Discover Wellcare’s Medicare Advantage plans covering addiction treatment. Find affordable rehab options and get the care you need today.
WellCare Health Insurance For Addiction Treatment
Discover Wellcare’s Medicare Advantage plans covering addiction treatment. Find affordable rehab options and get the care you need today.
Wellcare has been in business for more than 20 years and they offer Medicare Advantage and Medicare Prescription Drug Plans (PDP). The company operates in all 50 states and helps you find affordable coverage that adds to or goes beyond Original Medicare. They are a fully owned subsidiary of Centene Corporation.
Wellcare serves 1.2 million members through Medicare Advantage and 4.1 million PDP plan members. They offer multiple benefits in their Advantage plan such as dental services and telehealth visits as well as in home support and more.
While exploring treatment choices or determining what your insurance will cover, you can learn more about rehab options to review programs that match both your benefits and healthcare needs.
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 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.
Literally the best rehab center I’ve ever attended. Had intensive group therapy multiple times a day, and it help me with all my issues. They had a full blown gym, and I made actual brothers there. I would recommend this facility to ANYONE.
Connor Hopson
1 year ago
This place will forever have a special spot in my heart. The employees saved my life every single day for 30 days. The therapists are also something to not overlook, they go WAY above and beyond to educate what's really going on with our minds and body. I've been through 4 recovery centers, two in Kentucky one in California and then this one. This is the only one I can truly say that they take this lifestyle seriously and the presence of a higher power flows through every body in the house. I wouldn't recommend any other place. Thank you for everything staff! I won't forget a single one of you.
Ryan Raffensperger
1 year ago
I have been to this treatment centers at least 3 times and the e town facility twice. I’ve been to treatment as a controlled environment for this program over 40 times. But for 7 months through an implant in my ear I have had to listen to 2 or 3 people in my ear for 24/7 mostly about my ex boyfriend who the program hired to mess with me as well. Every treatment center and sober living I have been in for 7 years has participated all my so called friends, family, even bf were brought into it. I’m harassed about every trauma or horrible experience they could create or find out about. This was a good place but I hit 4 treatment centers in 4 weeks because they went too far stressing me with the voices in my ear canal as well as the clients and staff they recruited to play games while my thoughts broadcasted to the people around me. For the government to issue whatever for hips to be violated and them to enter a rehab for research grounds or court order is all that could do it. It’s been 17 years of nastiness especially the last 7 years but they hired my bf to leave me and play games with me so the voices in my ear could non stop torture me with him and how he took a job to leave me. The truth is they have had me isolated and single for 17 years and they had to get me lit and him away from me to be able to do this stressed out miserable research on me. So they brought him into the group payed to monitor me to get him away and make me feel miserable and isolated and they make sure I know it was about money from my boyfriend or ex I guess since I get a vague wish washy text ever 2 to 3 days to string me along so they can keep torturing me about him.how much money did it take. Why after I find someone after 17 years did you destroy it? Thanks for your part Stepworks London this was the second fight in 4 centers I had been to in 4 weeks. Crown was playing and Lackey and SouthShore RW in the past 6 weeks this program was even brought into the AA meetings I attended and my Clinicians were up to it too
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.
Amazing program! Everyone shows they care about your recovery.
R R
3 months ago
Never have I seen a treatment center with an onsite TEAM of therapists of this magnitude. Group and individual therapy has been life changing. The accelerated resolution therapy is cutting edge and onsite with an array of professionals! If you are serious about recovery, look no further than Roaring Brook Recovery
Paul F
4 months ago
A treatment and sober-living that cares about the recovery and well being of their participants. Its a great program, with a high rate of success. No short-cuts here! Praise Jesus Christ! All Glory to His Holy Name!
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.
AlcoholismOpioid AddictionDrug AddictionDual DiagnosisSubstance AbuseMental Health
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program
Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceFinancial Aid
Great facility and staff,Brittany is my go to resource . If you have ever had the pleasure of working with her you would understand why!!
