Mercy Care Insurance Coverage for Addiction Treatment
Explore MercyCare’s addiction rehab coverage in Illinois and Wisconsin. Verify your benefits today to get the care you need.
Mercy Care Insurance Coverage for Addiction Treatment
Explore MercyCare’s addiction rehab coverage in Illinois and Wisconsin. Verify your benefits today to get the care you need.
MercyCare was founded in 1994 and offers health plans in Northern Illinois and Southern Wisconsin. The insurance plans use the Mercyhealth hospital system as their network allowing members to access seven hospitals and over 85 specialty facilities.
The company offers individual and family plans on the state Marketplaces as well as employer plans and Medicare supplement plans. They are committed to high quality affordable medical care.
When seeking the right treatment approach or checking whether a program accepts your insurance, you can learn more about rehab options to discover aligned facilities.
By Cary Damerow
Cary holds a BA in Liberal Arts and over 30 years of nursing experience as a Licensed Practical Nurse. During her career she has focused her work on high risk populations including pregnant women, children and adolescents, and those facing healthcare disparity.
Medically Reviewed by Anna Spooner
Anna has 10 years of experience in insurance and has been a content and copywriter since 2011. She strives to make all of her writing approachable and easy to understand while drinking copious amounts of tea. Anna writes about accessing addiction treatment, insurance, and finance.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionMental Health And Substance AbuseSubstance AbuseMental Health+1
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary ProgramProgram For Women
Private InsuranceSelf-Pay Options
Wonderful program with one on one sessions with highly skilled therapists and a very caring staff. Warm and inviting environment that includes massage, acupuncture, pool and yoga.
Holli Shindler Burns
2 months ago
Place was absolutely snazzy, #excellent experience 🤙
Garrett Burns
2 months ago
Senergy was such a blessing in so many ways. I have dealt with high anxiety, panic attacks, and it came to a point where it was hindering my personal relationships and my health. Senergy was a place of personal healing and growth with the incredible staff and the friendships I gained. There are opportunities to find ways to cope in many ways. From yoga, dance, circuit workouts, a walking trail, music therapy, art therapy, clay art, group and one-on-one therapy, there are many opportunities to find something new to take with you! Thank you Senergy!
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 began IOP and individual counseling at Rosecrance in February 2026, and I can honestly say it has been one of the most positive and impactful decisions I’ve made. My counselor Dominique is truly exceptional — she embodies everything you hope to find in a counselor.
From my very first session, Dominique made me feel genuinely heard and understood. She listens with real empathy, never makes you feel judged, and creates a space where it’s safe to be completely honest. That kind of environment is rare and so incredibly valuable, especially when you’re navigating something difficult in your personal life.
What sets Dominique apart is her combination of warmth and professionalism. She doesn’t just listen — she provides thoughtful guidance and practical tools that I’ve been able to carry with me outside of our sessions. Her knowledge and approach have helped me build real coping skills that have made a meaningful difference in my day-to-day life.
Rosecrance as an organization has also impressed me with the quality of care and the caliber of their staff. Dominique will absolutely keep you on your toes, but if you want it bad enough, anything is possible — just put the work in and you will have true companionship throughout the entire experience. I cannot recommend her enough.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Laura is excellent! You get to be you, and to be in a peaceful conducive environment aimed at healing. Thank you!
Peter S
3 months ago
Great place for anyone beginning there journey of sobriety. If you start here you'll finish where you want to . Best Counselor ever .
Tim corse
4 months ago
It was my first time at Rosecrance. It was very comfortable with my time with Robert. There’s a lot to my story to relate, and Robert listened very attentively and asked questions at the right time. He did take the time to make sure that I was comfortable with everything,
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.
Joan listens to me and cares about my concerns. I thank her for all of her help
Venessa Roetter
2 months ago
Joan Butler is so sweet (she’d be great for a pediatric patient). She was thorough and cared about me; she brought up new options to try to help me that I hadn’t thought of/heard of before.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
I was a resident in treatment for 28 days at the North Scottsdale location. My experience was second-to-none, and I would like to thank each member of the staff.
