When you complete the form below, we’ll verify your benefits quickly and discreetly, then reach out to walk you through your coverage and answer any questions you may have. In many cases, insurance may cover up to 100% of treatment costs. Simply submit the form below, and we’ll take it from there.
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Disclaimer: A treatment center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, that this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits is subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” The treatment center will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.
We respect your privacy. We request this information to provide you with detailed coverage of benefits. By sharing your phone number, you agree to receive SMS messages via text from us – including details about your benefits. Message and data rates may apply, and frequency varies, text STOP to unsubscribe or HELP for assistance. Sharing this information is not a condition of treatment.
Disclaimer: A treatment center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, that this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits is subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” The treatment center will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.
We respect your privacy. We request this information to provide you with detailed coverage of benefits. By sharing your phone number, you agree to receive SMS messages via text from us – including details about your benefits. Message and data rates may apply, and frequency varies, text STOP to unsubscribe or HELP for assistance. Sharing this information is not a condition of treatment.
Checking your insurance is private, simple, and comes with no obligation. It does not alert your employer or commit you to treatment. It simply allows us to contact your insurance company to see what your plan covers for addiction treatment.
You fill out the secure form with basic insurance details, and our admissions team verifies your benefits, including coverage levels and any estimated out-of-pocket costs. Once complete, we’ll contact you with a clear explanation of your coverage and answer any questions you have.
Submit the form below, and we’ll handle the rest — quickly, securely, and confidentially.
Every plan comes with its own rules, network structure, and cost-sharing model. Knowing these differences helps individuals make informed decisions, and avoid unexpected bills, before starting treatment.
Because HMOs focus on network-based care, they typically offer lower monthly premiums and out-of-pocket costs, making them a cost-effective option for many families. However, the trade-off is less flexibility in choosing where to receive rehab services.
With a PPO, people can visit providers inside or outside the network without a referral. Out-of-network care will usually cost more, but it remains an option, something HMOs rarely allow.
When it comes to paying for addiction treatment, a handful of major insurers cover a large share of Americans. Each works differently, and understanding their approach to substance use disorder (SUD) treatment can help families make clearer, more informed decisions.
It remains one of the most widely used insurers for behavioral health support. Through its dedicated mental health and substance use programs, Aetna provides coverage for detox, inpatient care, outpatient therapy, and medication-assisted treatment, depending on medical necessity and plan type. Its public resources explain how members can access behavioral health services and what their plans typically include.
Q: Does Aetna require preauthorization?
Often, yes. Aetna usually requires prior authorization for inpatient detox, residential care, some outpatient services, and MAT medications. This is to confirm medical necessity before treatment begins.
This one company operates through a nationwide federation of state-specific companies, meaning coverage differs based on where someone lives. Most BCBS plans offer comprehensive behavioral health benefits, including substance use evaluations, counseling, rehab programs, and aftercare. They also follow federal parity laws requiring equal treatment of mental and physical health benefits.
Q: Are out-of-network facilities covered?
That depends on the plan type. BCBS PPO plans often include out-of-network benefits, but HMO plans typically require in-network treatment unless it’s an emergency.
It provides access to one of the largest behavioral health provider networks in the country. Its plans typically include services for early intervention, inpatient stabilization, intensive outpatient programs, and long-term relapse-prevention support.
Q: Does Cigna cover detox and MAT (Medication-Assisted Treatment)?
Yes. Cigna typically covers medically necessary detox, buprenorphine, methadone programs, and naltrexone-based treatments. Members may need to follow Cigna’s MAT provider guidelines.
This one is known for its broad coverage of substance use treatment. Many UHC plans include inpatient detox, residential treatment, outpatient therapy, and FDA-approved medications used in MAT.
Q: Will UHC cover services if the facility is out-of-network?
PPO plans may offer out-of-network benefits, but HMO and EPO plans generally require members to stay in-network for full coverage.
This insurance company offers mental health and substance use disorder benefits across many of its Medicaid and Medicare plans. Coverage often includes screenings, counseling, outpatient treatment, and in some cases inpatient rehab. Humana’s behavioral health pages outline how members can access therapy and SUD services through approved providers.
Q: Does Humana require referrals for treatment?
Medicaid and HMO plans may require a primary care physician referral for specialty behavioral health services, depending on the state.
This major insurer affiliated with Blue Cross Blue Shield in several states, provides extensive behavioral health coverage focused on whole-person care. Many plans include inpatient rehab, therapy, case management, and digital mental health tools to support recovery.
