Optimum Healthcare Coverage for Drug & Alcohol Addiction Treatment
Discover how Optimum HealthCare’s Medicare plans cover addiction treatment. Learn about coverage options, verification process, and more.
Optimum Healthcare Coverage for Drug & Alcohol Addiction Treatment
Discover how Optimum HealthCare’s Medicare plans cover addiction treatment. Learn about coverage options, verification process, and more.
Optimum HealthCare provides Medicare Advantage plans to eligible individuals. Medicare Advantage Plans replace Original Medicare Parts A and B, offering benefits such as fewer bills, lower premiums and copays, and access to more benefits.Optimum HealthCare was founded over 15 years ago to deliver quality and comprehensive benefits that are affordable and meet the diverse needs of seniors and people with disabilities.
Optimum HealthCare operates under the umbrella of HealthSun Health Plans, which is part of Anthem, Inc (now Elevance). This is one of the largest health insurance companies in the U.S. This affiliation allows them to leverage the extensive resources and expertise of Anthem to deliver high standards of care and customer service to their members.
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 AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private InsuranceSelf-Pay Options
This place saved my life. Great facility and staff. I was very nervous/scared to come here but the staff were very friendly and helpful. If you are thinking about treatment I highly recommend this place.
xCochise
2 weeks ago
This program dramatically help me get back on track in my recovery and was very well staffed and organized was an amazing experience.
Jacob Berghaus
3 weeks ago
I recommend calling the facility to confirm what the sales team tells you is true. The staff facility and people are great.
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 AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Self-Pay OptionsPrivate insurance
All In Solutions received me with open arms for the second time. The staff make sure you receive a high quality care treatment. I’m grateful for the love and care . God continue to bless everyone.Thank you for you do .
Jianil Richiez
5 days ago
This place changed my life. My therapist was great and all the staff was great.
Ash Leigh
1 week ago
My time at All in Solutions has been the most valuable important decision I’ve ever made. I have nothing but love and respect and gratitude to all the staff who helped guide me to a freedom I thought I could never have!!! I love you guys from the depths of my soul!!! Thank you Thank you Thank you!!!!
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.
This is an ad and The Recovery Team – New Jersey is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More
The Recovery Team New Jersey truly sets the standard for compassionate, high-quality care. From the moment you walk in, the staff is welcoming, professional, and genuinely invested in each person’s recovery. The environment is clean, supportive, and structured in a way that promotes healing and growth. You can tell this team is passionate about what they do and treats everyone with dignity and respect. I highly recommend The Recovery Team to anyone seeking effective, caring addiction treatment in New Jersey.
Nicolette Caimi
1 week ago
Great facility! Would definitely recommend!!
Rebecca Mayo
2 weeks ago
The Recovery Team New Jersey has helped me in my recovery in multiple ways. The structure of the program has kept me on point which is extremely important in early recovery. The staff here takes good care of us especially Phil. I can tell he genuinely cares about me and wants the best for me in my future and I know this not only by his words but by his actions. Stand up dude.
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.
Phenomenal place! All of the staff are very helpful and friendly. Anthony, client care coordinator is always checking in to make sure you are ok and if anything is needed, helps with a smile! Jason(therapist) is great, more in tuned than most I have seen. . Karen (EMDR) is gifted and am privileged to have been able to work with her. Magic Mike will blow your mind with his knowledge and things he can do. Food is good. Facility is clean. Beds on residential side are comfy.bon detox they are average. Such an amazing group! I have been to a few different rehabs and this one is top notch!!!
LEA
6 days ago
The staff here its great! Love my therapist Jason. And the trauma Therapist Karen has been very helpful also. And love her group sessions. Along with Pastor C, Dr. Harris and Dr. Alvin and others.The chefs have been great with accommodating my very restricted diet with no gluten or dairy. Shout out to Mariano and the head chef. BHT’s Gene and Harriet have been very helpful. And a shout out to Anthony. Met with him when I first arrived, and he helped me work through some questions and has been a great resource, along with being very kind. And thank for delightful Audrey, a nurse, color brightened my day and went above and beyond. And to all the nurses, as I know, they are very busy. Lauren in aftercare and Ashley, who helped with insurance have been extremely helpful. Lauren is very efficient. And Roni in administration is also a joy. I am extremely glad that I chose Haven for treatment And I’m definitely getting the help I need.
