Luminare (Formerly NGS CoreSource) Insurance Coverage for Drug & Alcohol Rehab
Explore how Luminare, a third-party administrator, connects employers with addiction treatment options for self-funded health plans.
Luminare (Formerly NGS CoreSource) Insurance Coverage for Drug & Alcohol Rehab
Explore how Luminare, a third-party administrator, connects employers with addiction treatment options for self-funded health plans.
In 2022, NGS Coresource was acquired by Health Care Service Corporation (HCSC) and rebranded as Luminare.
Luminare is a third party administrator of health benefits that helps with self funded insurance plans. They work with employers, hospitals and medical systems, indigenous tribes, and other organizations. Your employer may use Luminare to access medical networks and provide specialized care and case management. Organizations can also get backend tools to help them track the use of services and costs.
As an employee or member of an organization you might see Luminare’s name when you look for in network providers or have questions about coverage. They can also help when you need help managing a complex health issue or request preauthorization for services.
Does Luminare Cover Addiction Treatment?
Luminare provides employers and organizations with connections to doctors and facilities that can provide care. However, they don’t decide what’s covered. Instead, they will help your employer or organization build a unique coverage plan and then help provide the services your organization decides on.
Self funded health insurance plans are not required to offer any specific benefits the way many other insurance plans are. However, if they do decide to offer mental health and substance treatment they have to provide them at the same coverage level as other care according to the 2008 Mental Health Parity Act.
It’s very important to check with your organization’s benefits specialist or to contact Luminare with your plan’s name to find out what is covered and at what level. That way you won’t have any surprises when you start treatment.
What I love about this facility is their exceptional patient-to-therapist ratio, which really helps in the treatment process. Couldn't be more thankful to them.
Gwnekbs Sbbeosbd
1 month ago
When we started, I was hesitant about making changes, even though I knew I needed help. My goals were to keep my relationship strong, revive my passion for my business, and address my mental health issues. I'm forever thankful! Their support and service truly transformed me in ways I never imagined possible.
All the staff is great. Very helpful place. I would recommend for someone who is going through a rough patch in life
Anthony Mazzamuto
5 months ago
This place saved my life jeff is amazing nitza and john are the BEST therapist's I've ever had Erica and shifra are the BEST nurses ever Abraham will Talia Ms Janet art Robert Austin are the BEST techs ever Dr k Felicia Tyler kitty are the BEST group facilitaters ever if your struggling with addiction pick up the phone and come here this place is absolutely life changing I'm becoming a new person because of these amazing people who care so much absolutely the best center
Nicholas Duvall
6 months ago
My experience at Transitions was a positive one. The staff was helpful and courteous. The techs really make the difference Abraham the Housing Director was great & should be applauded for the techs he hired especially Will, Talia, Rob, Austin, Art and Janet. I would highly recommend giving this place a try. The new Clinical Director, John was amazing therapist to me while I was there together with Nitza. My favorite group leader was hands down Dr. K. & Kitty. Thank you Transitions Family for all you’ve done for me. God Bless.
Great support and accountability, staff is friendly and reliable. Rick was amazing to work with.
Toby Bell
4 months ago
Highly recommend attending outpatient for anyone struggling with addiction or coming out of in patient treatment. The longer term support is essential to staying accountable, being with your peers, and building the life skills to stay sober. Lakeside is attentive and flexible in order to meet your needs; I ve had a really positive experience being in their care.
I have never had to do anything like this before in my life (and hope never to have to do so again). They made the experience so easy to understand and answered any and all questions that I had. The course itself was very informative. I discovered things about myself, family and friends that I never considered before. I would not want to be in this predicament again, but I would strongly recommend anyone that is struggling to please avail them of their services.
