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.
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.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private InsuranceSelf-Pay OptionsFinancial Aid
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.
Jim Heitz
2 months ago
I don’t even know where to begin. This treatment center is truly changing lives. My husband attended their program during one of the hardest times our family has ever faced, and I can confidently say they gave us hope and confidence in his recovery.
From day one, the staff treated him with compassion and dignity. They weren’t just professionals—they were caring, patient, and truly passionate about helping people rebuild their lives. The counselors went above and beyond, not just helping him work through addiction, but helping him rediscover who he is without it.
What meant the most to me as a spouse was how they kept family involved and supported throughout the process. I felt heard and understood. This wasn’t just treatment—it was transformation.
Christi Singleton
3 months ago
Discovery Point is an amazing place. I’ve only been here for a week, but it already feels like home. A pool, nice gym, great staff, and amazing chefs. Drew (chef) on top of her great cooking, is so positive and always smiling, and Star makes the best desserts - we even get desserts at breakfast when she’s here!! At the support staff and nurses are so kind and patient.
So if you need a place to heal and recover from your addiction issues - this is the place:)
First off, the all staff were nice and friendly.
Food was fantastic 5 star chef, nurse's on site 247 techs also. It's on the water, you can fish. Get massages or acupuncture. They really make you feel like home. Aa na meetings daily. I have nothing negative to say about summer house detox, the best in south Florida hands down
Rob Osceola
1 month ago
This is the best detox center by far! The staff is amazing! They genuinely care. It’s a very relaxed comfortable place. I would recommend this to anyone that is struggling with alcoholism/addiction. It truly is an amazing place! Not a bad word to say about this place!
Taylor Filiatreau
1 month ago
My experience at Summer House was incredible! The staff were so kind and attentive — they really made me feel cared for from the moment I arrived. The beds… oh my gosh, like sleeping on clouds! And the food? Wow. It honestly felt like eating at a restaurant every day, from breakfast to dinner.
The nurses truly care about your health, and the therapists put so much heart into helping you heal mentally and emotionally. I’ve never felt so safe or supported in any detox before.
I would recommend Summer House to anyone who needs help. Thank you, Summer House — you truly saved my life and helped me start fresh on my journey to recovery.
I am so grateful for the RCA fellowship! Sharing my story with the Westminster community was a positive experience for me. Everyone was warm and welcoming. Thank you, Peter for helping me get comfortable being uncomfortable. I appreciate Peter asking me to share my story. Knowing that I belong and the connections made with this community, keeps me going! I have learned that sharing my story is about growth and change. Every story matters! That is HOW this works. Speaking these honest, heartfelt words about my experience, strength and hope — I know I am not alone. - Kim R, RCA Devon Alumni, sober date: 9/12/24
Kimberly K. Raff
3 weeks ago
The staff at RCA helped me through the toughest time of my life and supported my decisions while I worked on me!! Specifically Rob, Mike, Peter, Max, Brad and Mel…they all knew that I truly wanted my recovery this time (yes relapse is part of my journey) and they respected that I may have to leave early in my treatment due to some major life issues outside of my control. But they all were there to support and talk to me! They made what was already a tough time (let’s face it, rehab is not all fun, but they do show you that you can have fun getting and being sober) easier with a life and death situation outside of the safety of those walls. Moreover, RCA allowed me to breathe and give myself grace and forgiveness - and it also gave me some fairly straight forward tough love with some true recovery stories from the aforementioned staff. We all know recovery is what you put into it and you have to want it…but if you are willing and if you (or your loved one is willing) the EXCEPTIONAL counselors I mentioned will be there to share their experiences, their strength and their hope.
Melissa L. Brodeur-Lynch
3 weeks ago
RCA Westminister has a 30 day program that literally has saved my life.This coming from a guy that went there thinking I would be there for a week. From the staff ( amazing ), to the facility and the lifelong friends I have met. The program set me up with a solid foundation of recovery. I am now a proud member of their Alumni Association. I stay connected on a daily basis with my lifelong RCA friends. And yes I took yoga for the first time in my life! 😄👍…Such a great place ! Save your life and spend the 30 days !
I just left this place last week, and I loved my time there. It truly helped me a lot I moved on to the next steps of the program but I genuinely miss it there. Chef is amazing and a lot of the therapists and staff are great.
