First Medical Health Plan Coverage for Alcohol & Drug Rehab
Explore First Medical Health Plan’s coverage for addiction treatment in Puerto Rico. Learn about plan options, provider networks, and mental health services.
First Medical Health Plan Coverage for Alcohol & Drug Rehab
Explore First Medical Health Plan’s coverage for addiction treatment in Puerto Rico. Learn about plan options, provider networks, and mental health services.
First Medical Health Plan is a health insurance company that covers people in Puerto Rico. They’ve been in operation since 1977. If you live in Puerto Rico, you may have an employer sponsored health plan through them.
If you’re a government employee, you may also get your health benefits through them. You can also sign up for their plans as an individual. In recent years, they’ve become one of four government health plan providers for the territory. The government health plan is also known as Plan Vital and includes Medicaid.
Does First Medical Health Plan Cover Addiction Treatment?
Many First Medical plans cover mental health and substance use treatment. They may cover services like inpatient and partial hospitalization as well as standard outpatient treatment.
Notably, some of their private plans limit you to one detox episode per year for a maximum length of 45 days. You’ll need to check the details on your specific plan before you commit to treatment.
Their provider network has several hospitals that may be able to give you inpatient drug treatment. Keep in mind you might need to get prior authorization before going. If your primary care provider refers you, they may be able to get the prior authorization for you. You may also be able to get it from the emergency room.
AspenRidge has been an absolute game changer in my recovery journey. Straight out of residential treatment, I was able to start a 5-day a week IOP group. Over about 5.5 months, I slowly went down from 5 days, to 3 days, to 1 day a week. I benefited from the groups everyday I attended, and still today, more than half a year later. I am now 14 months sober as of August 28th, and loving every part of life. The skills, relationships, and knowledge I gained and continue to gain from AspenRidge have been invaluable. I will forever be grateful for them as a resource. I continue to stay connected via the Alumni program, and highly recommend this Treatment Center to all needing help.
Riss da Silva
8 months ago
This business is impressively educational concerning one's own mental and physical health! CAUTION: Please, for your own wellbeing, DO NOT interact with JEREMY, who is a new therapist at AspenRidge...based on my experience with him, this man has PLENTY of his own mental health issues to deal with before he can reach out to help others Other than him, the clinicians who work there are all quite compassionate and empathetic!
This place was amazing it really changed my life 70 days sober now
John Dasher
5 months ago
Thee best experience in recovery I've ever had. If anyone needs help with drug or alcohol addiction please call Serenity Springs. Their staff is amazing.
Daniel Flesch
5 months ago
Amazing. Serenity Springs is a first class facility. From the staff to the facilities and the compassion that everyone displays, this place is second to none. To those who are struggling or have family members in need, please reach out. Serenity Springs will change your life.
Spring gardens has changed my life.I enjoyed all the activities and groups.i recommend this program to everyone who's struggling with addiction or just with mental health.thank u to everyone there.even after I graduated they reached out to me to check on me.I want to also say thank u to Eric because if it wasn't for him calling over and over the week before I went in I wouldn't ever had the courage to go.All the staff are friendly.Ms.sam is amazing person.All the nurses are amazing as well.I mean I never been to a program before where everyone welcomes u with u a smile everyday like this one did.
Tamara mccord
1 month ago
Spring Gardens Recovery changed my life! Their mind, body and spirit approach to addiction is exactly what I needed. I've been to many inpatient rehabs, but Spring Gardens got to the core of my addiction and healed me in so many ways. I got rid of my guilt and shame, forgave myself and others and learned who I really was. It brought out my spirituality and love for life. I HIGHLY recommend Spring Gardens to anyone who is suffering from alcoholism or addiction!
Cathie
3 months ago
SGR (Spring Gardens Recovery saved me from a life of uncertainty & discord.I can't thank the program, staff, clinicians, doctor & cooks enough for what they do to help people get back on track and back to living a full and meaningful life.If you're looking for an alternative approach to sobriety. Then, the holistic approach privided by SGR might be what you need to regain control of your life & your thought process.If you work the program, you will be a new person when you walk out of those Gates. You owe it to yourself & your family to make things right. Don't wait until it is too late. Take that 1st step NOW. !I did, with the support of my wife. And It was the best decision I ever made
Trueself absolutely was the best decision I ve made in along time. Out of all the treatment centers I ve bn to this one has turned out to be the best of all and I ve been to several luxury rehabs. This place is ran by people that has been in the exact same shoes as us they understand where we ve been and r not teaching things they know nothing about like a lot of other rehabs. They help u to be a better person and to make better choices along with giving you the tools to stay clean! I absolutely love it thanx so much Trueself!