N. Gross
4 months ago
Hands down easy and most importantly the service is amazing as posted on tik tok great employees shout out to Teresa and Oscar and thank u for being amazing
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay OptionsFinancial Aid
I m writing this review as it has been 6 months and 1 day since a small group of family and indirect supporters led me to Enterhealth after months of isolating with Tito s was followed by years of binge drinking and drinking throughout the day, to get through the day.Everyone s journey in sobriety is different and people take away different things from recovery. This is my 2nd time to go to treatment and it has been completely different than my 1st time. I feel like Enterhealth not only got me sober , but they helped me battle this by addressing my physical health, my strengths and weaknesses as well as my mental health. I also feel like I was given the freedom to be in charge of my own recovery plan. Physical and mental health were important to me and they allowed me to dive into that. I m also not religious so I was much more receptive to their curriculum on the disease instead of just praying it into remission with AA. (Although they do offer AA based groups).Other things such as the community, the food, the privacy of your own cabin, the routine and the amenities are all major perks that help you focus on your treatment.I will say, this place is a major investment. I would be wary if your loved one is resistant to change. I feel like Enterhealth is a huge gift. I would recommend this place to anyone who is ready to embrace a better life and is ready to work for it.
Becky McCurley
8 months ago
My experience exceeded my expectations in every way. The staff and professional therapists treated me with respect, warmth and kindness. Laura Auldridge was especially instrumental in my healing with her knowledge, compassion and humanity. I firmly believe any individual in their care that puts in the work will be justly rewarded in their experience. I would highly recommend Enterhealth Ranch.
Bob Adair
11 months ago
I could not recommend Enterhealth Ranch more. The entire staff were professional and courteous. They go above and beyond to help you. You can tell they genuinely care about your sobriety. Autumn, in particular, showed compassion as she navigated me throughout my stay. Always answering my questions or concerns promptly. Every therapist I met was phenomenal. The property is beautiful and peaceful. You have your own room and can have cellphone- which is a plus. The food was great and nutritious. Kitchen staff were lovely. Everyone knows your name and asks how you are. Attend all the classes and get to know the other clients. I appreciated and learned so much from them. Enterhealth s unique, challenging curriculum taught me a lot about the disease of addiction and my part in it. How to challenge my thoughts and beliefs. I look forward to attending monthly Alumni events. I m also continuing my aftercare with their IOP program in Dallas. Could not thank Enterhealth enough for my jumpstart on this sobriety journey.
Great place to get some structure during recovery!
Robert Gooding
6 months ago
Had nothing but honest answer from staff
Joe Fecera
8 months ago
In my time at gatehouse I was able to meet some incredible sober support and enjoy life again, what I enjoyed in particular was being able to go to the gym with my peers which was very helpful for my recovery. There are several techs that seem to genuinely care about you and offer there advice and experience, I've grown to care about my peers and got alot out of helping others, I hope to stay connected with them in my recovery journey
This is an amazing outpatient class where you get to learn about addiction and more importantly yourself, Bill is a no bullshit guy that wants nothing more than for you to excel and become a better person without substances. I totally would recommend lakeside.
Shayne Norton
3 months ago
Although there have been some bumps along the way Lakeside Milam has changed my life. When I first got here I couldn t understand how far into my addiction I actually was. Bill Bomber is the counselor that will tell you what you need to not what you want to hear. He was one of the most influential people in my early recovery. I am so grateful for the work we have done together.
Mike Pugmire
3 months ago
This program truly gave me insight into my illness and tools to manage it positively. The group was inviting and supportive and our counselor led us with knowledge, skill, and compassion.
I came here on 11/4/24 for treatment due to my substance and mental health. During my time here I have discovered alot about myself and the reason I was making unconscious decisions. The staff here has been very helpful and instrumental in my recovery. More especially Mr George, Mr Dooley, Mr Ronnie, Mr Joey, and Ms Vonda. The program is very hands on and a great resource for those willing to put in the work. It recently was a deciding factor on the judges decision on not incarcerating me. I highly recommend this program and pray for it's continued success.
