Discover how HealthSmart helps organizations build custom health plans, including options for addiction treatment and care management.
HealthSmart Insurance for Drug & Alcohol Rehab
Discover how HealthSmart helps organizations build custom health plans, including options for addiction treatment and care management.
HealthSmart provides medical network options to employers who choose to self fund their health coverage for employees or organization members. They serve health insurance brokers who need custom solutions for clients as well as employers and Native tribes and anyone else who pays for health insurance coverage for an organization.
Clients can get ready made health benefit plans or simply opt for a medical network solution. The company also offers care management services and claims processing technology along with robust reporting so clients can understand their health care coverage and spend.
HealthSmart focuses on not only saving clients money and providing efficient solutions but also on treating health plan members with dignity and respect.
If you’re reviewing recovery programs or confirming what your insurance supports, you can learn more about rehab options to evaluate nearby facilities that may qualify.
By Serg Valencia
Serg Valencia is a writer and Psychologist with 13 years of experience in the healthcare space. After a nine-year corporate career with Fortune 500 pharma brands, he now channels his firsthand experience to craft actionable medical content that helps people make informed health choices.
Medically Reviewed by Anna Spooner
Anna has 10 years of experience in insurance and has been a content and copywriter since 2011. She strives to make all of her writing approachable and easy to understand while drinking copious amounts of tea. Anna writes about accessing addiction treatment, insurance, and finance.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
By far the most respectful, professional staff. Because of the care, compassion from the CEO down to the RSS staff. With their personal guidance, I continue to stay sober, happy and a clear headed member of society. I will forever be grateful.
Ed Lima
2 weeks ago
The people are nice and facility is beautiful
Alexandrowicz Jessica
2 weeks ago
My wife is in there and it's an awesome place very strict rules like it should be
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Edit Aug 2026: I still like this place & think it's better than most other clinics in the Richmond area. There have been some screwups over the years but mostly I've had good experiences. Things definitely also depend on your own attitude & your counselor, so switch counselors if you're not a match with yours.
Original: This place has improved drastically since the new director has taken over approx 1 year ago. Its the only clinic that has ever shown me they actually care about their patients. Awful lady who gives you your meds at the window (Tunisia?) is gone, also so is awful front desk lady (Cheryl). I made a complaint about them 2 weeks after new director took over and didnt receive retribution or bad treatment they actually told me I was 100% right, I could not be any more right, what can they do to correct this? I couldnt believe it, as someone in recovery, I had never been treated this way (treated well!). There are many wonderful people now working at this place! Much better clinic than ANY of the others in the area
Tiger Eyes
1 month ago
I've been going here for 6months and before that I was at the VA. There's a few differences between them both but most of all I can tell the Care. I have had 2 Counselors which is understandable considering the work load they have. Since the begining I have been happy and impressed how easy they made my transferring. I started just where I left off at the VA.The only thing I don't agree with or understand is when getting an increase u have to pick up for 3days before getting ur tak homes. I can understand this policy when u a starting out. But it doesn't make much sense after that. I can also say when there was a problem with my pick up (ther Mistake) my councler fixed and had all my bottles in 30mins. All I can say is If u work the program it works. Thank you
Kevin Armstrong
1 year ago
I love my counselor here at Pinnacle treatment center FCCR Radford. I feely counselor Lauren is amazing she's does everything she can possibly do for. Shes supplies me with wonderful advice, wonderful resources and everything else a counselor should do. My panic attacks got to such a bad point that she gave me her cell phone number in case I need to message or call when I need her. FCCR RADFORD SAVED MY LIFE!!!
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private InsuranceSelf-Pay OptionsFinancial Aid
The staff here will truly change your life. While small managerial issues happen, the staff worked through them and now the facility is in prime position to change your outlook on the world to a beautiful hopeful vision. Thank you DPR for a wonderful residential stay. Special shout out to JJ the RC and Cassie to the nurse.
micheal ramsey
1 week ago
My time at Waxahachie DPR has not only improved my want of sobriety but also my want for help. I am so thankful for this program and the wonderful staff.