Christine Kerr
6 days ago
Please do not detox alone. You do not have to detox and enter recovery alone. The environment matters and the staff and clients at The Haven brought me to a place in my life I never thought was obtainable. I have fought alcoholism for approximately 18 years. I spent the past 7 years trying, very unsuccessfully to get sober on my own. Finding and choosing The Haven Flagship facility in West Palm Beach (with their help) was the best decision i have made in 7 years.
Do not wait like I did. Your health & happiness are worth fighting for and doing it in this environment makes it so much more comfortable. There is no judgement, no shame and it is not worth risking your life detoxing without this extremely well oiled machine called The Haven.
When i made my first called all they dis was listen and talk to ne and encourage me. Once I opened up they knew exactly where i should be and asked if i minded coming to a facility that was further away because they said West Palm Beach would be the beat fit. They were not wrong. They had never met me but understood what I needed and directed me PERFECTLY.
While here I detoxed safely under excellent supervision. (Please do not do this alone without medical professionals).
I attended 3 of 4 beneficial classes per day. Classes I avoided while alone on the outside of their facility while my health & drinking just got worse by the minute.
To say the staff here is nice & professional doesn’t do them proper justice.
If you need to talk to someone I suggest you just start with a call.
I wish that I had done it sooner.
God bless you all who are suffering with addiction and those who dedicate their lives to get the addicted into recovery mode.
Monica L.
Serenity Springs Recovery truly saved my life. When I went through their inpatient program, I gained the strength, guidance, and tools I needed to finally turn things around. I have been sober ever since my stay there, and I continue to use the lessons I learned every single day. The staff genuinely cared and went above and beyond to support me on my journey. I am extremely grateful for my time at Serenity Springs and for the new life it helped me build. I highly recommend them to anyone seeking real recovery.
Anthony Gomez
3 months ago
Beautiful Facility, Staff was mostly friendly, professional & helpful. Most patients were nice; few bad apples; but expected. Learned a lot & really glad I went. I would highly recommend it to others. 👍😎 Martin
Martin Dodge
8 months ago
This place was amazing it really changed my life 70 days sober now
This is an ad and The Recovery Team – North Little Rock is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More
Love Love this place nice to know I have an amazing recovery family 😁
Andrea
2 weeks ago
The Haven recovery team has treated me better then expected and the treatment plan was a perfect match.
Travis Allen
2 weeks ago
I had an absolute amazing experience at The Recovery Center not only was all staff kind and compassionate about helping the clients but also was a major step in our recovery journeys and development of our new lives we will lead in the world after this . I’ll allways have much love and appreciation for every single one of team members that not only aided me but also supported and encouraged me through this process. Rating a 10 out of 10 highly recommended!
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.
The experience with Never Alone was a breath of fresh air. My 16 year old son completed his journey 11/19 and came home with a whole new perspective on life and his future. His clinical technician Karissa was a wonderful aide in the process dealing with my son. The family sessions were a great opportunity for me, my son and his mom to work on communicating with one another which was hard to accomplish before our sessions but Karissa helped navigate that and allowed us to grow through our sessions. The weekly parent groups were a very helpful resource and tool as well. I appreciate all the support and encouragement the staff at Never Alone gave to my son and salute them for taking their time to guide my son through his journey.
Simione Corbett
2 months ago
My daughter spent over 2 months at Never Alone on her recovery journey. We can't say enough great things about the staff and the facility. The staff communicated well and provide support for the entire family. They have been the biggest step and help in her recovery, they provided her with tools she can use in her daily life to stay on tack to help cope with hard things that happen in life. She says now that this was the best thing that could have been provided to her while in addiction.