Alexander Stevens
4 months ago
Powell is a great program it helped me get my life together and gave me a chance to work on things for me and helped me every step of the way Mrs. Boobi was a great addition and help for me and my recovery she helped me with almost everything that I needed and I am very grateful and she with other clients are apart of my recovery network I would recommend anyone to Powell
It s a good program for the person that s ready to get clean off drugs completely it s the right program.Good staff the medical staff very professional educated peopleThe most important person big shout out to my COUNSELOR MONICA THANK FOR EVERYTHING AND U ARE A BIG REASON WHY IM STILLL MAINTAINING MY SOBRIETY
Judy Guerrero
4 months ago
I love this outpatient clinic the DR and nurses and counselors are very nice they treat u with a lot of respect I will recommend this clinic if ur trying too get back on ur feet one day at ah time
One Time
9 months ago
After a decade-long battle with severe opioid addiction, where even Suboxone treatments failed, I found solace and genuine support at Recovery Solutions Methadone Clinic in Santa Ana. Unlike previous experiences that left me feeling traumatized, the compassionate staff, many of whom have personal journeys with addiction, welcomed me without judgment. The moment I walked in and saw their sign advocating against the War on Drugs, I knew I was in good hands. Swiftly, they adjusted my methadone dosage to tackle fentanyl withdrawal, and within just over a week, I'm already experiencing stability and reconnecting with my family. A heartfelt thank you to the doctors, nurses, and the wonderful front desk team. I'm committed to this journey of recovery with them by my side.
I'm positive this place saved my life. They have the best staff in the world. You can't find a more caring staff any place. They go above and beyond what is required of them. I learned so much here in just the short 45 days I was here. I have over a year of sobriety, that's something I hadn't achieved in over 20 years. Highly recommend this place!!
Kim Carpenter
2 years ago
Seems like a good place. The staff was friendly and helpful. A friend of mine went there a long time ago, said it helped her out tremendously.. Keep up the good work.
Garrett R.
3 years ago
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Frequently Asked Questions
What Insurance Products Does Luminare Provide?
Every self funded employer or organizational plan is different, and Lumiaire offers a variety of elements that employers can combine to create their own unique insurance coverage. Not every plan will have all the elements described below.
The most important part of Lumiaire’s help is the connection to a medical network. They can offer over 40 different provider networks including options from Aetna and Cigna along with Multiplan and First Health and more. Networks can be national or regional. As an employee or organization member you’ll want to understand the provider network so you can maximize your insurance coverage and keep your out of pocket costs low.
Luminare also provides healthcare management services such as a phone number for plan members to call and find out details about benefits and a department that approves coverage based on medical necessity criteria.
The company also has case management options to help members navigate difficult health situations and condition specific care for oncology, maternity, and gene therapy. As a health plan member you may get access to a 24/7 nurse line and telehealth care options.
Finally if the employer or organization needs flex spending accounts (FSA) or health savings accounts (HSA) or health reimbursement accounts (HRA) Luminare can administer them.
What Inpatient Addiction Treatment Does Luminare Cover?
Self funded plans are not required to cover addiction treatment — however many will. It is important to understand your benefits coverage before starting any type of treatment to ensure it is a covered benefit.
All insurance plans require that services are deemed medically necessary before they cover them. A treatment plan created by you and your primary care provider will help support the need for addiction treatment. These are often required for preauthorization.
A normal part of developing a treatment plan is the ASAM assessment. This takes into consideration factors such as biomedical and psychosocial needs as well as strengths and assets. It also looks at your support system and resources. By assessing how you are affected by their SUD providers are able to determine the appropriate level of care you need.
In some cases you might benefit from inpatient medical detox. Medical detox offers you FDA approved medications during the detoxification process. During this process you are closely monitored by medical professionals to assess your physical and emotional condition. The use of medications decreases withdrawal symptoms and lowers the risk of health related complications. On average, medical detox lasts from 7 to 10 days but this differs from person to person.
While not everyone requires inpatient medical detox those who have undergone this process generally go on to inpatient or residential rehab. For those who do not require medical detox inpatient rehab may be the first step toward recovery.
Inpatient rehab involves 24/7 supervision in a safe and controlled environment with medical and addiction professionals. During inpatient rehab you receive individual and group therapy and you may also participate in experiential and recreational therapy.
Peer support is an important component of inpatient rehab as well. The amount of time an individual remains in inpatient rehab differs from person to person. On average the stay is somewhere between 30 and 90 days. Studies report the best success with the 90 day programing.
