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.
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.
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
7 months 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
Jason Gibson
7 months ago
The best treatment center I've ever seen the staff are knowledgeable be on your wildest dreams
The food is top notch and the counselor's are respectful and the medical staff knows how to make things easier
Out of all the treatment centers I've been to, Roaringbrook has met my every need in alcohol/drug addiction(treatment wise)and has helped me improve my mental health with counseling, peer support,therapy,and A.R.T. sessions.On the 11th of this month I'll celebrate 7 months sobriety,with the help of Roaringbrook!THANK YOU,GUYS!
Jason Lillie
2 months ago
Roaring brook has the best staff I have encounter in treatment , they truly cared about my welfare and wanted me to get better . I love the people at roaring brook and would highly recommend it to anyone wanting sobriety they will make that happen if you are willing to work for it they can and will help.
Richard Anderson
2 months ago
This place saved every aspect of my life. The staff and everyone involved were great. I owe a lot to them. I personally still attend there building for therapy and etc I would recommend this place for anyone or a family member struggling to cope with addiction. If it wasn t for roaring brook. I wouldn t had learned or gained the tools to deal with life and my addictions. Thank God for roaring brook if you want to get sober this is the place to attend.
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
4 months 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"
Micaela Tarr
1 year ago
IT'S A GREAT PLACE IF YOU'RE SERIOUS ABOUT REMAINING SUBSTANCE FREE. MY COUNSELOR IS THE BOMB!!
Everything about this place is amazing.. this is the first rehab that I ever been to and I was blessed to find white sands....from all the bht's, to the therapist, to the nurses and doctors... If I could rate it 100 stars I would.. they truly care and help out anyway possible and I'm thankful and appreciative for everything that they done ... They truly helped and changed me and cared... Not just a little but a lot.. I recommend white sands to anyone thats looking for rehab... Thank you white sands for helping me, and getting me back on track...WHITE SANDS IS THE BEST...HANDS DOWN
Eugene Harris ll
2 months ago
Danny my case manager. made me feel like I was the only person on his case load. His attention to my needs were breath of fresh air. He legit made my stay here amazing. My box spring had broke and he didn't rest until it was replace and he actually stayed late to get it done. If you struggle with addiction whitesands is the place to go. I highly recommend Shay to be your therapist and Danny to be your case manager. Also I can't forget the BHT team. Keith , Elijah, O'Shea, Anthony, Dominic, Vanessa, Joey, Rose, Rachel, Dasiah you guys made me feel safe and kept me in line and last but not lease my best friend Ryan who made sure I got to my doctor appointments between all of them they've made a great impact on my recovery I can't express truly how much you guys helped me throughout my struggles. I mean this with my whole heart. THANK YOU ALL!! But most of all I want to thank Heather. She has talked me off the ledge more times than I can count. Heather always lends her ear and with her infinite wisdom calls me on my bullsh!t, and never blew smoke up my butt. I've never met anyone who cares about patients like she does. I highly respect everyone I mentioned and I hope that if you're struggling with addiction you get the opportunity to meet these amazing humans and find your path to sobriety.
Shawn Alday
2 months ago
Where to begin?? This place saved my life. If I could rate WS 9 stars I would. (Nobody's perfect) 99% of the staff here are tremendous!! From day 1 I was treated with kindness, compassion and respect. Ms NICOLE....such a sweet spirit. I'll miss your enthusiastic smiles and attentive ears. DENNIS, you know how to pull things out of a person that helped me recognize a destructive trend i need to work on. DEB, SHAY, HEATHER, ERIC, ANNE MARIE, SHANNON.....THANK YOU. MISSY...Thanks for the great conversations and fantastic coffee.The Behavioral Health techs were awesome.Shout outs to GLEN, AUDREY, NEAL, ROSE AND ANTHONY.As with everything in life, if you sit on your ass and put nothing in you'll get nothing out. If you open up with your therapist, participate in the classes, get out of your comfort zone and TRUST THE PROCESS White Sands Will change your life for the better.
Great place. Wonderful staff. Very attentive to you as an individual. More than just clinical needs. Clean facility. Plenty of food and a very eclectic mix of both patients and staff. Had a good 30 days here and would recommend it in a heartbeat.
Nicholas Seiller
2 years ago
It was the best decision I could have ever made! The staff is 100 percent with you in your recovery what ever it may be! God Bless the work that they do!
Quinton Crite
2 years ago
Absolutely a great program.Great staff, very very knowledgeable about the steps to remaining sober A++
Great recovery center they are on top of everything they don't judge you they work with you and your every need from recovery to counseling to financial needs
Brandi Thacker
3 years ago
AppleGate is a safe friendly environment to begin your treatment process. Some recovery center her in Dayton do not have your best interest in mind, just in the recovery business for the money, but here at AppleGate it s a small family oriented staff who are in the recovery business for the right reasons. Some of the staff have been through recovery themselves and can relate to your situation without prejudice or a feeling of being judged. They are here willing to help you pull through this storm and take back you life that you deserve. Love yourself enough to get help, even if you feel no one else dose. You are worth the time and effort, learn to love yourself again because they will hold your hands till the storm subsides and the sun shines again.