Chevy
2 weeks ago
dpr is a great place the residants helped me out and the therapist helped me so much
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary ProgramTeen ProgramSeniors Program
Private InsuranceSelf-Pay OptionsMedicareMedicaidMilitary InsuranceFinancial Aid
This facility is just amazing! Truly felt like everyone cared about me, and I can honestly say I trusted everyone in there. Trust is very hard for me, but the adult program and the staff allowed me to be myself with no judgement. I'm trying so hard to follow the rules and not name any staff but will give a broad review. Right when you walk in the staff is friendly, always smiling which in turn made me smile. The supervisor is amazing; the head of the counselors who leads the group therapy is one of the best people I ever met. The staff that lead the groups cared about me, and it was genuine, and they are so smart and fun. From the psychiatrist to my therapist everyone was on the same page. I just want to say thank you to everyone there from the bottom of my heart!
Really caring staff that create a safe and welcoming atmosphere for patients. They provide lots of quality education/resources for behavioral health, along with making sure patients feel heard. A great choice for modern mental health services.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Free goes beyond addiction and helps you to explore the reasons for your addiction. Most places treat the symptom but at Free they treat the symptom and the problem as long as you're open and honest with yourself.
michael rose
3 weeks ago
Fbts is a great place to get a fresh start at life. Very helpful and I highly recommend.
Percy Novelozo
4 weeks ago
I am due to be picked up tomorrow and praying they still do ive been pretty indecisive and recovering from a major assault having my face literally ripped open 4x in a year has seriously escalated my DUAL ADDICTION CO DEPENDENCY WAS THE CULPRIT MY POINT IS IVE BEEN THRU TREATMENT BUT NEVER IN MY WILDEST DREAMS HAVE I SEEN A PLACE LIKE THIS THE WATER HAS ALWAYS BEEN MY SAFE PLACE HAPPY PLACE I AS BE FIRE ER GRATEFUL FOR THE OPPORTUNITY
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
One of the most thorough and holistic approaches to mental health there is! The treatment team and staff are incredibly invested in your recovery, they are kind, compassionate, and relatable! Highly, highly recommend this program for anyone struggling with mental health including: PTSD, Anxiety, Depression, OCD, Substance Use Disorder, Eating Disorder, etc.)
Joe Pascucci
3 weeks ago
Suncloud health is a trusted treatment program that I rely on to help clients and Lori is great to work with on referrals.
S Elliott
3 months ago
HIghly Recommend : the level of compassion, clinical expertise, and individualized attention at SunCloud is unmatched. If you are looking for a place to truly heal and reclaim your life, I cannot recommend SunCloud Health enough. They save lives.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
I started treatment here this week barely. Truly feels like a gamechanger in my life. Wish me luck
Luis
2 months ago
I’ve been a patient at Aegis Treatment Centers for a while now, and I really want to give a heartfelt thank you to the nurses there. Whenever I’m sick or not feeling well, they always step in right away and make sure I’m taken care of. It never feels like I’m just another patient to them. They genuinely check on me, help me through it, and make sure I’m as comfortable as possible.
All of the nurses work together in such a kind and supportive way, and because of that, I always feel really welcomed when I walk in. Even on rough days, I know I’m going to be met with patience, understanding, and care instead of stress or judgment.
It’s honestly a comforting place to go when I need help, and I’m really grateful for how consistently compassionate and attentive the nurses are.
God bless 🙏🏻
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
This is my second visit to summer house and expected they welcomed me open arms. the staff is absolutely amazing from the techs to nursing, i already feel like a new beginning has began. special thanks to Jen, Katie, Eddie & Wade. Love you guys .
Shawn Word
1 week ago
Extremely comfortable, good food, great staff. All needs are met
Daniel Francis
1 week ago
Ronnie is a very great technicianThiis facility is top notch.The gentle man Ronnie is exceptional with his work i highly recomend.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceFinancial Aid
Im gonna be flatout honest i came here ungrateful and with a rotten attitude the groups were amazing and i learned a lot from them… people there are kind some of them are a little harder but i look at it as tough love… the only reason im giving them 4 stars was they had no dryer for a month but other than that my complaints are non-existent
Sawyer
1 week ago
This facility really helped a loved one. Really glad we sent them here to get the help they needed. The facility is staffed with professional and courteous employees that truly value the well being of the folks they take care of.