Dwight Clayton
3 months ago
Amazing treatment services center, and even better staff especially Brittnay. She has been a great person to work with in the community ,and an amazing asset to the individuals who need her the most. She goes above ,and beyond for anyone in need of her services. I know this first hand as she was the person who gave me hope almost 6 years ago, that I could get to the other side. From listening to her Im now where I am today helping others and able to work with her as a primary resource for our clients. BRITTNAY is amazing.
Heather Harris
3 months ago
Brittnay from Provive Wellness went over and beyond when I was desperate to find a help center for my son. She walked me through the entire intake process step by step. She made me feel comfortable and hopeful that my son would get the help and support that he needed. I had a lot of questions and concerns and she did all the leg work to help me through this situation. Brittnay is truly an amazing employee and a huge asset. She continues to reach out to me and my son along his journey making this difficult situation a lot easier.
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.
Compassionate staff, all of whom are recovering addicts. If you stick and stay for the 11 month program, the statistics against you lessen. I'll be graduating in September. I just hope all the Medicaid cuts won't affect the program
Janine Holmquist
8 months ago
Isaiah house saved me! I was at the Shelley Center during the most difficult times of my life as I had breast cancer. I had a mastectomy on both sides. I hated myself. My appearance seemed awful in my eyes. Shelley Center staff helped me work on fear and they went above and beyond to make sure I loved myself again. They went as far as to buy me my prosthetics so I could start loving myself again and feeling like a normal human being. They're not just an organization, they're a family. I couldn't have made it through the toughest time in my life without their love and support!
Ashley
8 months ago
They helped me save my life and I found Jesus again while I was there. Highly recommended and forever grateful.
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've been going here for 6months and before that I was at the VA. There's a few differences between them both but most of all I can tell the Care. I have had 2 Counselors which is understandable considering the work load they have. Since the begining I have been happy and impressed how easy they made my transferring. I started just where I left off at the VA.The only thing I don't agree with or understand is when getting an increase u have to pick up for 3days before getting ur tak homes. I can understand this policy when u a starting out. But it doesn't make much sense after that. I can also say when there was a problem with my pick up (ther Mistake) my councler fixed and had all my bottles in 30mins. All I can say is If u work the program it works. Thank you
Kevin Armstrong
1 year ago
I love my counselor here at Pinnacle treatment center FCCR Radford. I feely counselor Lauren is amazing she's does everything she can possibly do for. Shes supplies me with wonderful advice, wonderful resources and everything else a counselor should do. My panic attacks got to such a bad point that she gave me her cell phone number in case I need to message or call when I need her. FCCR RADFORD SAVED MY LIFE!!!
Sarah Marie
2 years ago
This is the only MAT program clinicnive ever been to but they have been amazing. If you are serious about your recovery they most definitely are going to help you. I've had a couple friends go to other clinics and from what was said FCCR is more strict and that's so important. Especially if you are serious about your recovery and do really want to better yourself and your life. The office staff is amazing there. The nurses are wonderful. I've had 3 different counselors due to 2 of them moving on to better their lives, but every counselor I have had has been wonderful. Very helpful. Easy to talk to. Thank you FCCR for being there and helping me better myself and my life. "It works if you work it"
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.
Very easy intake process , the staff is very helpful and the parking lot is always. Monitored by cameras and security
Ruben
7 months ago
I would like to thank Elena that works in the accounting department at Seasons clinic... She is not only very kind she is very professional and so very helpful to my situation.. Elena has been so kind and respectful, And Seasons is lucky to have her as an employee!!