This place gave me my life back. They helped me uncover the root of my problems. They guided me through intensive therapy. Their staff took genuine care of my well-being through a balanced routine of individual and group therapy, education, physical, and nutritional practices. They allowed me space and time to look inward to process grief, trauma, self-destructive tendencies, behavioral issues, addiction, and mental health issues.
Michael handled my individual therapy and lead process group. His wisdom, charisma, and honesty lead me through breakthrough after breakthrough from my trauma, my triggers, and the root causes of my behaviors. He helped me outline a treatment plan suited to my individual needs and goals. He was the maestro and I the musician.
Cami provided education, lead group discussion, and gave us tools daily to help me through treatment. She provided clarity and helped me navigate the deeps waters of my issue simply by supplying the life vest to keep me afloat. As the case manager she helped me navigate the balance between my wants and my needs.
Gerry was the behind-the-scenes director of the house, the staff, and the structure of my care. She managed every in and out of the schedule, provided a foundation for the house, a structure for the day-to-day needs of the residents and the staff who cared for them. She is the ultimate mother hen, tediously and tirelessly devoted to overall well-being of all who enter the home.
Patsy is the resident chef and an absolute angel of a person. Not only did she provide the residents with the best meal plan, catering to the needs of everyone, she professionally and excellently prepared and configured every meal. She wasn't just the chef, she was the glue to bring everyone together. Having her around during the day offered a safe space to communicate, to show care, and bring love, light, and kindness to the home. She will give it to you straight with a smile and then drag your ass to the gym when you’re ready.
The nurses, Layla and Vicki, were so wonderful. Responsible for keeping our meds, appointments, and care daily. They meticulously took notes and monitored our mental and physical well-being. Not only so but were a part of our lives lead medical and mental health classes and facilitated group activities. Beautiful souls and caregivers.
The BHT’s were outstanding and uniquely suited to run the inner workings of the house and its processes. Keeping the schedule, maintaining our accomodations, managing our routine, schedule, and structure.
Krispy (spelling?) was a perfect gentleman and a caring soul. Devoted and willing to do anything needed with a smile. He was genuine, hilarious, thoughtful, and kind. Easy to talk to and helpful in any way. Nate was a gentle, observant, and spiritual soul. Relatable, considerate, and an advocate to all. He showed up with a willingness to work and help others, always. Brian, a man of true integrity, wisdom, and heart. Often he would engage with every individual and provide honesty, guidance, and actionable advice. A real no BS straight shooter, but a loving, thoughtful and caring man genuinely looking out for the well-being of everyone he interacted with. Desha, a hardworking, insightful, and calming presence. Willing and able to meet anyone at their level. Considerate, giving and thoughtful, another true gift to the program. Jay is a yoga master born of light and love, ready to guide you to peace. Master T is a man wrapped in light and positivity. As a trainer he challenges your physical body and sharpen your mind along the way.
I will forever be grateful to each and every one of the people who contributed to helping me get back to my wife and children a better and whole man, forever changed for the better. If you need help please seek this place out. I promise they will take care of you and in turn help you take care of yourself. You are worth it!
Caleb Rock
2 months ago
I started at Cornerstone in December of 2024, thinking I would be in and out in the virtual program. Now, see I needed a liver transplant and thinking it would help get me on the list quicker do this and be done. Todd My counselor and the rest of the staff helped me through my ups and downs and understood when I wasn’t with it! But I still showed! They saved my life and were there for before and after transplant. The staff showed me I needed to love myself before I could work on myself but I needed to work on myself before I could love myself.
Now I get the pleasure to be part of the staff. I always say it is hard work but when you get it , you get!
Hilary Canen
2 months ago
I completed residential treatment at Cornerstone. I was at Grayhawk Manor with 8 other people. My experience was completely amazing. The staff and therapy is 5 star as well as everything else about my stay. I cannot recommend the facility enough. If you are a loved one are struggling with mental health and/or substance abuse you will get fantastic care at Cornerstone.