Sinful Clair
3 months ago
Thank you amber and Dylan
Terry Belt
3 months ago
I've tried other recovery programs and this is the best one I've been to. The staff here really cares about your recovery.
This place is ok. You have to realize this is Florida, so you are going to get cockroaches. Just ask staff for a fogger they are happy to get you one. I have had no problems with staff. Long days keeping you busy. Van rides get tiring. We do outings Everglades on a airboat was amazing all the Alligators was just coll. The best thing about this place is the LIV Program. Troy Adam Ericka, Daniel. Are the best we do all sorts of outings will miss them as going home soon.
Trina Chambless
3 months ago
I have not personally had the experience of Recovery with Zinnia Health, but I do have friends that work there and I can not praise them enough as people. They are the hardest and kindest people who go above & beyond for their friends & patients!
sal jones
3 months ago
Amazing transition between there facilities, supportive environment and atmosphere.
Great place! Staff is extremely personable and helpful. The rooms and food were top notch. The classes will really give you the perspective needed to adjust your outlook on your life and how to adjust your path. Highly recommend this facility
Daniel Monks
3 months ago
No second guessing that I would definitely recommend Recovery village Their Behavioral Tech Staff Are Top Tier Attentive To A Patient's Needs .
This place was amazing it really changed my life 70 days sober now
John Dasher
5 months ago
Thee best experience in recovery I've ever had. If anyone needs help with drug or alcohol addiction please call Serenity Springs. Their staff is amazing.
Daniel Flesch
5 months ago
Amazing. Serenity Springs is a first class facility. From the staff to the facilities and the compassion that everyone displays, this place is second to none. To those who are struggling or have family members in need, please reach out. Serenity Springs will change your life.
Our daughter is there for 3 weeks now and is showing more signs of improvement than we saw in years. Dr. Moran and the team really know what they are doing and have tools and desire to make a difference. Plus now we are more equipped then ever to keep on track for recovery once she comes back home, thanks to all education we received from FCRF. I finally have hope! I know if you are reading these reviews, you are desperate, same as I was a month ago. You don t need to be, don t wait! I recommend this place without reservation!Update: it has been almost 2 months after my daughter left FCFR and it s the healthiest 2 months we ve seen in a long while. She hasn t used any substances, found a part time job which she loves, graduated her failing semester with As and Bs and about to get her drivers license! It s not all rainbows and butterflies, we still need to work hard daily on keeping things on track, but now the hope is getting more real every day!10 months update: FCFR has truly been a game changer for us! Now my daughter is just a difficult (normal) teenager, but the disaster and desperation is so far behind, it s almost hard to recall how it has been. Now she is committed to getting better and going on with her life, and that s the most important part. Of course there will be ups and downs, but the terror of being constantly afraid for her and of her is far behind and I never ever want to go back. If we ever go back (it gives me anxiety to even write those words), we know who to call.One last thing. There are a lot of comments about lack of tender, love and care at the facility. TLC FCFR does not provide indeed. But they provide something better: treatment THAT WORKS. I m sure every story is different, but I m also sure a lot of people have experienced the same thing I did: TLC does not treat psychiatric illness.
Vlada Bazylevska
9 months ago
The police ministry at this center has been a blessing for my life. The guest speakers they bring in every month have nurtured me spiritually and everyone at this place is so welcoming and kind. The head minister Jorge is a great man of God and he works very hard to spread the Gospel of Jesus Christ that is so wonderful.