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Frequently Asked Questions
Does HealthSmart Cover Addiction Treatment?
HealthSmart helps employers and other organizations build health solutions but they don’t determine what services are covered or what level of coverage is available. That is up to the employer or organization.
Self funded health plans don’t have to offer the 10 essential health benefits listed in the Affordable Care Act (ACA) although many plans do. If self funded plans offer mental health or addiction coverage they are required to provide them at the same level of coverage as other medical care in accordance with the 2008 Mental Health Parity Act.
Because self funded plans vary widely it’s especially important to check with your organization’s benefits specialist to get the full details on your coverage. That way there won’t be any unexpected challenges when you start treatment.
What Insurance Solutions Does HealthSmart Offer?
HealthSmart offers organizations benefits solutions and care management along with provider network options. The primary focus of HealthSmart’s business is their medical provider networks. These options are flexible and customizable which means every insurance plan is unique. The primary network is HealthSmart Preferred and is a preferred provider organization.
With a PPO you don’t need a doctor’s referral to see in network specialists and you will likely have access to out of network coverage. However out of network coverage is much more expensive for you — you’ll have much higher deductibles and copayments or coinsurance.
HealthSmart also offers ancillary networks that can help organizations fill care gaps or flesh out more limited primary networks.
Along with their medical networks HealthSmart offers benefits solutions such as health plan design and claims processing along with help administering flex spending accounts and more. As a member you’re unlikely to see these behind the scenes operations but they can help your organization offer health coverage more effectively.
Finally HealthSmart has care management available for clients as well. This helps your company or organization point you toward the right care at the right time based on your needs. The company helps clients focus on improving every member’s health because that’s the best way to take care of people and the best way to ensure a cost effective health plan.
What Inpatient Addiction Treatment Does HealthSmart Cover?
Addiction treatment is not a legally mandated obligation for self funded plans. Nevertheless many will offer some form of coverage. You’ll want to talk to your benefits administrator to get the full details of your plan.
Insurance’s main goal is to provide medically essential care so make sure to get a treatment plan formulated by your doctor. Clinicians utilize frameworks like the American Society of Addiction Medicine (ASAM) Criteria to decide the appropriate level of care you need. Your doctor will use the assessment to evaluate parameters such as health status and withdrawal risk to determine if your situation demands residential care.
Medically supervised detox is the initial step of inpatient treatment for many people. 24/7 onsite clinical support helps you manage the withdrawal symptoms that come with stopping using a drug.
Residential care is often the next stage of an individual’s recovery journey. In this phase you’ll be in a highly structured environment with 24/7 support. This allows you to focus fully on your recovery and avoid temptations and triggers that might lead to relapse.
What does a day in the life of a participant in an inpatient program look like? Individual counseling and group activities are frequent. You’ll get workshops on how to manage abstinence and reenter the workplace as well as reduce relapse risks. These classes are critical components of residential care to equip you with the skills needed for long term recovery.
What Outpatient Rehab Does HealthSmart Cover?
Your insurance plans may use HealthSmart to offer three classes of outpatient rehabilitation: Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) along with general outpatient care.
PHP is the most intensive outpatient treatment form. You attend almost full time for 5 to 6 days a week but go home at night and on weekends. People tend not to work during treatment due to the time commitment.
An IOP has a much more flexible schedule — many require 9 hours of treatment over three days. You can often choose between morning and evening treatment so you can manage work or school obligations. General outpatient care meets for one or two hours a week to help you sustain long term outcomes.
Outpatient programs aim to help solidify the habits that are foundational to long term recovery and prevent relapse through targeted therapies that empower you to establish yourself in an independent and productive life. Aftercare services are intended to strengthen your support networks and connect you to essential services like housing support.
Before starting an outpatient treatment, double check your insurance coverage. Self funded plans may vary widely in benefits and limits as well as requirements for outpatient rehab.
