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.
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private InsuranceSelf-Pay Options
Great Staff helping you learn about your addiction and how to beat it.
There is nothing wrong with struggling or being afraid.. They will help you through everything and help you set goals for your future.
Joseph Brown
2 days ago
This place was an overall great experience, lovely staff and counselors that truly care about your well-being. I would recommend anyone who's seeking help come to this facility.
j s
2 days ago
The best decision I ever made , this place literally saved my life !! Please anyone with addiction get 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 Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Self-Pay OptionsPrivate insurance
I had my phone the whole time. For anyone coming from a detox program where everything gets locked away, that's worth knowing. Being able to stay in contact with family and handle things in my life while doing the program made it feel sustainable, not like I'd put everything on pause.
Chris Deluca
4 days ago
Friday mornings are alumni speaker meetings. Someone who's been through the program and come out the other side sits with the current group and talks about what it looked like. That's a different kind of session than anything a therapist can run, and it became the part of the week I looked forward to most.
Nathan Foster
6 days ago
I had an amazing experience here! All of the staff and techs provided top notch care! My therapist Nicole was very caring, insightful and informative. Pastor Dans groups were fire and Chris P was very compassionate and supportive! 12 out of 10 I highly recommend!!!
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.
Glad I came here to get help with my mental health. Employees really care about everyone and want to help you get better. The facility is clean and very nice. Highly recommend
Patrina Avila
4 weeks ago
nice and friendly staff who put client care first and super nice and clean facility
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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 AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Private InsuranceSelf-Pay Options
My wife completed residential treatment here for alcohol addiction and the change has been remarkable. Family therapy sessions helped all of us understand how to support her moving forward.
Rosalind Actongale
4 days ago
Attentive medical staff during detox, comfortable rooms, board-certified providers who explain everything clearly.
Tobias Kingsley
6 days ago
The residential mentors actually check on you, not just clock in and out. Small thing but it made a real difference during a hard stretch.
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
Todo fue especial. Muy agracecido con todo el personal. Todos muy amables comprometidos. Muchas gracias
Michael Gordillo
1 week ago
Haven Detox ha sido un lugar de bendición para nuestro familiar. Todos sus empleados, desde terapias, trabajadores sociales, médicos, los cocineros y todo el personal en general tiene la vocación y la empatía para hacer más q su trabajo, hacen que se sientan en familia. No tengo como agradecer el cambio q hemos obtenido.
Es el mejor lugar para tratar la adicción de un ser querido! Que DIOS los siga usando de forma poderosa!!! Gracias Josefina por ser la persona que nos ayudó a llegar a este lugar!
BlancaPor Perez
1 month ago
El mejor lugar para tratar la adiccion de un ser querido. Un excelente grupo de profesionales que hacen mas q su trabajo, es su vocacion. Recomendado al 100% El mejor centro en Puerto Rico. Mi agradecimjento a Josefina q fue la persona contacto en Puerto Rico, quien con mucha paciencia y amor nos facilito llegar a este lugar maravilloso
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.
Really changed my life. Feel like a completely different person leaving than when I first got here. The group facilities are fantastic and really are able to help you on a deep level. The community overall is phenomenal and recommend it to anybody who is struggling
Aiden Muska
1 week ago
★★★★★
I would highly recommend Indiana Center for Recovery. No treatment facility is perfect, and there are a few things I think could be improved, but overall my experience was very positive. In talking with residents who had been through treatment before and experienced relapses, I repeatedly heard this was the best facility they had been to. After my experience, I understand why.
The biggest area for improvement is communication. There can be a lot of redirection between staff when trying to get an answer, and expectations aren't always communicated clearly. When someone is already in a difficult place and there to heal, even small communication issues can become frustrating.
For example, there's a sign-up sheet for cleaning the lunch area that I didn't know about until I discovered I was on it. It's no big deal—about 15 minutes with several people—but knowing beforehand would help. Mail is another example: you need to check the office after sessions each day if you're expecting something. Small things, but clearer communication would make the experience easier.
A few practical recommendations: bring an inexpensive wristwatch because you won't have your phone and clocks aren't always readily available. If you smoke, you can't bring a lighter, although techs are readily available to light cigarettes. A small, dim flashlight is useful for finding things at night without disturbing roommates. A blanket can also help in a cold room or with getting comfortable in a chair.
Where Indiana Center for Recovery really shines is the people and treatment. Syndey, Greg, and Dave are excellent facilitators. Classes cover a wide range of subjects and include traditional groups along with activities such as art and music. I learned a great deal about recovery, myself, and how I look at life. They also offer acupuncture and a variety of other therapeutic activities.