Travis Walker
1 month ago
The greatest time of my life! Learned about who I am and who I wanted to be!! I graduated in May and I'm still sober!! In college and living as a house manager in sober living in Austin. You guys saved my life!!
Robbie Kelley
2 months ago
Good experience for me. definitely going to the php program
I was here for a short stay I regret leaving so soon the owners are awesome and i remember the kind staff and great FOOD.
Shemcho “Meko” Hackett
2 months ago
I want you to come on and give a big thank you I came to Free By the Sea in August of 2022 and at that point I was at the lowest point of my life I lost everything my addiction had completely consumed me August 17th of this year I celebrated 3 years Clean and Free I am living a wonderful life I am a year from graduating with an undergrad in human services and I'm working in Behavioral Health working with other people who have struggled just like I did I credit my life and my success to the beginning I got at Free By the Sea when I got my life back to all the wonderful counselors and all the wonderful staff and just the wonderful environment that gave me my life back I will forever be in gratitude and I'm so thankful for all of you for being a part of my journey and as I continue in my life I hope for continued success and I hope that I too can continue to give the gift with the people that I work with the gift that you all gave me my life my freedom my sobriety and my happiness thank you again
Brian Birrer
2 months ago
I recently completed a stay at Free By The Sea in Ocean Park, WA, and I can honestly say it was a truly transformative experience. When I first arrived, I felt powerless and hopelessly caught in my addictions—tobacco, marijuana, caffeine, and even my phone. I was lost, broken, and spent countless hours trapped in my own thoughts, unsure of what to do next.
From the moment I arrived, I was welcomed not only by the caring staff but also by the residents. The sense of community here is more than I could have ever hoped for. Each day, I had meaningful conversations with others, gaining perspective and insights from stories shared openly and honestly. Judgments are left at the door because everyone here understands what it’s like to be vulnerable. We’re all in this together, regardless of our backgrounds or struggles.
One important lesson I learned during my time here is that progress, not perfection, is what truly matters. I’ve come to understand what it means to walk down the road of substance use—how sometimes you can find yourself so far gone that turning back feels impossible. During my time here, I had an epiphany about the dangers of THC and other substances, realizing how they can impact your health and well-being in ways I never fully understood before. This experience has given me a new perspective on the importance of sobriety and self-care. Also, meeting others who shared similar traumas and experiences helped me realize that healing is possible through connection and support.
The owners and staff have cultivated an environment where authenticity and connection thrive—an environment that encourages you to be yourself and embrace the healing power of nature and community. Everyone, from the cleaning staff to the medical team, to the front office and administrators, are kind, helpful, and nonjudgmental.
My biggest advice to anyone considering this recovery center is to persist. Persist in your recovery, in your sobriety, and in yourself. You truly deserve a fresh start and the chance to breathe again. If you're looking for a safe, supportive place to begin your journey, I wholeheartedly recommend Free By The Sea.
Suncloud was a lifesaver for me. I appreciated that we could openly talk about SI and I didnt feel so alone. It really helped my depression. Thank you so much Suncloud!
Jennifer S
1 month ago
I am so impressed with Suncloud and all the clinical talent they have on all levels. I love what they stand for and the care they give my clients. I send all my clients to their program. Dr Dennis had a huge impression on me when I met her 20 years ago and what she has created is in alignment with the best outcomes a client wishes for. Thank you for your authenticity and dedication to recovery.
Mari Richko
3 months ago
SunCloud Health made a huge difference in my friend’s life. They offer truly comprehensive care for people dealing with both mental health and substance use issues, and the staff understands how deeply connected those challenges can be.
My friend had been to other treatment programs before, but none addressed the full picture like SunCloud did. The team took the time to get to know them as a whole person—not just a diagnosis—and built a treatment plan that met their unique needs.
Thanks to the support, structure, and clinical expertise at SunCloud, they finally started to feel real hope again. I highly recommend this place to anyone looking for quality, compassionate care for co-occurring disorders.
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
1 month 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.
