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.
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
I came here at a very low point in my life so I wasn't expecting a whole lot..they were going thru a transition at the time but they were trying to make the process work. The staff were the absolute best though. Cindy Kendra, Kate jj were the high point of my stay. Starr in that kitchen had me always anticipating something good she would be putting together. BREA is the best counselor ever!!!!!
Michael Brunson
4 months ago
DPR was truly an amazing experience. They genuinely care about you and your recovery journey. Lucus pours his heart into this place and it shows. Cindy, TJ and JJ were extremely supportive and personable. The nurses, Amanda, Kenya, Bradie, and Kate were so kind and helpful. And of course Drew and Star were a highlight with the awesome food they prepared and had really great insight. It is truly a gem in the recovery community.
Lakyn Discher
8 months ago
The facility, staff and overall program was first rate. I cannot recommend Discovery Point enough to those seeking help with learning to control an addiction and living a clean healthy 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.
I had a wonderful experience considering the circumstances. The entire staff was amazing, very helpful and friendly but especially undertaking. I particularly thought very highly of Jennifer but the rest of the staff were exceptional also. The food was the best I've ever had. Hopefully I will never require this service ( God.willing) but if I did it would definitely be Summer House. I am forever grateful to the entire staff. They are doing God's work for sure.
I would recommend Summer House to anyone who needs help.
Adrian Vazquez
3 weeks ago
Great staff and service
Israel Alfonso
3 weeks ago
Unfortunately, I have been to several detox places over the last 10 years. Without a doubt, Summer House is head and shoulders above the rest. Every single staff member from Mike, Burt, Jen, Ronnie, Gunnar and Tiffany, to the therapists, nurses and support staff, treat you like family and genuinely care and consistently go above and beyond to make your stay as comfortable as possible. In addition, the food is incredible. If you go to any other detox, you're making a big mistake that could effect the trajectory of your 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.
I want to thank the entire staff at RCA Westminster . Each person treated myself and my service animal Jasper, with respect, dignity and compassion throughout our entire stay. You have provided me with the tools I need to be the best version of myself and continue with my recovery.
Erica Eaton
3 weeks ago
Great staff…. Great facilities….. go above and beyond
patrick moran
3 weeks ago
I love working with Mike, Rob, Pete,Roy, RSS NINA, Amanda for their hard work to make sure that I’m well taking care of and ED with my mental health
AlcoholismDrug AddictionDual DiagnosisSubstance AbuseMental Health
Private InsuranceSelf-Pay Options
My experience at Wolf Creek Recovery was truly life changing. From the moment I arrived, I felt genuinely supported by a compassionate, caring, and hands-on team that made me feel safe throughout the entire process. Having all psychiatric and clinical care fully in person made such a difference and created a much more personal and connected experience.
The EMDR therapy was especially impactful for me and became such an important part of my healing journey. It helped me work through things on a much deeper level, and I’m so grateful for the therapists who guided me with so much compassion, patience, and professionalism.
Another part of the program that meant a lot to me was the family therapy and integration component. Wolf Creek recognizes that recovery affects the whole family, not just the individual. The support and involvement they provided helped create more understanding, healing, and healthier communication for everyone involved.
The facilities and amenities are beautiful, upscale, and incredibly comfortable while still feeling warm and welcoming. Wolf Creek Recovery truly combines luxury accommodations with meaningful, high-quality clinical care. I would wholeheartedly recommend it to anyone looking for a supportive, immersive, and truly healing recovery experience.
Alyssa Danielle Sagaró
1 month ago
I have been to many rehabs but this one is the best by far.. Im surrounded by people who acutally care no matter how much I dont want the support. Steven Nolan is a great guy who has helped me in many ways and takes time iut of his day just to check on me....Harrison is the case manager and he knows excatly what to do and say. My therapist Allen my therapist makes me feel so comfortable and John who I finally met today was amazing. He took time to sit down with me and asked me If I was okay.. I wouldnt trade Wolf Creek for anything, highly recommended!
han woodward
4 months ago
As a mom of two little ones with a full time job, I felt I’d never have the opportunity for rehab. I accepted I’d have to live the way I was living forever. Thankfully, my closest friends and family saw my alcoholism rapidly progressing and found Wolf Creek for me. When I arrived, I was greeted with warm smiles and compassion from all - staff and residents. I felt supported and loved. There were abundant resources from which I learned and grew day by day. The amenities were second to none. I was comfortable and able to focus solely on myself. I am forever grateful to the staff at Wolf Creek Recovery for giving me my life back.
My name is Vitaliy and I stayed at FBTS for a few months!!
This place really helped me to completely recover.
Experienced friendly staff, great place and service, ocean and classes bring so many benefits and help for people who need it.