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.
6 months sober and yall were right life truly does get better :) I came all the way from St. Louis and I felt nothing but love as soon as I walked in the doors. My first time in rehab and 4 hours from home the anxiety was real. Justin, Madison & Alexander truly gave me so many words of encouragement and life advice I will forever hold close to my heart. When I wanted to turn around and walk out those doors and they reminded me it was important to be comfortable in uncomfortable situations because that’s how I would grow. My counselor Angela was also amazing. She made me feel like she was my best friend and connected with me and made sure I truly felt seen. she didn’t seem to try to hard to do that either, it was just naturally done of her. All the workers there made sobriety look so cool. I will forever thank rosecrance for giving me my life back :)
Emma Leiner
3 months ago
Wonderful staff this is where conversations go to come back to reality everybody that works there I appreciate you and don't listen to none of this bs
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.
Tammi, Tammy, and Virginia are all amazing at this location never have I had an issue getting my medications needed, super friendly super caring over all just an amazing staff that genuinely cares about the well being of their patients you guys are awesome over here at Intensive Treatment and would recommend this location to anyone who’s going through struggles a tough time or just looking to better themselves in General Ty ladies for the support Ty for the guidance and most of all Ty for the help yall are Alstars and the impact you have on anyone who walks through your doors doesn’t go un noticed Ty Ty Ty!!! Have a great day and God Bless ☝️☝️☝️💯
Duck Goose
3 months ago
Great place to seek treatment. Tammy is the nurse who works most days out of the week sometimes she is here 6 days a week. Super fast at getting you your dose. They offer a van service to pick you up and drop you off at home. ( There is some limits with the van service it's not like Uber or Lyft ) When the driver can pick you up he will call you. He is always very prompt and when he says he will be there in 15 minutes he will be there in 15 minutes. All the staff is great. I came from CMS and this place is heaven compared to CMS. They are strict about alcohol use. Its not tolerated at this clinic. Its a great place and I cannot recommend it enough. A few people also have come from Unhooked and have said nothing but nice things about I.T.S.
Also Tammy deserves a raise for being awesome and such a great nurse.
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 don't really care where I live, this is my clinic. The staff turnover is not bad, at all, practically non existent, many have been there for a very long time. Everyone is super caring, accommodating, and always respectful. Plus, their hours are ideal for anything life throws at you.
Sage Owens
2 months ago
I have been coming here for over 15 years and would tell anyone struggling with opioid addiction that there is a place where you can find help and never have to suffer from debilitating pains in agony because your body is going thru withdraw and you will never have to suffer in silence trying to hide from your addiction that is always going to catch up with you so if your ready to free yourself from burden of having to chase pills and always wandering if you'll have enough to make it thru another day just hoping you can find someone who has some thing to stop those withdraws this is the place for you to find what your looking for. Methadone treatment saved my life and don't listen to what anyone tells you or what you may have heard about methadone treatment just make the call and come talk to one of the counselors to get the facts and then give it a chance because they don't expect anyone to be cured overnight but they can offer the support and start you on medication and give you more the next day and keep sticking to that plan to show up everyday youll keep getting a little bit more everyday by the end of your first week you will start to feel so much better by end of week 2 you'll be able to get a good night's rest 3rd week you won't worry because the withdraws will subside by week 4 you'll still be raising your dose but withdraws will be gone but you may still have cravings or you may not need to raise your dose any higher but whatever the case they will give you everything you need to get you drug free until you have no more cravings and you will soon wander why you waited so long to start treatment. Whatever excuses you have not to start or keep going back they can help with getting rides , filling application for access if you need help paying or can't pay they have lots of programs that might qualify you for help to get started on treatment so give them a call , you won't regret it and privacy for patience is a top priority so if your worried someone might find out like an employer or family member they do not and will not ever acknowledge if someone is or is not a patient so they can protect every person who walks thru their doors from having to worry about the choice to come there and consequences of someone finding out they make every patient sign a non disclosure agreement so if someone you know happens to show up one Day they are banned from exposing any person or patient or even talking about seeing someone while they are there for treatment so it's very discreet and you need to take a chance make the call and get your life back on track because your never to old to learn something new like how to live your life sober and happy so they will give you the tools you will need to succeed and I hope if I can convince just one person to try then these words will have been worth all it took to get them somewhere to let someone find them and if I save just one person that's enough for me and I hope to see you there one day
Forever Lisa99
1 year ago
This place doesn’t make you feel worthless because of the reason you are here. They extend more than just help with drugs. They’re sincere and human and my counselor Marne is amazing and a wonderful woman. She has definitely been in my life and has made such a huge difference in my recovery from prescription pain meds to now Suboxone. This is going to be my sixth year in recovery. Highly recommend this place.