Does HealthSmart Cover Methadone & Suboxone (MAT)?
If your insurance plan covers medication assisted treatment (MAT) it can be a valuable therapeutic resource for overcoming alcohol and opioid abuse disorders.
Once someone becomes opioid dependent specialized management by a licensed clinic may be required for safe addiction recovery. Methadone or buprenorphine are medications that assist in managing cravings to help you avoid relapse during treatment. Other medications available may include naltrexone and Suboxone.
Alcohol dependence is also a viable candidate for MAT as clinicians utilize medication in the initial detox phase to counteract withdrawal symptoms from stopping consumption. Acamprosate and naltrexone are therapeutic alternatives for supporting long term sobriety due to their craving reducing properties against alcohol.
MAT does not replace counseling. It is most effective as part of a holistic recovery program that endows individuals with the skills to prevent relapse.
Before starting treatment verify your insurance coverage as you may need a referral or preauthorization. Plans offer different benefits and vary in the type of medication they cover and for how long.
Does HealthSmart Cover Other Mental Healthcare?
Self funded plans are not legally required to provide mental health benefits but many do. Verify your insurance coverage before commencing treatment to avoid unexpected expenses.
Successful mental health interventions take into account each person’s unique characteristics. Treatment tends to start with assessments given by qualified professionals to determine the best type of care for every person. Some individuals may struggle with mental health issues alone and others may have addiction and mental health needs at the same time — which is known as co occuring disorders.
Substance abuse tends to happen simultaneously with mental health concerns. One million children and 22 million adults in the US are diagnosed with anxiety, depression, or mood disorders while they battle an addiction. Successful treatment in these cases requires tackling mental health and addictive behaviors at the same time to give each person the best chance of long term recovery.
The difficulties that mental health conditions cause—like sadness and mental anguish—may stimulate addictive behaviors as an escape. Substance abuse can aggravate a preexisting mental health concern or predispose someone to a mental health diagnosis. That’s why medical professionals address them together.
How Long Will HealthSmart Cover Rehab?
Your insurance plan will determine coverage limits and requirements for specific benefits so check with your benefits specialist or plan paperwork to find out if there are specific limits on addiction treatment.
Care length is not predetermined but rather depends on your individual medical needs and what parts of the continuum of care you need.
Typically residential care provides 24 hour supervision, and patients stay for a few days to a few weeks. Care averages 30 days but some people stay for as many as 90 days. An IOP provides 9 hours of treatment divided over 3 days each week for 30 to 90 days.
General outpatient programs are most successful when a person commits to them for at least 90 days but they can last 6 months or even a year if a medical professional considers it necessary.
Long term recovery depends on embracing each step of your treatment journey. Enjoy each step of the process and complete them with diligence—they will increase your chances of creating the life you dream of.
Does Addiction Treatment Need to Be In Network?
Self funded plans vary in their benefits much more than standard plans. However if they use HealthSmart the network will be a preferred provider organization (PPO). A PPO does provide some coverage for out of network care so your plan may include some coverage for non network providers.
Nevertheless, even if coverage is included you’ll pay far more out of pocket. You’ll have much higher deductibles and coinsurance or copayments.
Always verify with HealthSmart coverage and network status before starting any treatment. In network providers will always be the best way to get the most out of your insurance’s benefits and keep your expenses under control.
What to Do if HealthSmart Won't Cover the Cost of Rehab
Your addiction treatment options may be more limited in a self funded plan and you might encounter less comprehensive benefits — but do not let these circumstances be a reason to avoid seeking the care you need.
Some treatment centers award scholarships or offer sliding scales of fees based on income or payment plans to facilitate treatment. You can proactively reach out to them and ask.
Another option is to get creative. Low cost and even free rehabs exist. The Salvation Army runs programs where you can work instead of paying and your county or state may also operate free or low cost alternatives.
The investment you make today in recovery can become the stepping stone to building a better future.
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.
Calls to numbers on a specific treatment center listing will be routed to that treatment center. Calls to any general helpline could be forwarded to SAMHSA or a verified treatment provider.
If you wish to connect with non-sponsor centers, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.
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