Explore how Medical Mutual covers drug and alcohol rehab, including inpatient and outpatient options. Learn about eligibility and plans.
Medical Mutual of Ohio Coverage for Drug Rehab
Explore how Medical Mutual covers drug and alcohol rehab, including inpatient and outpatient options. Learn about eligibility and plans.
Medical Mutual is a family of companies associated with the parent company Medical Mutual of Ohio. Most Medical Mutual health insurance plans are located in Ohio but there are some in certain counties of Kentucky, Florida, and Indiana.
Medical Mutual of Ohio, where the company started and is headquartered (in Cleveland), serves 1.6 million customers throughout Ohio. They have more than 43,000 primary care and specialty providers in their HMO network, located in every Ohio county. Medical Mutual of Ohio is a mutual health insurance company, which means that it is owned by its policyholders. Insurance coverage is provided to members at or near cost and profits and investments are shared with members.
Does Medical Mutual Cover Drug and Alcohol Rehab?
The 2010 Affordable Care Act requires most health insurance plans to cover mental healthcare and addiction treatment. Therefore, most Medical Mutual plans should cover some forms of drug and alcohol treatment.
There are exceptions to the law, however, and services will vary according to the policy you have. Before starting rehab, it is important that you verify with your insurance company the details of your coverage and the treatment options available to you.
It’s important to note that insurance coverage is based on medically necessary care which usually means that a primary care physician has diagnosed you with an alcohol use disorder (AUD) or a substance use disorder (SUD) and has created a treatment plan for you to address it. You will want to work closely with your doctor to ensure the treatment plan meets your needs.
As you review local treatment centers or confirm insurance acceptance, you can learn more about rehab options to explore qualifying programs.
This place is amazing. Amazing staff. Attractive facility. Very therapeutic. Attention to everyone's needs. Highly recommended. I wish I knew about this place 4 treatments ago.
Marco Hernandez
6 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
This place is special. It saved my life and set me on the road for a long and fulfilling future.
Alex Brooks
3 weeks ago
Prosperity Haven (Now Wellbrook Recovery) saved the life of one of my loved ones and I (as well as my family) will forever be grateful for it!!! We were able to visit every week and the staff and other men staying at the house were always so kind and welcoming to us. The house and property are so nice and well taken care of. The counseling and therapy as well as the friendships that my family member was able to find through this program was so unique and special, I truly believe it saved his life and allowed him to live a life he's really never been able to live before. He is now an alumni and still continues to participate in AA meetings and alumni events. Every week he is excited to reconnect with the men he met at the house and at alumni events since then. His experience at Prosperity Haven has allowed him to fully understand his substance abuse behaviors and how to find the right tools to handle his urges and temptations. It has saved his marriage and relationships with friends and family. I would definitely recommend this facility to anyone who is seeking a place that focuses on both mental health and addiction in a supportive, welcoming environment!!
Kelly H
1 month ago
Great place to be.. Not like any other place I've been..The staff is amazing and they truly care about you... Wellbrook has helped me change my life..
I'm David Moore that went thru the program! It was rough for me at first but the whole experience was amazing. The staff was very caring,loving,understanding and respectful. You get one on one therapy as well as group settings.Thinking of groups I learned so much about myself and made some true friends. We helped each other grow and lift the ones that needed a helping guiding hand. Remember we are all broked in our own way.Reach out please to Transitions Recovery! You will find yourself and learn all about your own true self and feel love and you will really find out how amazing you really are. TO ALL OF TRANSITIONS RECOVERY STAFF I LOVE SND THANK YOU 😊 ❤️! Y YOU TOO JOSH AND AUSTIN THE MIKE'S MISS JANET SUMMER WILL STEPHAN too many to list i love ❤️ you guys
David Moore
2 months ago
Transitions Recovery Program in Miami didn’t just help me get sober it gave me a life beyond my wildest dreams. I walked in lost, broken, and unsure if real change was even possible. What I found was a deeply compassionate and structured environment that not only supported my recovery, but challenged me to grow in ways I never thought I could.
The staff is incredible many of them are in recovery themselves, so they get it. They met me where I was without judgment, but also didn’t let me stay stuck in old patterns. The clinical team, the group sessions, the one-on-one therapy, and even the everyday accountability they all played a part in reshaping how I saw myself and the world around me.
What really sets Transitions apart is that they don’t just focus on staying sober they teach you how to build a meaningful, fulfilling life in recovery. They helped me reconnect with who I really am, helped me process trauma, build healthier relationships, and most importantly, believe in myself again.
I’ll never be able to fully put into words how grateful I am for this place. Transitions helped me reclaim my life and then some. If you’re struggling, if you’re feeling hopeless, please know that change is possible. This program showed me that.
Chaston karr
5 months ago
Transitions literally saved my life. It’s like no other rehab I’ve ever been at before, I’ve been to over 20 different rehabs and this one will definitely be my last lol. The staff here treat you like family and really care about you here. The outings were always so much fun, the groups were great, and I love how it’s a reality based program. 10/10 if you are thinking about coming here do it. Shout out Abe, Will, Shiffra, Josh, and Austin 🐐🐐🐐
This place is amazing! From the community to the staff and the nurses! If anyone needs help with addiction Swift River is the place to be ! Thank you !
