Wellmark Inc. Insurance Coverage for Drug & Alcohol Rehab
Discover Wellmark’s comprehensive coverage for drug rehab and addiction treatment in Iowa and South Dakota. Find the support you need.
Wellmark Inc. Insurance Coverage for Drug & Alcohol Rehab
Discover Wellmark’s comprehensive coverage for drug rehab and addiction treatment in Iowa and South Dakota. Find the support you need.
Wellmark, Inc. is a mutual insurance company and an independent licensee of Blue Cross Blue Shield Association. A mutual insurance company is owned by its policyholders and not by investors. As an independent licensee, they have access to Blue Cross Blue Shield resources but can act independently to provide customized plans for their local community.
Wellmark offers insurance coverage to people throughout Iowa and South Dakota. They are accredited by the National Committee for Quality Assurance, and each year the company publishes how the premium dollars are spent to stay accountable to policyholders and reduce unnecessary costs.
Wellmark was founded in 1939 as Wellmark Hospital Service Incorporated of Iowa. This later became Blue Cross of Iowa. The name Wellmark was adopted in 1997, and then in 2016, they created two new companies so plans could be delivered on and off the Health Insurance Marketplace.
If you’re searching for care providers or narrowing down programs within your insurance, you can learn more about rehab options to compare facilities that align with your plan.
By Rita Milios
Rita Milios, The Mind Mentor, is a recently retired psychotherapist, freelance author (recovery, mental health, spiritual growth), seminar leader, and podcaster from Kissimmee, FL. She provided counseling in rehab facilities in Ohio and Florida, as well as in her private practice. Rita also served as a DOT Substance Abuse Professional (SAP) consultant.
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.
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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 AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Self-Pay OptionsPrivate insurance
This is a great facility and great program a lot of great people work here that care about helping others !!!!!
Jarrett Alfieri
2 days ago
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
1 week 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.
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
Awesome staff and great facilities. All my needs were met and they got me on the road to recovery.
Brian Mckinney
2 days ago
Everything here was really great. The stars and medical team was very helpful. I left here with a new life
Lucas Deters
1 week ago
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.
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 AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Private InsuranceSelf-Pay Options
My experience at All In Solutions exceeded my expectations. I was treated with respect, honor and dignity. I was kept comfortable while detoxing.
Timothy Snow
1 day ago
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
1 week ago
Attentive medical staff during detox, comfortable rooms, board-certified providers who explain everything clearly.
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 someone who has been to several treatments, The Abbey is the only place that, after going, I’ve been able to maintain my sobriety. The staff is brilliant and very kind. The building is beautiful and usually you get your own room and bathroom! Also, the food is great. I’d recommend this to my own family and to anyone struggling with addiction.
Jonathan Larson
4 months ago
Best place in the world as it saved my life. I am on a spiritual journey that I started at The Abbey and life has only gotten better. The staff there is like no other. They love you until you can love yourself!
Heather Kusinski
9 months ago
The ABBEY, has an absolutely wonderful, & amazing program, the counselors & staff are excellent, I highly recommend this center to anyone who is struggling with addiction and mental health issues. ❤️❤️
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
2 weeks 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.
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 can’t say how grateful I am for the Haven! I highly suggest to anyone who is out there struggling just like I was, if and when you hit your rock bottom and are ready for help…Allow this place to be the hands that lift you and carry you back to the top! The entire staff show love and compassion and treat everyone that walks thru their door as if you were there as family. I can’t say enough about how amazing my time was and how blessed I am to have them in my corner for my next chapter of life!!
Lindsey
1 day ago
Thank you for the experience and detox. Yall were the best!
Dan Alex
1 day ago
Had a great experience at The Haven Detox. They helped me stay comfortable throughout the process and helped me with my second step in the recovery process
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 dad had surgery and everyone in that matter was amazing for dealing w a grumpy old man. I got lost on the way to the cafeteria and an employee was heading the same way so she walked me down and gave me a tour and made sure I was alright. The people here are truly amazing and kind hearted. Thank you to all the awesome staff.