Mark Sells
3 years ago
5 stars! The staff here is great they genuinely care and go the extra mile to make sure patients are cared for. Amy is always smiling and friendly when I come in, Paula and April and lisa are always attentive and helpful! I recommend applegate to anyone seeking a personalized recovery plan for them.
If you want sobriety, this is the place. I came addicted to meth for 40 years and a drunk for 20 years. I'm not finished yet with my 30 days, however, I can tell you that detox is tolerable, and the food is resort grade, so delicious and made with love. I made some friends that will last a lifetime.They picked me up 30 minutes after I called for help, saved my life.Thank you to everyone at the ARC.
Dee Foley
2 months ago
I just wanna say the ARC saved my life . The staff, in residential and IOP were amazing , kind , and TRULY CARE! staff members like KATY WHO WORKS AT IOP, DOM THE DIRECTOR, LUIS THE DIRECTOR, DOM RSS, ASHLEY RSS, JOSEPH RSS, NICOLE RSS, and honestly I can sit here and go on on on but ALL THE STAFF DESERVE A 5 STAR RATING. I LOVE YOU ALL . THEY REALLY WANT TO HELP THOSE WHO STRUGGLE WITH ADDICTION AND I JUST WANT TO THANK EVERY PERSON WHO I MET AND HAD GROUP WITH. WITHOUT THE HELP OF THSES KIND LOVING , HARD WORKING PEOPLE I WOULDN'T BE HERE! THEY SHOWED ME RECOVERY IS POSSIBLE AND TAUGHT ME THE SKILLS TO USE IN EVERYDAY LIFE WHEN THOSE URGES AND THOUGHTS ARISE. I LOVE THE ARC AND THANK U. I HIGHLY RECOMMEND THIS PLACE TO ANYONE SEEKING A LIFE OF SOBRIETY. I WAS DEALING WITH MY SONS DEATH WHILE IN THE PROCESS OF FIGHTING ADDICTION AND THEY WERE JUST THERE AND HAD MY BACK 1000 PERCENT. LOVE U ALL. GOD BLESS.JOJO
Joe Mendoza
4 months ago
I am so grateful for this place! My best friend was suicidal and had given up on life before entering this facility. Now whenever I talk to him on the phone, he tells me how amazing the counselors , the staff and the program has been. For the first time in years I have hope that he is finally going to be ok! You all literally saved his life! . I only wish that there could be more places like this one!
I came here for courtesy dose in August and again in November. They are great there! If I move out here this is the clinic I definitely would go here.The price for just 7 days of methadone was $140!! This is the 2 nd time I paid this price for a week. We don t have much money we are trying to get our lives back and this is a life or death medication for us.The methadone is way overpriced here, while it is not an expensive drug from the pharmacy.
Andy S.
6 months ago
FIRST AND FORMOST I COULDN'T BE HAPPIER..FROM THE VERY FIRST DAY MEETING EVERYONE I WILL SAY EVERYONE THERE ALWAYS GREETS YOU WITH A SMILE AND ALWAYS ASK HOW YOUR DOING AND HOW YOUR FEELING TODAY..AND THEY SAY IT WITH TRUE CONCERN.ITS NOT JUST A JOB THERE DOING .U CAN FEEL THE CONCERN.FROM THE FRONT DESK TOO THE BACK WHERE THE DOCTORS AND COUNSELORS ARE .I WOULD HIGHLY RECOMMEND THIS LOCATION.WHOEVER GAVE THE EMPLOYEES THERE TRAINING DID A EXCELLENT JOB .CUZ THEY MAKE YOU FEEL SO COMFORTABLE AND WELCOME ..THANK YOU EVERYONE AT Aegis treatment center ..god bless all of you for ur kind and warm hearts ..
Johnny Ruiz
7 months ago
Thanks to Aegis Treatment Center I have been Clean for 10 month I am on Suboxone and I been doing amazingThe staff is great my Counselor is amazing we work on my treatment plan cooping skillsThank you Aegis for doing g what u do best helping us that want to change our lifeGod bless you all
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I had a great experience with La Jolla recovery the staff looks out for the people in recovery. They do have days where they are busy and can t get to your request right away but they always abide by what they say they re gonna do! We had a cooked meal for us everyday, and amazing group facilitators, and we go out outtings a few times a week! it has definitely been very beneficial for my recovery, I would definitely recommend this program!!
ly smb
2 months ago
It All.started with Ashley in Admission.,She would go above amd beyond! Bless to have her on our side..Then to Detox Amazing care Wonderful Chef & Staff that takes time with u one on one ,The Center is full of Growth! The push and support the staff untouchable. It's not all pounding they take u to Super fun outings ,cookouts .Try to remind u what real sober life is about! And NOLAN U RULE !!!!! AND NONE OF THIS WOULD BE POSSIBLE WITHOUT DANNY TYSM FOR EVERYTHING ! U ARE THE START TO A SECOND CHANCE!
Laura J
3 months ago
2 years sober 02/25/2025 and because I started my journey with LaJolla Recovery first. NICK AND BRE gathered me by phone I was lost ,confused out of journeys and burnt-out from work. Thank You God for LaJolla Recovery and awesome staff so grateful I started with You!!
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What Plans Does Wellcare Offer?
Wellcare offers Medicare Advantage and Medicare Prescription (Part D) plans.
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.
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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