Thanks Elena , Sincerely Patrick 2688
Patrick M. 47
7 months ago
I’ve been coming to New Mexico Treatment Center for some time now there’s been a lot of staff that have came an gone it’s sad just when we start to open up to these counselors the next week they’re gone .Theres a few really good counselors up stairs .Theres 1 Dedicated to Her patience the most is Darlene, any time anyone has questions or concerns she’s on it. She goes above & beyond for her patience helps get dog food donated for those who are homeless with animals. They didn’t have security when I first started coming now they do it’s helped, u just have those without any where to go so yes they do hang around . I think they’re should be more programs that are hands on because Being an addict is one thing and for some it’s even harder for some to sit in a room full active users it makes it hard for those who are taking their sobriety serious. Keep up the fight to end addiction.
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.
My name is Keith markland. I just got out of stepworks January 9. I am very grateful they helped me get a second chance because without them I would hate to think where I would be now. I learned so much while I was there and each and every staff member were there to help me. It has a very positive and uplifting atmosphere. Since I have returned home I am still doing great. I live one day at a time and I use everything I learned there to help with my sobriety. I found AA/NA meetings to go to. I want to thank you all for my second chance at life and I love all of you. I would greatly recommend stepworks because they turned my life around
Keith Markland
7 months ago
I love this rehab center. From the moment I got here, the staff were super accommodating and helpful with my needs all the way from detox to programming and therapeutic needs. They were friendly and the services were plentiful. The food was great and I love the therapeutic rehabilitative environment they provided. Teaching you the skills you need to give yourself basic skills to enter society again like cooking for yourself, doing basic chores, the classes were easy to comprehend.
Samantha Marciano
11 months ago
I love STEPWORKS in Nicholasville, KY. My therapist was Alaina and she was such an amazing, caring, listener when I needed her. She is highly compassionate and intelligent in her field. She knew everything I needed her for and never let me down. Jen, the Facility Administrator, is such a sweetie. She listened and gave me great advice. The staff is truly emphatic. They have various addiction backgrounds and knew all the right things to say. They gave me advice I will keep with me forever. Duke, the amazing Duke. I will miss that little guy with all my heart. "Puppy!" is such an outgoing ESA dog. He loves everyone he meets and for being 9ish years old is still the king of his castle. He is so loving and a great fit to keep love in the air there. Having Duke there to lend his 4 legged care and compassion makes StepWorks such a loving place. Some might say they wanted to leave or they didn't like being there. Those people didn't finish the program or take it seriously. I wanted to leave numerous times, but after a while it wasn't because of the program, but issues I was having mentally. After talking with the staff and doing the much needed changes to myself mentally, I realized it was me and not them. You have to take the program seriously to benefit from it. You have to follow the rules, be involved with the classes, do your chores appropriately... All to gain what is needed to live the sober life. Don't use the program as a way to have shelter, food, utilities, to meet a lover. You will not gain what you need to keep from being a statistic. Do as your supposed to, and you will leave there a new person and a changed sober person. I did and I'm not looking back. Thank you StepWorks for all you did for me. I'm glad I didn't leave, I'm glad I followed the program and rules, and I know I'll be successful in life when I wouldn't have made it without your help. Love you all!!! Rehab Chick for life!! Angie Hatmaker
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.
Private insuranceSelf-Pay OptionsPrivate InsuranceFinancial Aid
Arista Recovery is a top tier facility that has truly separated itself from the average substance abuse treatment facility. The amount of effort that the ownership puts into hiring staff that is able to connect with the clients on a level where they all feel welcomed and cared for is a blessing. The admissions team in particular is so effective at making you feel like you are so much more than just another voice on the phone. Shane, Michael, and Ryan N truly played a crucial role in having me follow through! I highly recommend Arista to anyone struggling with substance use!
Ryan
1 month ago
Thank you so much Ryan! He was incredibly helpful throughout the entire process. He was kind, patient, and took the time to listen and answer my questions. I truly felt supported every step of the way.
Daniel Farmer
1 month ago
Ryan was so helpful to my family; he showed empathy, was patient, made it feel like he went out of his way to make others feel heard and supported. 5 stars all day, 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.