Amanda Freiburger
3 weeks ago
So very pleasantly surprised. An amazing improvement since the last time I needed medical attention. The care I received from (Dr. Lidtke) and staff was top shelf. I observed several things that made me proud to have been a long time patient. Many thanks, Daniel J Hilton
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
Self-Pay OptionsPrivate insurance
The alumni support program is something I don't see mentioned enough when people talk about what makes a rehab worth considering. Getting through treatment is one thing. Having some kind of structured support afterward is a completely different conversation, and it matters.
Michelle Grant
2 weeks ago
Simi Valley was a good fit location-wise, and the residential setup is a structured 24/7 environment away from the usual triggers. That's exactly what the early stages of serious recovery tend to require.
Thomas Hale
2 weeks ago
Checked on insurance before anything else and the process was quick and pressure-free. Knowing coverage before committing takes a lot of the financial stress out of a decision that's already hard enough.
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.
It was an amazing experience and wonderful days spent.
Saul Tracy
1 year ago
My son is 18 and struggling with a fentanyl addiction. To say the very least it’s been hard and traumatic. My son went to the crossroads detox facility. The 12 step program works miracles and the people that work within the facility have first-hand experience often times with their own addiction recovery. Rose and Bridgette were incredibly impressionable on my son and worked very hard to influence him positively. If I could afford to open a dozen more of these places I would. God bless these people and those struggling with addiction.
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Frequently Asked Questions
Does Wellmark Insurance Cover Drug Rehab?
Most health insurance policies written by Wellmark cover drug rehab and addiction treatment. However, there are exceptions to this rule. The 2010 Affordable Care Act mandates that most individual and small employer health plans offer essential health benefits, including mental health and substance use disorder treatment.
However, not all plans fall under this law, so it’s important to verify your insurance before committing to a treatment center. Getting the details of your insurance coverage will help ensure you are not surprised by unexpected bills when you’re trying to focus on your recovery.
What Are Wellmark Plans?
Wellmark offers several insurance plans to help cover Iowa and South Dakota residents.
The employer plans are available for all sizes of businesses. The plans and benefit packages available are based on employer size and the state where the plans are offered. Employers who need small group plans in Iowa can choose a range of coverage from strictly in state to national access for employees, while employers in South Dakota have access to more traditional healthcare offerings.
Wellmark also offers individual and family healthcare plans in each state’s Insurance Marketplace. Plans are in one of three tiers – Gold, Silver, and Bronze. The Gold tier plans are more expensive in terms of monthly premiums but cover around 80% of the cost of care. Bronze plans have lower premiums but only cover 60% of care. Silver plans are in the middle and cover 70% of care.
Wellmark also has Medicare Advantage and Medicare supplementplans for people in Iowa and South Dakota who qualify for Medicare. A Medicare supplement plan helps cover some of your out of pocket expenses in Original Medicare. A Medicare Advantage plan replaces Original Medicare but generally includes additional benefits. However, you will generally need to use the Advantage plan’s provider network and you may need preauthorization for care.
How to Verify Coverage With Wellmark
Given that every plan is different, it’s important to verify your insurance coverage and understand your limits so you are not surprised by unexpected bills during or after treatment.
There are two main ways of verifying your insurance and understanding your coverage level. The first is to contact Wellmark member services who can answer questions about your specific policy, let you know if prior authorization is required before treatment can begin, and tell you about your benefit limits.
The second way is to work with the treatment center of your choice. They often offer the service of contacting your insurance provider to verify your coverage. This includes information about prior authorization or limitations on the type of treatment or the number of times you can receive treatment in one year.
Many treatment centers also offer initial phone assessments to determine if you are a good candidate for their program, and can connect you with their financial counselors to help estimate your out of pocket expenses.
How Much Does Rehab Cost Without Insurance?
The cost of drug rehab without insurance can be significant. However, if you do not have insurance, you may qualify for state or federal funding to help cover the cost, including Medicaid or other special state funding programs.