Vitaliy B
3 weeks ago
It wasn’t me that went here but rather my dad. After losing him this year I’ve been reflecting on his time at treatment, and I attribute a lot of the sober time I had with him to here. This place had something he never found anywhere else, and I think that’s special
Caleb Peterson
1 month ago
This place is an absolute game changer. I could've have asked for a better place to get right. It's almost like being on vacation. They take all different approaches to helping u recover from addiction. The food is amazing and The staff are great and it's almost like you become family. Greg, Kim, Amanda, Keefer, Kelsey, Tonya, Lisa, Nina, Diane, Pattie, Sabrina if your reading this I love you guys and miss you all. I can't wait to come for a speaker meeting one day. Ty for all your help!
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceFinancial Aid
Sent a friend here. Hands down best detox in the area. Chloe went above and beyond to give him the best experience. He is still clean today!
Tolga Gezer
4 weeks ago
I want to first say THANK YOU MARK for everything he was the tech when I was in detox he was the BEST!! He needs a BIG raise he went above and beyond no question asked!! Thank you for everything MARK! I also want to THANK the Director Adrian for putting up with me and being SO patient with me while I was detoxing! She was so supportive and patient with me! She definitely needs a raise also she came back and checked on me after I had a bad day and was so sweet! Thank you Mark and Adrian for EVERYTHING!
Mya Reid
1 month ago
Chloe and heba are truly amazing I wouldn’t know what I would’ve without them , they went above and beyond to help my husband and myself with calls everyday and giving me therapy as a spouse of an alcoholic husband they truly are amazing and I can’t thank them enough I really appreciate everything they did
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 can’t say enough good things about my experience in Suncloud outpatient programming. The group therapy environment along with the individual care you receive is truly amazing. You are given the tools to work on yourself in an environment that is supportive, free of judgement, and with staff and peers who want the best for you. I made friends and worked with staff here that I will remember for a lifetime. It works if you work it
Stephen Linder
3 months ago
I am consistently blown away by the care that SunCloud provides for individuals specifically with co-occurring disorders. They have a new adolescent residential program in Matteson, IL where care is literally non-existent. Colleen Kestel is their VP of Operations and is very selective on who she works with. I’ve trusted Colleen as a dietitian for many years, as well as Dr. Kim Dennis. I highly recommend SunCloud, especially for those with co-occurring disorders, who need a higher level of care!
A place of security and has all the programs and tools anyone needs to begin a life worth living. A peaceful environment!
Kennard Mitchell
1 month ago
85 days sober and still going strong. Every single person at Starlite played a role in saving my life. From the tireless kitchen staff to the nurses, therapists, and instructors, I was met with genuine care, compassion, and professionalism at every turn.
What touched me most was the community of people in recovery. They became my family when I needed one the most—lifting me up on hard days, motivating me when I doubted myself, and reminding me I was never alone.
Thank you to the entire Retreat program staff. Because of you, I found hope, strength, and a new way forward. You truly changed my life.
**Update**
Thanks again to all the staff at Starlite...167 days sober!
Anthony
2 months ago
Starlite Recovery has been the best Rehab I could recommend for any Active Duty Military, Veteran, or First Responder. The counselors Teresa and Jill were the nicest most loving and caring people I have ever met, they went above and beyond to do whatever they could to ensure you get better while staying here. The techs as well were awesome, especially Terri. The nurses were amazing as well, Robbie always knew exactly what I needed and Stacey always did whatever she could to ensure I was having a great day.
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.
Suncloud has been a life saver. The staff was and is always welcoming and caring. One of the things that has been the most helpful for me has been the aftercare, follow ups and continued connection I get with them. It has become part of my family now and its a lifestyle. One of the things I lost in my life was a sense of being part of my community and having that desire to isolate from people. I dont feel that way anymore because of Suncloud. Now I have friends and people I really trust. Which is huge to me with my trust issues. Suncloud taught me that I cannot do this alone and showed me that I wasnt alone. This is a lifelong journey and my life is better now because I chose to do something about it, and Suncloud gave me the tools I needed. The aftercare is something I look forward to now and I really appreciate all the friends I've made along the way. 🫶❤️
Bil Fern
4 months ago
SunCloud has such caring staff. They are truly magnificent. SunCloud is the place to go to when needing a little extra care. Met some of the best people during my time there.
Haley Bohne
8 months ago
As a provider, I’ve had the opportunity to collaborate with SunCloud Health on multiple occasions, and I am consistently impressed with their professionalism, communication, and dedication to patient care. Their team goes above and beyond to ensure that each individual receives truly comprehensive support, with treatment plans that address not just symptoms, but the whole person.
What stands out most is their collaborative approach. They value input from outside providers and maintain open lines of communication, which makes continuity of care seamless.
I have full confidence in referring people to SunCloud Health, knowing they will receive excellent, personalized care.
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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.
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.
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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