Christian Fernandez
1 year ago
I love the school. My daughter can read and write her name. Very happy with the school
I have to say I m beyond blessed to find this place! I was scared, anxious, and nervous walking in. Within 2 days I felt at home! My group was amazing the bond I have created with them. They will always be family. To my therapists thank you! To my group facilitators thank you but let me shout out Manny and Dustin! What I learned from Manny and Dustin and the care they put in towards me truly has opened my eyes and given me a new meaning to life when I walk out these doors! I m so thankful to learn from you guys and I appreciate all you did for me during my stay! To the BHTs thank you! Most importantly Maria that s my best friend for life! I d go to war for her in a heart beat! Thank you for the hot funions. To the nurses thank you. You guys are amazing and on top of it always. To Barbara the nurse practitioner she was the first person to open my eyes and really show care towards me! She gave me a better understanding and just encouraged and loved up on me when I needed it. Thank you so much Barbara. To my case manager Maria thank you. She answered all my questions and between her and my wife had my FMLA AND SHORT TERM approved in no time and gave me the relief and comfort I needed while I was hear not worrying about a job. Last but not least my man Brian the chef! He is one hell of a cook definitely gained 5 pounds during my stay. He puts heart and effort into everything he makes. He cares listens and works with you! Overall 10 out of 10 this place was amazing and id recommend it to any and everyone! Thank you guys so much! With all love time to go home!
Dakota Simkins
3 months ago
This place saved my life!!! If I had not come here and received the treatment they provided, I would have probably been dead. The admission specialists was very helpful and resourceful. The Doctor is truly amazing and spot on when it comes to diagnosis and medication. The Therapists are awesome, caring and resourceful. The case manager really knows how to communicate with your job, so that's something you don't have to worry about at all. The nurses are very caring and holds conversations with you, make you laugh,. The BHT's are Awesome!!! They treat you with compassion and love that's genuine. They are very helpful and will help you anyway they can. I definitely would recommend this place for anyone needing treatment. This is the best place to get the help you need.
True Church SC
3 months ago
My stay here was great! Everyone was so kind and caring. 5 stars to all the therapists that work here and got me through my hard times. Also 5 starts to Brian the cook. He did outstanding on accommodating my pickiness on food choices. If you re looking for a place to get help I would totally recommend coming here for treatment.
This was the best decision I could have made for my mental wellness. Everyone has life issues and experiences. Sometimes you don t know you need professional help until you re in the middle of it. Well I was. I am blessed to have a support system who was on board for my self care.I researched various IOPs/PHPs that my psychiatrist suggested. The Heights Treatment sounded like the best fit for me. Based on reviews and researching the area, solidified my choice to start treatment there. So I did.From the intake for IOP5, to individual therapy sessions, to group sessions including equine therapy, to individual sessions with Dr. R, was well thought out to get this group of professionals to help people. The one who held it together with scheduling to communicating to even listening for a couple of minutes in passing, was truly a blessing. Their client care services, Adam, is kind and professional. They all make you feel welcome.Bre - my therapist, help tremendously. Various group sessions, helped me realize so much. They gave me the tools to help me reach my goals. They helped me choose to do the work. Be it daily checking in, verbalizing my emotion at the time, concerns, etc, these are the things for me, that were so beneficial in my mental wellness.Trust your gut. Don t hesitate to get the help. If you choose The Heights Treatment, you will be in great hands.
Celeste G.
11 months ago
Heights Treatment was a Godsend and it saved my life. I love how unique each therapist is. They have a wide variety of therapies including equine therapy, emdr, trauma processing, as well as individual and group therapy. Scheduling was easy, the staff was kind and were always available for me when I needed to talk. Not only have I come to living life, but they've given me a toolkit on how to navigate life and live it to the fullest.
Grady
1 year ago
Outstanding treatment and team! Sarah Bolton makes the process seamless and is an absolute light in the darkness.
Angie Wilkerson
1 year ago
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Frequently Asked Questions
Does First Medical Health Plan Cover Methadone & Suboxone (MAT)?
First Medical plans generally cover all the medications that are used to treat opioid addiction and alcohol misuse, including methadone and suboxone. If MAT is the right treatment for you, you’ll have to get your daily medication dose at a clinic while participating in evidence based treatment there.
The FDA approved medication used in MAT helps manage cravings so that you can avoid relapses and even overdose during treatment. This allows you to focus on recovery and lay a solid foundation for your future. Over time you’ll taper off the medication support so you can live fully substance free.
Make sure to review your specific plan to find out the coverage details before you start treatment.
What Are First Medical Health Plans?