Generally, the cost of rehab depends on several factors, including your customized treatment program, the geographical location of the treatment center, the length of your treatment program, and whether you require inpatient or outpatient care. The National Center for Drug Abuse Statistics tracks the average cost of drug rehabilitation over all states.
What Inpatient Addiction Treatment Does Wellmark Cover?
Wellmark covers inpatient addiction and substance abuse treatment when it is deemed medically necessary by a physician. So, you may need to get a referral from your medical provider, with a treatment plan included, to be eligible for coverage of inpatient addiction treatment.
Your treatment may start with medical detox which may use medication assisted treatment (MAT). You’ll have medical support and perhaps FDA approved medications to help you get through the uncomfortable symptoms associated with detox.
Inpatient treatment takes place in a hospital or clinic, and residential care happens in a facility that offers a more home like environment. Inpatient and residential treatment provide around the clock support in a structured environment. Treatment is provided by credentialed clinical staff, including medical and mental health professionals. During residential and inpatient treatment you are away from everyday life so you can fully focus on your recovery.
What Outpatient Rehab Does Wellmark Cover?
Outpatient addiction treatment is generally part of Wellmark’s behavioral health and substance use disorder coverage. You’d need to check the details about your plan to see what requirements there are and what coverage you have. There are multiple types of outpatient treatment that may be part of your treatment plan.
The most intensive option is a partial hospitalization program (PHP) which provides 20 or more hours of addiction treatment each week, scheduled over 4 to 7 days. A PHP program often lasts 3 to 4 weeks. The next level is an intensive outpatient program (IOP) which usually provides 9 to 20 hours of treatment each week, with the program running for a total of 4 to 8 weeks.
Finally a regular outpatient program (OP) typically meets once or twice a week with sessions that last 1.5 to 4 hours each. The length of these programs varies by facility but it’s common for them to last 30 days.
Many outpatient treatment programs offer aftercare services once you finish treatment. These services might include additional counseling sessions, 12 step peer group recovery meetings, and alumni meetings that offer socialization opportunities.
Does Wellmark Cover Methadone & Suboxone (MAT)?
MAT (medication assisted treatment) can be used in detox and/or as an ongoing treatment for alcohol or opioid addiction. It’s recommended that MAT be used in conjunction with evidence based treatment to help you lay a solid foundation for recovery.
Methadone and Suboxone are FDA approved opioid treatment medications. Suboxone is a combination of buprenorphine and naloxone. If you are diagnosed with opioid use disorder (OUD), your primary care physician could refer you to a certified opioid treatment center. In that case, most Wellmark plans would provide coverage. But, since healthcare plans vary, you should always verify your coverage by contacting the insurance company.
MAT can also be used to treat moderate to severe alcohol use disorder (AUD). Naltrexone is used as a MAT medication for alcohol misuse. You would start with detox before starting MAT. Naltrexone blocks the euphoric effects of both opioids and alcohol and decreases cravings for both drugs.This can help you stay stable and avoid relapse while you work on your recovery.
Does Wellmark Cover Other Mental Healthcare?
Following the guidelines of the Affordable Care Act most Wellmark plans do offer mental health care. However services vary by plan and there are exceptions. So, always verify your specific coverage before you start treatment. Mental health treatment options available in Wellmark plans may include crisis care, counseling, psychotherapy, and medication management.
Dual diagnoses — where a person has a mental health disorder and an addiction as well — are common. In such cases, both conditions should be treated simultaneously using a coordinated treatment plan. If you have a dual diagnosis be sure to find a rehab center with the integrated services you need to assure long term success.
Can I Travel Out of State For Treatment With Wellmark?
In most cases, Wellmark members have plans that utilize a pre authorized network of local providers. So, most members will not be covered if they travel outside their network coverage area for services.
A few Wellmark plans include out of network coverage which means and they may pay for some services delivered by out of state providers. However the extra expenses incurred (through higher premiums and copays) makes this choice challenging for many people. If you choose to pursue out of network care be sure you’re aware of the higher costs.
You can often find many high quality addiction treatment center options within the provider network of your Wellmark plan. To maximize your insurance coverage it’s a good idea to choose one of these if possible.
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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