It is always important to remember that each recovery journey is unique and that treatment plans differ greatly depending on the needs of individuals.
What Outpatient Rehab Does Luminare Cover?
Depending on your insurance plan outpatient rehab may be covered. It is extremely important to check with your insurance plan before starting any program to verify if a referral or preauthorization is required before you start treatment.
Outpatient care could include partial hospitalization programs (PHP) and/or intensive outpatient programs (IOP) and/or general outpatient treatment and aftercare programs.
AÂ PHPÂ is an intensive outpatient program for people with alcohol and substance use disorder. For some this is the first step in the process or it could be a second step for those who finished inpatient rehab. This treatment option requires 20 hours per week or more of programming but allows you to return home each night. You get treatment similar to inpatient care.
An IOP is less intensive than a PHP and requires around 9 hours per week. The program usually lasts for 90 days. You can often work the schedule around work or school obligations. This type of treatment is best for people with mild to moderate addiction and those who have a high motivation for recovery. An IOP involves individual and group therapy with a focus on relapse prevention as well as improving coping skills and developing tools to recognize triggers. You’ll also work on support system repair and development.
General outpatient treatment is best for people with mild alcohol and substance use disorder and few psychosocial risk factors. Individuals work one on one with a therapist or addiction specialist to prevent relapse. Learning to recognize triggers and improving coping skills as well as healing from past trauma are integral parts of relapse prevention.
Does Luminare Cover Methadone & Suboxone (MAT)?
Medication assisted treatment (MAT) may be a covered benefit with your insurance. Before starting any type of program it is important to remember to check with your insurance provider to determine if you need a referral or preauthorization.
MAT uses FDA approved medications to help those with alcohol and substance use disorder during the early recovery period. These medications — such as naltrexone and buprenorphine along with methadone and acamprosate — ease withdrawal symptoms and help to normalize brain chemistry and stabilize body functions. This is especially important during medical detox.
Some individuals only need MAT during the detox process while others need it throughout treatment to help manage cravings to reduce the risk of relapse and decrease the risk of overdose. For most people longer term MAT is combined with inpatient or outpatient treatment to help you establish long term recovery.
Does Luminare Cover Other Mental Healthcare?
Self funded plans are not required to cover mental health treatment but many plans do. It is important to know what your benefits are and to verify if preauthorization is required before starting any type of mental healthcare.
Mental healthcare is especially important for people with alcohol and substance use disorder. The National Institute on Drug Abuse reports that people with SUD commonly have co occurring mental health diagnoses. These may include anxiety or depression as well as PTSD or bipolar disorder or other diagnoses. It is important to address both mental health and addiction with an integrated plan to treat them together.
Does Addiction Treatment Need to Be In Network?
This differs from one self funded plan to another. Again it is important to understand what your benefits are before starting any type of treatment.
With most self funded plans it is reasonable to assume that most plans will require the use of in network providers. Even if out of network care is covered it’s best to stay in network if you can for the best coverage and the lowest out of pocket expenses.
What to Do if Luminare Won’t Cover the Cost of Rehab
If your employer’s self funded health plan does not cover the cost of rehab there may be other options to help pay for care.
One option is to pay for treatment yourself. Many treatment centers have payment plans available or offer a sliding scale of fees based on income. Others offer scholarships to help pay for the cost of treatment. Another may be to apply for a Care Credit card which will allow repayment over time.
Finally free services can be found in many communities through organizations such as the Salvation Army or YMCA along with homeless shelters or faith based organizations. As with all types of medical and mental health care it is extremely important to verify accreditation and ensure the highest quality of care when seeking free or low cost treatment options.
How to Verify Coverage With Luminare
With self funded plans the best place to start would be with the benefits manager or contact person within the organization. If there is a member identification card there may be a customer service number on the back of the card to contact.
Self funded insurance plans differ greatly from one to another. Before starting any type of treatment plan you should speak with a representative from Luminare to fully understand your benefit coverage and need for such things as determination of medical necessity before starting care.
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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