Some of First Medical’s plans are PPO plans. PPO stands for preferred provider organization. In this type of plan, you get the best coverage if you stay in their provider network, but you do have the freedom to see a provider who is outside their network. Your individual plan will specify what they will cover if you go out of network.
Their Plan Vital offering functions like a Health Maintenance Organization (HMO). They require you to stay within their network. You can check online to see if a provider is in their network. You also have to get a referral from your primary care provider for specialist care, but not for your mental health providers.
As long as your mental health providers are part of their network, you can see them without a referral.
First Medical plans are available for government employees, individuals, and families. Private companies can also get insurance plans to offer their employees.
Where Does First Medical Health Plan Operate?
First Health’s network has providers you can see throughout the island of Puerto Rico. This is true of First Health’s private plans as well as their government sponsored plans through Plan Vital.
In the past, if you had a Plan Vital plan you would have to stay within a region of the island. This is no longer true. Regions were eliminated in 2021 when Plan Vital started allowing you to pick a company to manage your benefits.
With First Medical plans, you’re free to get your care in any part of Puerto Rico where you can find a provider from their network.
What Inpatient Rehab Does First Medical Health Plan Cover?
Before going to inpatient treatment you’ll first need a clinician to assess that it’s the right level of treatment for you. First Medical will use the information from that assessment to make a determination about coverage.
If your provider determines that you need medically supervised inpatient detox you can expect to be at a facility between three and ten days. With inpatient detox trained professionals monitor how you’re doing with withdrawal. They will work to prevent and treat symptoms as they occur which may include medication assisted treatment (MAT).
Once you’re through detox your provider may want you to go to inpatient or residential rehab. While there you can expect to participate in a structured program where you learn relapse prevention skills. Residential rehab usually lasts 30 to 90 days.
What Outpatient Addiction Treatment Does First Medical Health Plan Cover?
First Medical covers a few different types of outpatient treatments that might be right for you. You might step down to outpatient treatment from residential rehab but it’s also possible to go straight into one of these outpatient treatment types. Doing so would depend on how stable your medical situation is and your home environment among other factors.
Partial hospitalization programs (PHPs) usually expect you to be there the full day up to five days a week. The programming is a lot like residential rehab where you’re in groups most of the day learning and practicing skills that help you with recovery. The difference is you go home at the end of the day and usually on the weekend too.
Intensive outpatient programs (IOPs) are usually held for a few half days each week. The programming is otherwise similar to partial hospitalization. This option is a good one if you have time commitments like work or caregiving that you need to have time during the week to attend to.
General outpatient care meets around once a week and provides ongoing support as you practice your new habits and solidify your recovery.
Does First Medical Health Plan Cover Methadone & Suboxone (MAT)?
When providers use medication to treat your addiction, that’s sometimes called medication assisted therapy, or MAT. There are a few different ways to treat you with MAT.
One type of MAT uses medications to help you withdraw from the drug you’re addicted to safely and as comfortably as possible. This strategy is common in residential detox settings.
If you’re addicted to opioids or alcohol MAT may be used as a maintenance therapy to help you stay stable during treatment. Depending on the maintenance drug that’s most appropriate for you, this strategy will allow you to minimize or skip withdrawal. The medications that addiction specialists prescribe for opioid maintenance are methadone and Suboxone.
First Medical has methadone clinics and Suboxone providers included in their network listings. They may cover that treatment for you if it’s the right treatment for your addiction.
Does Addiction Treatment Need to Be In Network?
Whether you have to stay within First Medical’s provider network to get treatment depends on the specifics of your plan. While some plans may allow you to go out of network you will have to pay more if you use that option. Before going out of network consider taking note of how your copay and deductible and out of pocket maximum might change if you do.
How to Verify Coverage With First Medical Health Plan
First Medical gives you a few ways to verify coverage of a specific provider or facility. You can pick up the phone and call First Medical’s customer service line or you can log in to your account online and check that way. This will give you details about your plan and provider network.
You can also call the treatment center you’re interested in seeing and ask them to check if they take your insurance. With any of these options use your exact plan name and not just the name of the company to check your coverage since First Medical has different networks for different plans.
Calls to any general helpline will be answered or returned by a paid advertiser.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
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