Lucy Vilamaa
3 months ago
Never Alone brought back the child that was lost in drugs and addiction. We can't say enough about the staff and the facility. They loved and cared for her so well provide her with all the things she needed in her recover and helped her find herself again and provided her with the knowledge she needed to start her recovery. The staff cares about their jobs, care for the kids their wellbeing and their success in recovery and it shows in their dedication and interaction with the kids. Never Alone has provided her a new opportunity at life.
Serenity Springs Recovery truly saved my life. When I went through their inpatient program, I gained the strength, guidance, and tools I needed to finally turn things around. I have been sober ever since my stay there, and I continue to use the lessons I learned every single day. The staff genuinely cared and went above and beyond to support me on my journey. I am extremely grateful for my time at Serenity Springs and for the new life it helped me build. I highly recommend them to anyone seeking real recovery.
Anthony Gomez
3 months ago
Beautiful Facility, Staff was mostly friendly, professional & helpful. Most patients were nice; few bad apples; but expected. Learned a lot & really glad I went. I would highly recommend it to others. 👍😎 Martin
Martin Dodge
8 months ago
This place was amazing it really changed my life 70 days sober now
Staff is absolutely tremendous, and was a vital part of my recovery. The executive director Kelly Brown is extremely professional and beyond helpful. The facility is beautiful and kept immaculate. Food is amazing and very nutritional. I absolutely recommend this facility to anyone with addiction problems looking for help.
Dillon
3 weeks ago
Nice place 👌 GREAT STAFF!! Client care is number 1!!
Shannel Walsman
3 weeks ago
This center saved my life and gave me hope for the future. I'm forever grateful for the dedicated team that helped me through my toughest moments. Highly recommend! . "From detox to aftercare planning, everything was handled with empathy and expertise.😇
The haven detox had a great staff the food was great and the rooms were clean. Good place to go if you need detox or mental health treatment.
Whitney Hickman
2 weeks ago
This was my first time at a facility I can say was the best experience I had if I could do it all over again I would the staff was great. They helped me through everything and I’ll definitely recommend this place to family and friends .
Deavon Clack
3 weeks ago
I have all great things to say about this facility!! I received such positive HELPFUL treatment here. I highly recommend treatment here!
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Frequently Asked Questions
Does Optimum HealthCare Cover Addiction Treatment?
Yes, Optimum HealthCare policies are required to cover at least as much as Original Medicare. Original Medicare provides coverage for addiction and mental health treatment as an essential service defined by the Affordable Care Act. As a result, Optimum HealthCare will also have coverage for various mental health and addiction treatment services.
The specifics of this coverage will vary depending on your plan, so it’s important to verify your insurance before committing to a treatment program. Also, Medicare Advantage plans often require you to use the provider’s network, so you’ll want to make sure you choose the rehab center accordingly.
What Are Optimum HealthCare Plans?
Optimum HealthCare offers Medicare Advantage HMO plans. These plans cover everything Original Medicare covers and include prescription drug benefits that Original Medicare members have to buy separately. The Advantage plans also generally have additional benefits not covered by Original Medicare, such as dental, vision, hearing, and fitness programs.
Other benefits of Optimum HealthCare plans include preventive services at no cost to you and a personal emergency response system that includes a monitoring device so you have access to help around the clock.
The Optimum Medicare Advantage plan may also include 30 hours each year of in-home support, offering technology assistance, virtual services and companionship.
Another key feature of Optimum HealthCare plans is their emphasis on preventive health measures. They encourage you to get regular health screenings, vaccinations, and wellness visits to maintain your health and detect problems early.
A strong emphasis is placed on this proactive approach and customer service, offering support to help you navigate the healthcare options in your area and make informed decisions about coverage. The Optimum HealthCare Medicare Advantage HMO plans are designed to provide you with comprehensive care while helping manage your costs effectively.
