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.
By Gayle Morris
Gayle Morris, BSN, MSN has over two decades of nursing practice with a clinical focus on rehabilitation medicine. She has published and lectured throughout her nursing and writing career. In the last 15 years, she has directed her energy and passion to create content that informs and educates readers with the goal of improving overall physical and mental health.
Medically Reviewed by Eli Wood
Eli Wood is a content writer and content strategist specializing in healthcare, mental health, and LGBTQ+ sexual health and wellness. They have written for American Addiction Centers providing health insurance resources and information, as well as writing and reviewing detailed medical insurance and product pages for various platforms.
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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.
AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Self-Pay OptionsPrivate insurance
This place is amazing helped me get my life started on the right track, I really appreciate the faith based atmosphere great staff and wonderful community highly recommend this place for anyone still struggling with active addiction!
Jared McGinnis
1 week ago
This facility is recognized as the premier treatment center in Florida. Look no further... this is the one. Make the call to get your life back on track.
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.
nice and friendly staff who put client care first and super nice and clean facility
Cade Jackson
1 week ago
Great facility and even better staff!
Anna Allen
2 weeks ago
Oh my goodness, this was the best treatment facility. After they take me to Chattanooga, I feel it will be my last. I'm going to miss the staff; Mrs V has been so awesome, and Ms. Mechell, and Mrs, Tamiyah, and Desmond just a few that have made it a great experience.
This is an ad and Never Alone – Adolescent Addiction Treatment Center 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
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 ProgramProgram For MenProgram For WomenYoung Adult Program
Private InsuranceSelf-Pay Options
All in Solutions is the best Rehab I've been to, unfortunately this is my 3rd attempt. I have received more knowledge,and support than I've received in the last two. 5 stars
Frank Simmons
1 week ago
Its the best decision I could have made!! They have great groups through the day!! I came in a mess leaving a happy and blessed man!! All the techs are caring and thoughtful. Great nurse's they take really good care of you!! Don't miss 9:00 group with Kristina. She gets the day started. But all groups are a must to attend. Much love to all at all in solutions. Also they have an amazing Chef!! Food is excellent!!
Neil Hooper
2 weeks ago
Highly recommend, I spent 22 days in there and was one of the best experience. Carlos was the one who picked me up from the airport , he was very nice and explained the whole process to me. Group therapy was my favorite. Highly recommend if you need the help.
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 HealthMental Health And Substance Abuse
Adult ProgramSeniors ProgramLGBTQ Program
Private insuranceSelf-pay options
Ya era hora que esta Isla contara con un centro completo e integral. Un salvavidas para los que de VERDAD BUSCAN Y QUIEREN un cambio en sus vidas. Un faro de esperanza para sus familias. Un personal muy dedicado. Un lugar muy agradable. El centro esta en fase de crecimiento y en desarrollo de sus facilidades lo que les permitira mas pacientes y mas servicios. Aqui encontraras los 28 dias que marcan un buen comienzo a aquellos con mente y corazon dispuestos a un cambio de rumbo.
Remax Zone Puerto Rico
1 month ago
Excelente lugar, gran servicio y el personal realmente se preocupan por ti.
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 admitted myself for mental health. I was beyond terrified about seeking help that I had so desperately needed. But the beautiful people at ICFR helped me feel comfortable. The group facilitators were well beyond amazing. They have taught me so many skills that I can now take out into the world and continue my journey of mental health recovery. And the resident community is amazing. Everyone advocates for each other, and no one judges anyone. I want to give everyone at ICFR Bloomington a huge thank you for everything they have taught me. Keep doing the work that you do.
Dylan Shelton
2 weeks ago
Very helpful for mental health. I will say you get as much out of here as you put in. My therapist and the staff have been wonderful and I’ve learned a lot of useful tools for my life moving forward. I’m not fixed, but I have more balance.
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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! The only reason I gave 4 stars is this is not the place for residential treatment ....groups are aa ..lecture type no real interaction
LEA
3 weeks ago
Drivers picked me up, they were very professional. No judging, staff is friendly and all here to help and the kitchen is great ! And they even have ice cream !
erik bailey
3 weeks ago
I was so scared and nervous upon just asking for help. Thank you God I came here the staff are so caring and understanding no judgment was passed at. Morning noon or night they are here for you. The facility its self is 10/10 the staff is 109% on your side ready to listen and help. Most places you have to tell half truths here NOPE the all understood where you are coming from and are so. Amazing and down to earth and couldn’t be better. This has been the best experience of my life and after detox they make all the arrangements for you and are more than happy to do. Thank you so much to all the staff for the loving care
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.
This place saved my life! I've been to many reheabs but this one by far the best program . Every one was nice and met my needs. Would recommend to anyone out there struggling.
Dallion Jay
1 month ago
Haven NLR Recovery Team PHP is one the most magnificent and effective programs I've been to over all my 30 years of suffering from addiction. The Team and / or Staff have the genuine care and concern for people seeking recovery. I highly recommend this RECOVERY PROGRAM for all those like myself who are suffering from a addiction and are now honest, open minded, and willing to put their lives back together. Thank you Recovery Team of Haven! I would love to be apart of this Team after my year of Sobriety
curtis graves
1 month ago
Absolutely love the staff here at S.L.A
Thanks for the experience.
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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 DiagnosisOpioid AddictionSubstance AbuseMental Health And Substance AbuseMental Health
Adult ProgramYoung Adult Program
Private insuranceSelf-Pay Options
Sean rules
James Rumsey
1 week ago
I have done the program twice at mrc. The aftercare they have is one of a kind. The staff is amazing. There are far too many to list individually. It is truly the staff in the facilities that have kept me sober. The one huge thing I disagree with though is upper management. They have definitely become more about money than the patients. They only accept bcbs for insurance, so unless you have a lot of money, don't bother coming here. There is no breakfast to speak of. It is not about comfort I guess
Nicole Little
2 months ago
I am currently in MRC’s Phase 2 program I have been through the 30 days in residential and 60 days in Phase 1 a structured sober living with peer support. The nurses and peer support were fantastic at detox always there is you need anything. Or just a shoulder to cry on.
At phase 1 Tyler and Jermaine were awesome people to be around the peer support there. You could talk to them about anything and they drove us to meetings all around the metro. I am now living in one of the two phase 2 houses. I have a great job, that I love. Making rent every month and still saving at the same time because rent is so affordable. All in all I would recommend anyone to MRC including Tiger Woods
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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.
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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