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Frequently Asked Questions
Does MercyCare Cover Addiction Rehab?
Most MercyCare plans will cover addiction rehab, including all plans sold in the state Insurance Marketplaces. In 2010 the Affordable Care Act (ACA) was passed and one component of the law states that mental healthcare and substance use disorder treatment is considered essential medical care. However there are exceptions to the law so it is important to get your full plan details and understand your coverage and requirements.
In most cases a determination of medical necessity is required for insurance to cover the treatment. Your primary care provider can work with you to determine the appropriate level of care needed for your alcohol or substance use disorder.
One way this can be accomplished is by completing the ASAM — the American Society of Addiction Medicine assessment. This tool looks at factors such as your needs along with assets and strengths. It also considers obstacles and liabilities as well as resource structures to help determine the appropriate level of care for you and to create a personalized treatment plan. This treatment plan shows what’s medically necessary in your specific case and can help you look for the right treatment center right away.
What Are MercyCare Plans?
MercyCare offers multiple plans. You can get individual and family plans on the Illinois or Wisconsin insurance Marketplace. These plans are generally health maintenance organizations (HMOs) which require you to have a primary care provider (PCP) to coordinate your care. Your PCP will give you referrals to specialists such as addiction treatment or mental health professionals. They can also help you get preauthorization when needed.
MercyCare also helps employers offer health insurance to their employees. They have options for large and small employers. Many of these plans will have coverage for addiction treatment but you’ll want to make sure you check the details of your plan.
Finally for those who have Original Medicare and want help with their out of pocket expenses MercyCare offers Medicare Supplement plans. These plans are also known as Medigap.
What Inpatient Addiction Treatment Does MercyCare Cover?
Determination of medical necessity is often a requirement for any addiction treatment and especially for inpatient rehab. Inpatient or residential care is the most intensive and expensive type of rehab but it can allow you to lay a solid foundation for recovery if it’s part of your treatment plan.
Medical detox is one type of inpatient treatment that may be a covered service. For individuals who need close medical supervision and medical stabilization this is often the first step in recovery. This is especially true in individuals who have severe addictions to substances that can have dangerous withdrawal symptoms. Medical detox provides 24/7 medical supervision and may treat withdrawal symptoms with medication assisted treatment (MAT).
Inpatient or residential care occurs in hospital settings or addiction treatment facilities. For some this is a continuation of inpatient medical detox and for others this is the first step toward recovery. During inpatient treatment individuals have 24/7 care by medical professionals and addiction specialists. Individual and group therapy is a major focus during inpatient or residential care and uses a range of approaches including cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). Some centers also use motivational interviewing and eye movement desensitization reprocessing (EMDR) along with holistic treatments such as yoga and meditation. Residential treatment also includes exercise and recreational therapy as well as nutritional counseling.
Inpatient or residential programs typically range from 30 to 90 days with research finding the most success with the 90 day programs. It is always important to remember that each individual is on a unique recovery journey and your primary care providers and addictions team will work with you to determine the best program for your needs.
What Outpatient Rehab Does MercyCare Cover?
Depending on medical necessity and your plan details your MercyCare plan may cover outpatient rehab. Because plans differ greatly it is important to check with your insurance provider before starting any treatment programs to determine coverage and if there is a need for prior authorizations or referrals. You’ll also want to find out what providers are in the network.