Id love to give these guys a 5 but recently I was dropped due to insurance. ( I have medicaid. Which makes me less fortunate then others who pay for there insurance) so after about a year and a half. Outside of that the groups are excellent the facilitators truely care, and the people who are the ones that really make the groups they are great. I thibk due to the telahealth aspect people are more willing to dig into there traumas and passed. I can only hope they 1 day accept medicaid again not only for me but all the other addicts and alcoholics who cant afford insurance to 1 day be able to receive treatment in the same manor I did.
Travis
8 months ago
Choice point was such an amazing place to focus on my recovery they helped me so much to focus on my recovery helped me stay clean and also helped me become a better person I will definitely miss this place ❤️thank u to my counselor melisssa Darrien and my peers in group and all the counselors and staff at choice point for helping me be me again ❤️best rehab I ever been too ❤️thank u so much
Yahaira Medina
10 months ago
Helpful and great experience overall couldn't have asked for a better program. They gave me all the tools needed to continue my life in the right path. Forever grateful.
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Frequently Asked Questions
Does Wellcare Cover Addiction Treatment?
Medicare Advantage plans are required to cover at least as much as Original Medicare which means that there is at least some coverage for addiction and mental health due to the Affordable Care Act.
However because Medicare Advantage plans are offered by private insurers and not the government they may have different limits and requirements for coverage. Be sure to get the full details of your plan before committing to treatment. Also, you may need a referral or preauthorization and you may need to find a rehab that’s within the plan’s provider network.
Insurance focuses on paying for medically necessary care so be sure to work closely with your doctor to create a treatment plan that’s specific to your needs. That will allow you to look for the right kind of rehab program to start with and will provide proof of medical necessity to insurance.
The Advantage options have four types. The plan can be an HMO or PPO. It may also be a D-SNP or C-SNP plan if you qualify.
The Medicare Advantage HMO plans focus on access to care and affordability and offer more benefits than the Original Medicare. Wellcare offers a variety of HMO plan options and all come with personal daily support. HMO plans provide coordinated care through a network of providers. You will need to designate a primary care provider who can make referrals to specialists such as addiction counselors on your behalf.
Wellcare PPO plans give you more flexibility than an HMO. Not only do you continue to get additional coverage beyond Original Medicare but you also don’t have to worry about a primary care provider or getting referrals to specialists. However certain types of care might still need preauthorization. With a wide network of doctors and providers as well as specialists and hospitals the PPO plans give you the freedom to choose the providers that work best for you. You can even get coverage outside the provider network but you will pay significantly more out of pocket.
D-SNP plans are a special type of Medicare Advantage plan specifically for those who qualify for both Medicare and Medicaid. With this specific plan, you may be eligible for the EXTRA HELP program which will provide cost support for prescription drugs. You don’t need referrals for in network specialists but you do for out of network care. Additionally with D-SNP you can receive extra coverage for mental health services because your benefits will be based on Medicaid coverage as well as Medicare.
Wellcare’s Chronic Condition Special Needs Plan (C-SNP) provides coverage to manage chronic conditions like diabetes or cardiovascular disease or congestive heart failure. This plan is designed to provide savings on medical necessities such as insulin or other prescriptions. You’ll also receive coordinated care to help manage your condition. With this plan, you will select a primary care provider who will get to know your needs and will coordinate your care with other providers. They will also help you develop a personal care plan. You’ll have access to a care manager who will help you overcome obstacles associated with your condition as well as day to day struggles.
What Inpatient Addiction Treatment Does Wellcare Cover?
Insurance will focus on what is medically necessary which is why it is important to have a referral and treatment plan from your primary care provider.
Each treatment program is different but most of them will require some form of pre assessment prior to admission. Some programs will complete an ASAM assessment with you to determine your needs and mindset regarding treatment. Residential care can be recommended if you’re actively using substances or need a medical detox process.
Often programs have a medical detox unit and residential services that go hand in hand. This helps provide a smooth transition as you work on building toward recovery. During treatment you’ll receive evidence based care in a secure environment where you can focus fully on treatment with no outside distractions.