Q: Is preauthorization needed for rehab?
Usually, yes, especially for inpatient care. Anthem reviews documentation to determine clinical necessity before approving treatment.
Kaiser Permanente offers integrated care approach, blending mental health, addiction services, and medical treatment under one system. Members can access detox support, inpatient stabilization, outpatient counseling, and long-term recovery services within the Kaiser network.
Q: Does Kaiser Permanente cover addiction treatment?
Kaiser offers integrated mental health and substance use disorder care, including detox support, inpatient stabilization, outpatient programs, MAT, and therapy.
It provides behavioral health coverage through partnerships with major mental health service administrators. Many plans include inpatient detox, outpatient therapy, and MAT services. The insurer publicly outlines how members can access addiction treatment and what criteria determine authorization.
Q: What SUD services are covered by Medical Mutual?
Medical Mutual covers inpatient detox, outpatient programs, therapy, and substance use evaluations. Many plans also include MAT coverage.
This insurance company serves state employees and their families, offering robust mental health and substance use disorder benefits. Coverage often includes inpatient rehab, outpatient services, and therapy through approved networks. NYSHIP’s official resources explain eligibility, covered services, and how members can access specialized SUD care.
Q: Are all facilities covered under NYSHIP?
Typically, services must be provided by approved or participating facilities. Out-of-network coverage is limited without special authorization.
Insurance plans may all promise “behavioral health coverage,” but what they actually cover, and how easy it is to use those benefits, can differ widely between insurers. Below is a detailed comparison of how major U.S. providers typically approach detox, inpatient rehab, outpatient treatment, medications, and out-of-network options. This section helps individuals understand what to expect before verifying their benefits.
Insurance Provider | Detox Coverage | Inpatient Coverage | Outpatient/IOP Coverage | Pre-Authorization Required? | Out-of-Network Benefits |
Aetna | Yes | Yes | Yes | Often | Some PPO plans |
BCBS | Strong | Strong | Strong | Sometimes | Varies by state |
Cigna | Yes | Good | Yes | Often | Limited (HMO) / Yes (PPO) |
UHC | Yes | Yes | Yes | Often | Common in employer PPOs |
Humana | Yes | Varies | Yes | Sometime | Limited |
Anthem | Yes | Strong | Strong | Often | Good with PPO plans |
Medical Mutual | Yes | Yes | Yes | Often | Some plans allow it |
NYSHIP | Strong | Strong | Strong | Case-by-case | Limited unless approved |
Not having insurance doesn’t mean treatment is out of reach. Legacy Healing offers clear cost guidance, flexible self-pay options, and support in exploring affordable pathways, whether someone is applying for new coverage, checking Medicaid eligibility, or considering private-pay treatment. The goal is simple: make care accessible without adding financial stress.
Other options people can consider include:
Taking the first step toward recovery should feel supported, not confusing. Legacy Healing’s team is here to make the process easy, whether someone has comprehensive insurance, limited coverage, or is starting without a plan altogether. A quick verification can clarify benefits, out-of-pocket costs, and the treatment options available.
Check your coverage and get answers within minutes.
Your path to healing can begin today—one simple step at a time.
Frequently Asked
Not necessarily. Many plans (especially employer-based ones) will cover only clinically necessary services. High-end or “retreat-style” rehabs with spa amenities may not be fully covered unless pre-approved as medically necessary. For example, Cigna often excludes luxury amenities.
“Medical necessity” is a criteria used by insurers to decide whether to approve high-cost treatments like inpatient rehab. The treatment center often has to document clinical assessments, diagnosis severity, and treatment plan to satisfy insurer requirements.
Without medical necessity, your plan might deny coverage, or limit the days covered.
Yes, for many major insurers (Aetna, UHC, Cigna, etc.), MAT is covered, including medications like buprenorphine, methadone, or naltrexone. But the cost-sharing (copay, deductible) depends on your prescription drug tier and your plan’s pharmacy benefits.
Probably not. Even with good coverage, you may still have deductibles, copays, or coinsurance to meet, especially for higher levels of care. The exact amount depends on your policy, whether you stay in-network, and whether services are pre-authorized.
Yes. Aftercare (or continuing care) is often part of the SUD coverage. Many plans will cover ongoing outpatient therapy, relapse-prevention counseling, or alumni-level care, especially if it’s medically justified.
Our experts will review your coverage and help you explore treatment options.
All calls are 100% confidential.