There are various levels of outpatient rehab. The most intense outpatient treatment are partial hospitalization programs (PHPs). These programs allow individuals to return home each night but still require a full day commitment in most cases. Most of these programs require at least 20 hours of treatment per week. During treatment you get individual and group therapy which may include a wide range of approaches. These programs normally last for 90 days but that may differ from person to person.
Intensive Outpatient Programs (IOP) are more flexible because you’re only attending treatment for three to four hours each time. This allows you to work around family and work or school commitments. Relapse prevention and building healthy coping skills are the main objectives in this type of programming. Through individual and group therapy utilizing evidence based practices such as CBT and alternative therapies such as art and music therapy you’ll learn new habits and practice new mindsets to help you achieve and maintain recovery.
MAT is also an option for many individuals in these types of programs. Medication assisted treatment uses FDA approved medications to ease withdrawal symptoms and normalize brain chemistry while also decreasing cravings. When used over a longer timeframe MAT allows you to stay stable in treatment and avoid relapse until you can establish long term sobriety.
Does MercyCare Cover Methadone & Suboxone (MAT)?
Many MercyCare plans will cover MAT if it’s appropriate for your needs. Each insurance plan is different so it is important to verify what your coverage looks like and if you need a referral or preauthorization before you begin.
The use of FDA approved medication like Methadone and Suboxone has been shown to decrease the incidence of relapse and decrease the risk of overdose death. MAT can be used during medical detox or for longer term treatment for opioid or alcohol misuse. When used longer term it is generally paired with evidence based treatment to help you reach long term recovery.
Does MercyCare Cover Other Mental Healthcare?
Under the ACA mental healthcare is considered an essential health benefit and many MercyCare plans will offer coverage for it. However there are exceptions to the law and each plan will have different coverage limits and requirements so be sure to get full details before you start treatment.
For many with addiction there is a co occurring mental health condition such as depression or anxiety or PTSD or other disorders. Comprehensive treatment recognizes that successful recovery not only means sobriety but that underlying conditions are also addressed. For individuals with co occurring conditions integrated care is essential to address mental health and addiction at the same time.
Mental health care can include both inpatient and outpatient care that may include therapy and medication management along with other evidence based practices.
Does Addiction Treatment Need to Be In Network?
This depends on the type of plan you are enrolled in. It is important to understand your benefits in order to make sure you meet the requirements for coverage before starting a program.
Many plans will not cover out of network care. In cases where it is covered, there is likely to be higher out of pocket expenses such as higher deductibles and copayments. It is always best to try to remain in network to get the most out of your benefits coverage.
How Long Will MercyCare Cover Rehab?
The length of time MercyCare will cover rehab depends on a number of factors. This is where having determination of medical necessity and a treatment plan is crucial. Each benefit plan has different requirements and provides different levels of coverage. Working with your primary care provider and addictions team will help you to get the most out of your particular benefits plan.
Time in treatment varies from person to person. For inpatient and IOP, research has shown that 90 day programs are the most effective in preventing relapse and supporting long term sobriety. Individual therapy and aftercare programs can last for months or years, it is always important to remember that each recovery journey is unique and that there is no set time that is right for everyone.
How to Verify Coverage With MercyCare
There are a number of ways to verify coverage with MercyCare. The first is to contact the company directly. Often the member service phone number is on the back of your member ID card. Calling and speaking with a representative is a good way to help you understand what your benefits are and can help you find providers or facilities that will take your type of insurance.
Another way is to utilize MercyCare’s online member services page. Here you can find a wide variety of information including coverage information and in network providers along with details on requirements for coverage.
In some instances a treatment center can help to verify coverage. They will need the exact plan name and your ID and group number because each individual plan has different covered benefits and requirements.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
Calls to numbers on a specific treatment center listing will be routed to that treatment center. Calls to any general helpline could be forwarded to SAMHSA or a verified treatment provider.
If you wish to connect with non-sponsor centers, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.
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