaid cover rehab and detox?

It depends on the level of care and on authorization, but the benefit is comprehensive. West Virginia Medicaid's provider manual states that the state covers a range of behavioral health therapies and treatment for substance use disorder, and it describes medication assisted treatment (MAT) services and naloxone services as part of that coverage. The state organizes SUD care along the ASAM Criteria continuum, which runs from outpatient counseling through residential treatment.

That means the covered treatment spans:

• Withdrawal management and detoxification — managing withdrawal safely, sometimes in a hospital or dedicated facility
• Residential and inpatient treatment — structured care where you live at the program
• Intensive outpatient and partial hospital programs — step-down care that keeps structure without a full residential stay
• Outpatient counseling and behavioral health therapy — ongoing treatment you attend on a schedule
• Medication assisted treatment — methadone, buprenorphine and naltrexone

Intensive programs are the ones that most often need approval first. West Virginia requires prior authorization for behavioral health intensive outpatient, community psychiatric supportive treatment and partial hospital program services, submitted to the plan or the state's utilization management contractor.

How medication assisted treatment works here

West Virginia Medicaid covers all three FDA-approved medications used for opioid use disorder, and the provider rules are specific. For office-based medication assisted treatment, an enrolled provider must evaluate the patient before any medication is prescribed — an initial evaluation may be done by another staff member, but no prescription can be written until a physician, physician assistant or advanced practice nurse completes their own evaluation. Methadone is dispensed through an opioid treatment program, and providers must be approved as office-based MAT providers for the plan to reimburse them.

If medication is part of your plan, ask the treating provider which form your plan covers and where you fill it. For alcohol or benzodiazepine withdrawal, stopping suddenly can be dangerous and should happen under medical supervision.

How the plans fit together

West Virginia delivers most Medicaid coverage through managed care. The Bureau for Medical Services runs a risk-based program called Mountain Health Trust, which it launched in 1996 and which serves about 87% of the state's Medicaid membership. The state contracts with four managed care organizations, each covering all 55 counties:

• Aetna Better Health of West Virginia
• Highmark Health Options of West Virginia
• The Health Plan of West Virginia
• Wellpoint West Virginia (formerly UniCare)

Wellpoint handles West Virginia Medicaid and the Children's Health Insurance Program, WVCHIP, which has been part of Mountain Health Trust since January 1, 2021. One quick disambiguation: Highmark Health Options is a separate MCO from the plan that used to be UniCare, even though both names come up in West Virginia. And West Virginia expanded Medicaid under the Affordable Care Act beginning January 1, 2014, which is why a broad group of low-income adults can qualify for coverage that includes substance use treatment.

If a request is denied

You have appeal rights. The Mental Health Parity and Addiction Equity Act generally prevents plans that cover mental health and substance use disorder benefits from applying financial requirements and treatment limits that are more restrictive than those applied to medical and surgical benefits, and plans contracting with state Medicaid programs must meet certain parity requirements. When something is denied, ask which medical necessity criteria were used, then use the plan's grievance and appeal process and keep every letter and reference number.

How to start

Wellpoint members can reach Customer Care at 800-782-0095 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m., and can find the plan at wellpoint.com/wv/medicaid. The state's Bureau for Medical Services helpline is 1-877-716-1212 if your question is about eligibility. HELP4WV at 1-844-435-7498 (1-844-HELP4WV) is a 24/7 call, chat and text line for anyone struggling with addiction, and many who answer are peer recovery specialists.

If you would rather talk the options through before calling the plan, call (800) 653-9376. The call is free to you, the referral service is paid for by treatment providers, and there is no judgment on the other end.

If you are in crisis right now, call or text 988 for the Suicide and Crisis Lifeline. Call 911 for a medical emergency.

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