Deborah Sager
1 month ago
My psychiatrist recommended Suncloud because I was going through a really tough time in my life. I was hesitant because I was at another treatment facility and didn't have a great experience. I was pleasantly surprised when I came to Suncloud because the staff were all so kind and genuinely cared about helping you. Their process groups can be tough but are so helpful in working through your trauma. It's been a year now since I started treatment and I can confidently say that I learned the skills and created an amazing support group that have helped me be in such a better place. Even after you're out of treatment, they have an awesome alumni group with plenty of opportunities to connect with others that have gone through similar things. I highly recommend Suncloud.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceFinancial Aid
Sean is an amazing clinician who recently worked with our family member. As a very young adult, our family member needed someone who could call them out on the truth and still be empathetic, relatable, and very caring. We know this journey is a process, and we feel fortunate to have had Serenity and Sean on our team. I believe certain people come into your life for a reason, and I believe Sean is one of those people - someone who has had a positive impact. We are all grateful!
Kamm
1 month ago
Sean one of the clinicians, is the kind of therapist who doesn't sugarcoat things-and that's exactly what makes this place so effective! He sees straight through the excuses and games that come with addiction and holds you accountable in a way that actually pushes you toward change. At the same time, you can tell everything he does comes from a genuine care and deep commitment to helping people get sober. Forever grateful for his help!
Danielle Robinson
1 month ago
Sean, my therapist is a straight shooter, great communicator, and an asset to your team.
The whole team treated me with kindness and respect.
Great first week of sobriety, one week, then one day at a time 🙏🏼
Mark C.
AlcoholismDrug AddictionDual DiagnosisSubstance AbuseMental Health
Private InsuranceSelf-Pay Options
Wolf creek recovery helped save my life. I will be forever grateful to the staff and therapists. Who make recovery possible for so many people
RAIDERBUD 775
4 months ago
My daughter is currently here. We are from out of state and sending her somewhere that I had not been able to see or meet the people there was more than scary for her and for me!! All I can say up to this point is that all our fears are gone. It is everything they claim it is online and more. She is being supported in every single way possible. From addressing her addiction, her mental health, physical health, everything. The facility reaches out to me weekly to give me updates on her as well. I have had alot of experience with rehabs and know that it's rare when you get ALL of these things or that what it claims it is online, isn't what it is when you get there. I just wanted to let anyone else that is in the position I was about sending your child there sight unseen, to know that you are making an excellent choice in choosing Wolf Creek, they are an amazing place!!
Tracy Stone
4 months ago
The clinical care at Wolf Creek Recovery is truly exceptional, marked by compassion, professionalism, and a deep commitment to lasting healing. Their dedicated team of clinicians, therapists, and support staff create a safe, nurturing environment where individuals are treated with dignity and respect throughout every step of their recovery journey. Their personalized approach and unwavering support set a standard of excellence that inspires confidence. I would wholeheartedly trust Wolf Creek Recovery with the care of my own family, knowing they would be in the best possible hands.
TERESA BRUNSVOLD -100% deserves the salary of 2x whatever she is currently paid. She puts in countless amounts of long hours and late nights; and often came in on her days off. My personal experience with her as a provider was nothing short of flawless. She swiftly identified my needs, enabled me to process, and showed mastery in all facets of the profession. This woman has so much dedication and care for her patients and their recovery. She is selfless, empathetic, educated, kind, caring, empowered, and so much more. Her actions and words alone portray the highest standards of care. Myself and other patients have already promoted Starlite's Military/First Responder programs to case managers and colleagues because of how positive our experiences were (both individually and as a group); which wouldn't have been possible without Teresa. She is an asset that this organization would be foolish to undervalue, that positively helps people change their lives for the better, and that personifies what it means to set the standard.
Thank You So Much Teresa, you truly were the angel my life needed, and I know you'll continue to care for and guide others to their recovery goals in ways that only you can !
5 Stars and more! A+++
Teresa is an absolute Godsend for the Active and Veteran communities of Military/First Responders that come through Starlite's gates as patients. When patients are in crisis, depressed, anxious, addicted, hurt, etc. Teresa rises to the occasion day in and day out giving her best and showing that she really cares; truly; and provides outstanding patient care to those who have served our nation and its communities in some fashion.
If you are hesitating seeking help, don't!
This is THE PROGRAM and more specifically Teresa is THE PROVIDER, you need!
Jason Frank
1 month ago
I was involved with the liberty program for first responders a veterans as well as active duty military. The program is AMAZING! The counselors for our group are basically family members now. They made the 42 days I was there work for me and made sure I left with my tool belt full to deal in this crazy world and with my job as a fire fighter. The facilities were awesome, minus the food…lol. But I am a bit of a food snob. The property was very beautiful in the Texas hill country!
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Frequently Asked Questions
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.
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