What Types of Rehab Treatment Are Covered By Optimum HealthCare?
All insurance plans focus on covering medically necessary care, so it’s important to get a treatment plan from your doctor. Some of the covered services in your Medicare Advantage plan from Optimum HealthCare could include:
Detoxification Services: Detoxification includes medical supervision to help you safely manage withdrawal symptoms. These programs often offer medical care which includes prescription drugs to help manage symptoms.
Inpatient Rehabilitation: These treatments are offered in a residential facility or inpatient facility where you receive around the clock care and support for addiction. You’ll get counseling, fun activities, and help creating new habits and mindsets.
Outpatient Programs: Outpatient programs allow you to receive treatment during the day and continue to live at home or in a sober living residence in the evening. Some programs are highly structured and have up to 20 hours of treatment, while less intensive programs might have nine hours or less per week of rehab. These programs include individual or group therapy sessions focused on helping you live out your recovery in daily life.
Medication Assisted Treatment (MAT): Medications can be prescribed to help manage cravings and withdrawal symptoms. This support is combined with counseling and behavioral therapies to help establish your recovery long term.
Where Does Optimum HealthCare Offer Coverage?
Optimum HealthCare primarily offers coverage to Medicare beneficiaries in 24 counties throughout Florida. The coverage areas include counties in the center of the state bordered by Marion County in the north and Collier County in the south. They also offer concierge services in eight counties, including Marion, Orange, Sarasota and St Lucie.
The concierge services may vary in each county and may include personalized care coordinators, transportation services, home visits, wellness programs, and medication management. These services help improve your overall experience by providing you with convenient and personalized support that goes beyond traditional medical care.
How to Verify Coverage with Optimum HealthCare
Your insurance coverage through Optimum HealthCare will vary depending on your Medicare Advantage plan. Before receiving addiction services or care for mental health conditions, it is important to verify your insurance coverage.
There are several ways to do this. When you purchase a Medicare Advantage plan, you are given a member Services book that documents what your policy covers. However, these can sometimes be confusing to read. Optimum HealthCare also has a member services phone number where you can ask questions about your coverage.
The easiest and sometimes fastest way to verify your insurance coverage for addiction treatments is to work with the addiction treatment center of your choice.
The financial counselors will generally verify your insurance coverage with Optimum HealthCare and provide you with more information about the treatment center, your treatment options and what you can expect after admission.
Does Addiction Treatment Need to Be In Network?
Optimum HMO provider networks use credentialed professionals to deliver care and in most cases you need to use in network providers to get coverage.
However, on rare occasions, Optimum will cover an out of network provider. An example of when out of network services can be used is when emergency care is necessary and delaying care would be dangerous. If an emergency happens outside of your network’s service area, then in network providers would of course be inaccessible. So you would access emergency services and then when you return to your home service area you would get any follow up care from an in network provider.
To request out of network services in non emergency situations, you must ask for special approval, and these are rare. Another possibility is that you can pay for out of network care yourself rather than using insurance.
What to Do if Optimum HealthCare Won’t Cover the Cost of Rehab
If your Optimum plan informs you that it won’t cover the cost of rehab, you are not out of options. You have the right to appeal your insurance company’s decision to deny treatment. To start the process, call Optimum Member Services. You’ll find more information about the appeals process in Chapter 9 of your Optimum Evidence of Coverage (EOC) document.
To get help covering the cost without insurance you can apply for a grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA grants for addiction treatment are available in all states. You may also find financial assistance available through scholarships or grants from advocacy groups such as LGBTQ+ groups or through your church. Ask the rehab you are considering whether they accept these assistance program options.
Also ask if the rehab itself has a sliding scale which is a reduced fee option based on income. You can consider using a loan to pay for your addiction treatment. For example CareCredit is a company that specializes in providing credit to be used for healthcare needs. Or you could borrow money from family or friends. Because it is important to get rehab when you need it be diligent and creative when searching for your own 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.
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