Much love
Thomas McMaster
Thomas McMaster
3 months ago
Great place great community, great staff, all around great experience
The staff is very helpful and makes my visit very easy every time.
Eva Conley
7 months ago
From the 1st day I walked in Brightview I felt welcome. Each and every staff member treats you like you’re an old friend. They show compassion, kindness and you’re always greeted with a smile. I’m so thankful I came to Brightview!
Very pleasant experience! I would like to send hugs, love, blessings, and many thanks to all the staff, counselors, nurses, techs, and doctors for showing their support,, their love, care, and their kindness throughout my journey. Definitely a journey to remember, that I will always be so thankful for.
Victoria Horton
1 month ago
Allure & Recreate will always have a special place in my heart, without them I wouldn’t be the woman I am today. I came into Allure broken, lost and defeated. Today I get to show up a sober momma. Of three beautiful boys and a woman of god. I’m forever grateful for every staff member ❤️ THANK YOU LOVE YOU ALL
Ashley Williams
1 month ago
This place has changed my life. I came in literally at rock bottom and they built me back up one day at a time. From every single tech to the cleaning people truly care for your recovery. Michelle went out of her way for an impossible task for me and brought tears to my eyes for the 1st time in year. As for Joey compassionate, caring, understanding and above all a great human in general GOD took his time with him. Anthony cant say enough "LOVE" This is the place to get you life back together.
I didn't know what to expect when I showed up at Restore. I was scared and hating life. I ended up having a great adventure. Did everything run smoothly, no. But you show me a place that does and I will still call you a liar. I met empathetic, warm hearted and determined people who wanted to help me and see me get better. I have been through TX before so I had expectations, but after looking back at my time there, it was exactly what I needed. I am forever grateful that Restore answered the call when I needed help and hope the most. Thank you :)
Renae Dougherty
1 week ago
Restore taught me that relapse isnt failure its data about what needs to change next time.
Blanca Vaughn
1 week ago
My counselor saw my potential when I was at my absolute worst thats real love right there
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay Options
New Life Recovery changed my life. I started my journey to recovery in their in patient treatment rehab, after I graduated I moved to their day treatment program and am currently enrolled in the intensive out patient program. Having the after rehab programs has been a huge help to me. Thank you New Life for giving me all the tools and support I need to live a life in recovery
Jennifer Dart
1 month ago
This is an amazing place. It absolutely changed my life. I came in broken and left feeling like I was able to get my life back. The entire staff is very knowledgeable and very considerate to the needs of each client. Their residential program provides you with a structured schedule that is suitable for learning and not overbearing so that you can really work on recovery. Their outpatient programs allow you to soldify your foundation in recovery while you adapt to a sober lifestyle. I would definitely recommend this place to anybody that needs help.
Mark Pearson
1 month ago
I am very grateful for New Life Recovery Centers for giving me all the support, care,love and treatment I very well needed. I am very well on my way to a very prosporous and sober future. I want to thank all the Counselors and staff for understanding my addiction and giving me the all the tools necessary to overcome it. I want to thank Jake who was my counselor there very much for his support. Thank you for everything. You are all my Hero's. God Bless you all.
The combination of filters you have selected has no results. Please refine your selections and try again.
Frequently Asked Questions
What Are Medical Mutual Plans?
Medical Mutual offers a variety of plans. They offer individual and family plans through the Ohio Insurance Marketplace. You might also have one of these plans through your employer. Medical Mutual plans are Health Maintance Organizations (HMOs), which means you’ll need to get care within the provider network. You’ll also need a primary care doctor that will give you referrals to specialists such as addiction counselors.
If you qualify for Medicare, you can also get Medicare plans through Medical Mutual. If you have Original Medicare, you can get a Part D prescription plan and/or a Medicare Supplement plan. Another option is to replace Original Medicare with a Medicare Advantage plan. Advantage plans offer the same coverage as Original Medicare but generally include additional benefits as well, such as vision, dental, and hearing coverage. However, you will likely need to use the plan’s network providers and you might need preauthorization as well.
Finally, Medical Mutual offers add on plans such as separate dental, vision, accident, and life insurance.
What Inpatient Addiction Treatment Does Medical Mutual Cover?
Medical Mutual will usually cover inpatient addiction treatment if it is a medically necessary part of your treatment plan. You may need preauthorization and/or a referral from your primary care physician, depending on your insurance plan.
Inpatient treatment often takes place in a hospital or clinic. But sometimes it is provided in a residential facility that offers a more home like setting. Inpatient care provides around the clock monitoring in a structured environment. Treatment is provided by credentialed staff and living accommodations and food are included. Inpatient or residential care removes you from the temptations faced in everyday life and allows you to fully focus on your treatment. In cases of a severe addiction or a dual diagnosis or another health issue requiring close monitoring inpatient or residential rehab provides a good option.