The staff deserves a lot of credit. Toni, Justin, Sarah, Carter, the nursing staff, and many others do a great job. The atmosphere among both staff and residents is remarkably nonjudgmental and supportive. Everyone has a story and is working through something.
The facility has a gym, arcade, and plenty of outdoor areas for walking or sitting when the weather cooperates. Those things matter when you're temporarily removed from your normal life and routine.
Treatment isn't easy. Being away from home, without your phone and outside your normal environment, can be difficult. But Indiana Center for Recovery gives you an opportunity to step outside that environment, learn about yourself, work on what brought you there, and figure out what comes next.
I especially appreciate that treatment doesn't feel one-size-fits-all. They continually assess where you are, work closely with you, and help determine appropriate next steps for treatment, sobriety, recovery, or mental-health care.
There are communication and organizational details I would improve, but they don't outweigh the quality of the people, treatment, support, and overall experience.
For someone who genuinely wants help and is willing to participate in the process, I would absolutely recommend Indiana Center for Recovery. It earned five stars from me—not because everything is perfect, but because what matters most about the place is very good.
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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.
I’m still not sure who called who or if is all God . But one of the staff members called me and said we are coming to pick you up. I went through detox and residential. The staff and nurses have been amazing every step of the way. Made a lot of new friends. Groups are great. The place is extremely clean and organized. The chef’s are awesome. I highly suggest this facility to anyone that needs help. They have pointed me in the right direction. Now it’s on to the next chapter of my life. Thank you to all at The Haven.
JustPerformance
2 days ago
Roni is the best, staff is amazing. Place saves lives
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.
As a community partner, it has been incredible to watch the work Never Alone has done to create a welcoming, supportive environment for adolescents during an incredibly important period in their lives. The investment in the facility itself, from renovations to amenities like the gym and movie theater, reflects a larger commitment to making young people feel valued, safe, and cared for.
What stands out even more is the programming and the people behind it. Never Alone is helping adolescents learn self-care, build confidence, develop healthy coping skills, and understand that they do not have to internalize the stigma often associated with seeking help or going through a difficult chapter.
These young people are so much more than a brief period of struggle in their lives, and they deserve the opportunity to move forward without allowing that period to define who they are or who they can become. It has been meaningful to see a program committed not only to treatment, but to dignity, growth, and helping young people recognize their own potential.
I’m grateful to have Never Alone as a community partner and to see the positive work happening there firsthand.
Michael Burke
2 weeks ago
Great facility for a great cause. Beautiful location in the woods of New York State.
Margarita
2 weeks ago
Great staff, have heard only good things about this place
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
3 months 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
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
This place has truly changed my life, and it just dawned on me 5 months after completing the program.
Sorry in advance for the long post.
I started the MRC program around February 2026 for severe anxiety and depression. I was in a dark place, with no support from family or friends, and honestly I didn't think anything was going to help me at that point. The first day I arrived the staff were very welcoming but my anxiety was through the roof. I pretty much stayed in my room and only came out for meds and food too scared to really talk to anyone.
As the weeks went by, I started getting comfortable then realized my peers were literally going through the same thing I was same with the staff, some of whom had gone through the same program themselves It gave me motivation if they could do it I could do it too. One of the things I struggled with was my schedule. It got so bad it started bleeding into everything like one day I'd sleep at 9pm, the next at 1pm, then I wouldn't sleep at all for three days straight. When I got there I kept missing classes because I was oversleeping or straight up refusing to wake up, so I got a warning that my phone would be taken away. That scared me straight that's when I finally got my shit together lol.
Now 5 months later I had lost my job, totaled my car and pretty much everything I owned. A year ago that would've completely broken me. But I was okay. And that was the part that surprised me the most all this time I'd been chasing something that never had any real value to me in the first place. The job was good money sure but it brought me zero happiness. Working 90 hours a week was actively making my depression worse and I didn't even see it happening until I was already in here fighting to get my mind back. So when the termination letter came yesterday there was sadness but there was relief too. That job had become my whole identity a false one built on something that was quietly destroying me.
Now today at 8am instead of frantically getting ready for a job that only made me miserable I'm sitting outside bird watching and reading a magazine like I'm 70 years old lol. And that's the lesson that took me almost losing everything to learn chasing something that has no real value to you personally will wear you down piece by piece until there's nothing left. I'm just grateful I got to learn that here instead of losing myself completely over it.
Thank you MRC ❤️
Mohamed
6 days ago
Sean rules
James Rumsey
1 month 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
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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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