What Outpatient Rehab Does Wellcare Cover?
There are different types of outpatient services for substance use treatment that may be covered by Wellcare.
A partial hospitalization program (PHP) offers a very structured outpatient program. They have therapy in group or individual settings and may also offer medication management and additional support services.
With intensive outpatient (IOP) services treatment is still structured but it’s less intensive than a PHP. An IOP still offers evidence based treatment to help you establish long term recovery. Once you finish treatment you may be set up with aftercare services. This will give you ongoing support through therapy and case management as well as medication management if needed.
Does Wellcare Cover Methadone & Suboxone (MAT)?
Some form of Medication Assisted Treatment (MAT) have been covered by Medicare plans since around 2006. MAT can be used for both medical detox and ongoing treatment of opioid and alcohol use.
During detox services MAT medications are used to help alleviate painful withdrawal symptoms and help you slowly wean off of drugs so the detox process is not such a shock to your body.
For ongoing treatment you can be prescribed a variety of different medications depending on your specific addiction. If you are dealing with an opioid or alcohol use disorder you may be prescribed Methadone or Buprenorphine or Naltrexone. Each of these medications helps stabilize you and manage cravings so you can fully focus on treatment. MAT usually coincides with therapy and additional support services. Over time you establish yourself in recovery and you can wean off the medication support to live a fully substance free life.
Does Wellcare Cover Other Mental Healthcare?
If you are struggling with a mental health disorder alone or alongside addiction concerns your Wellcare insurance plan will provide coverage. You will likely have the option to receive medication and therapy services to treat your specific diagnosis(es). There are also emergency options for treatment such as crisis services which may be covered under your specific plan.
It is common to have a co occurring disorder which is a mental health diagnosis coexisting with a substance use disorder. It is important to treat both of those together to be successful in long term recovery. This helps you address underlying issues that can be associated with your addiction.
Wellcare Medicare Advantage plans will cover mental health treatment because of the Affordable Care Act (ACA) however there may be limits on coverage and requirements you need to meet. Make sure you know the full details of your plan before starting treatment.
How Long Will Wellcare Pay for Rehab
Each person is different and your specific medical need(s) and the doctor’s treatment plan will determine how long your insurance will pay for rehab.
In some cases there are limits on the number of days treatment is covered but it varies from plan to plan. There are other things that can be taken into consideration as well such as the standard length of a treatment program and your progress in the rehab process.
Can I Travel Out of State For Treatment With Wellcare?
Traveling out of state can be enticing but whether you can get coverage out of state will depend on your specific plan. For Wellcare the HMO plans do require that you stay within the defined provider network which means out of state care is generally not covered. The only time this differs is for emergency care.
For the Wellcare PPO plans there is an option for out of network coverage but you will pay significantly more in your deductibles and copayments. It is best to stay in network for treatment if possible. This will maximize your benefits. It is equally important to verify your insurance details before committing to a specific program.
How to Verify Coverage With Wellcare
You can verify your coverage in multiple ways. You can contact the insurance company directly using the customer service number. You can also log into your online account to find coverage information and in network providers.
One other option is asking your desired treatment program if they take your insurance. It is important that you state your exact plan name due to the wide variety of plans. It is also a good idea to keep a copy of your card handy so providers can better serve you if you have questions or concerns regarding your coverage.
What to Do if Wellcare Won’t Cover the Cost of Rehab
In most cases you will be able to find a provider within your network coverage. However if you want to do a treatment program out of the network and there’s no coverage you may need to figure out how to cover the cost of a rehab program. It is important that you get the care you need.
Some programs will offer different payment options such as sliding fee scales based on income or a payment plan that allows you to spread out the cost. You may be able to find a program that offers grants or scholarships.
There are also state and county funded programs or you might have friends and family that would help you pay for rehab. Additionally there are low cost or work based rehabs where you work in the program instead of paying for treatment.
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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