During inpatient treatment medical detox is often available. This process gives you medical care to manage withdrawal, including medication-assisted treatment (MAT). During MAT FDA approved medications aid withdrawal and reduce physical symptoms that are associated with it helping you be safer and more comfortable while going through detox treatment.
What Outpatient Rehab Does Medical Mutual Cover?
Addiction treatment delivered in an outpatient setting is covered by most Medical Mutual plans in line with ACA requirements. Your insurance company can verify details about your plan’s specific outpatient addiction treatment coverage.
Outpatient treatment does not provide overnight care. You return home following your treatment sessions. This allows for more flexible scheduling so that you can accommodate work or family obligations. But since you will still be in an outside environment you’ll still face the stressors and temptations that are present there. An outpatient treatment program works best for people with mild to moderate addiction or those who have recently completed an inpatient or residential program. Outpatient detox can also be helpful for those who have a low risk of experiencing severe withdrawal symptoms.
Outpatient treatment can include a partial hospitalization program (PHP) with at least 20 hours of treatment per week that is scheduled over 4 to 7 days and lasts 3 to 4 weeks. Or it can involve an intensive outpatient program (IOP) that provides between 9 and 20 hours of programming a week and lasts 4 to 8 weeks.
The least intensive option is a regular outpatient program (OP) that meets once or twice a week for one to 1.5 hours, or up to 3 to 4 hours, each day. The length of outpatient programs differs by facility but 30 days is a typical program length.
Does Medical Mutual Cover Suboxone & Methadone (MAT)?
Medication assisted treatment (MAT) involves prescribing medications such as Suboxone and methadone to treat withdrawal symptoms during detox and to manage cravings during rehab.
Longer term MAT is for those who struggle with opioid or alcohol misuse. It’s generally paired with evidence based treatment so you can build a strong foundation for ongoing recovery. Managing cravings helps lower the risk or relapse and overdose. Over time you’ll taper off the medication support so you can live truly substance free.
MAT may be covered by your Medical Mutual plan. However, it’s important to verify your coverage before you get your medication. You may need a referral or preauthorization to ensure you get the coverage you need.
Done Medical Mutual Cover Other Mental Health?
Mental health treatment is covered by Medical Mutual health plans. It’s important to find an in network provider to take advantage of this coverage. Medical Mutual members can visit the company’s website to find appropriate mental health care professionals who are covered by their plan.
Mental and behavioral health services are covered by Medical Mutual plans. These services include treatment for substance use disorders as well as anxiety, depression, and other mental health concerns. Both inpatient and outpatient treatment are covered by Medical Mutual plans, as well as telehealth options. Copays may be required. Members should refer to their Summary of Benefits and Coverage to learn more.
Does Addiction Treatment Need to Be In Network?
Most Medical Mutual plans are HMO plans that do not offer out of network coverage. A few Medical Mutual plans may offer an out of network option. But these plans would usually involve greater out of pocket expenses such as higher costs for deductibles and copayments.
Using an in network provider will likely be your most cost effective option. But if you choose to go outside of your network carefully review the details of your insurance policy to compare the service options and expenses involved.
How to Verify Coverage With Medical Mutual
You can verify your healthcare coverage by calling the customer service line at Medical Mutual or by logging onto your online Medical Mutual account. This will give you details about your coverage and help you find in network providers.
You could also call the addiction treatment center that you’re thinking about attending and ask if they accept your specific insurance plan. In that case you’d need to make sure that you correctly state the exact name of your plan. There are many different plans and some may have similar names.
What to Do if Medical Mutual Won’t Cover the Cost of Rehab
If your insurance plan doesn’t cover the cost of your rehab, you still have options. There are ways to pay for treatment without using insurance.
Many treatment centers have reduced fee payments based on a sliding scale. This allows you to pay less depending on your income and household size. Using this sort of treatment center can make rehab much more affordable. However you will want to make sure they are properly accredited and have licensed clinical staff.
Affordable government funded substance abuse treatment programs are available in almost every state. Some addiction treatment programs are run by county governments as well. You can find information about these programs by visiting the official government web pages for your state or county. You can also visit your state or county’s Mental Health Department’s website. Addiction treatment offered by government subsidized rehab facilities may be free or at least available at a very low cost.
Another free option is the Salvation Army Rehabilitation program which allows you to exchange work in one of their facilities for the cost of treatment in their addiction program. Visit the Salvation Army website to find links to their rehabilitation centers which are located in many states.
Other options include applying for a grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA addiction treatment grants are available in all states. Financial assistance may also be available through scholarships or grants offered by some advocacy groups or churches.
Finally, you might consider using a credit card to pay for your rehab treatment. CareCredit is a company that markets credit cards for specific use for healthcare needs. Or you might borrow money from your family or friends. What’s most important is to get the rehab you need so be diligent when searching for funding options.
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.
Sponsored Helpline
800-784-1361
Substance Abuse
Alcoholism
Drug Addiction
Opioid Addiction
Adult Program
Young Adult Program
Private Insurance
Self-Pay Options
Medicare
Medicaid
Military Insurance
Dual Diagnosis
Military Program
Mental Health and Substance Abuse
Sliding Scale Payment Assistance
Financial Aid
LGBTQ Program
