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.
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.
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.
Nicole Eccleston
1 year ago
Being at Crossroads has been a blessing in disguise extremely grateful for the peers, staff and the pretty souls God has allowed me to cross paths with. Crossroads gave me a second life and ever since ive felt reborn. It is now set in stone in my life and IAM forever appreciative for helping me recognize the purpose i have in this life and shining its light on me encouraging me to shine my light on those who navigate in the dark who are in need of a guiding light, thas what crossroads has been to me
illmaticisrael
2 years ago
Went in for 45 but stayed the 90. All in all I really enjoyed my stay and got the much needed help I wanted. Rehab is not for everyone but if I would recommend any 1 I would say flowers is the best shot you have.
Recently, my wife had a bout of e-coli infection, which followed close behind her thyroid surgery. We called an ambulance at 11:30pm, and spent the following few days in treatment and recovery. The staff at St. Lukes provided superb care from start to finish!
We want to especially thank the ER doctors and the nurses/assistants. We don’t know all the names, but Megyn and Eileen are outstanding.
Stephen Rotramel
2 months ago
Nice facilities
Sean LaMonte
4 months ago
I would like to Thank All concerned with my recent care as it was exceptional...I especially would like to Thank Diane Torres and Denice for the extra mile they went to get me through the ordeal my sickness brought upon me.
I was certainly willing to somehow give them an added appreciation for them.
Also , a special Thank You to Brittany,she was very instrumental in my getting back to what some would consider normal..hahaha
This hospital treats people very well,of course fixing so much food at a time leaves room for improvement but the care was exceptional....
I would highly recommend care at Unity Point/ St.Lukes Hospital in Cedar Rapids..!
I spent 8wks at The Meadows. It was life changing for me. The Survivors week helped me with my childhood traumas and learn how to heal my inner child. I met with my trauma therapist several times after this. Also met with evening and weekend therapists. Family week was intense but worth it. My husband joined me that week. They have a brain center where I got to use a CES device to help my anxiety and panic attacks. Also the Chi Machine. I was able to do the safe and sound protocol daily therapy (SSP) for a week. This is suppose to help get you out of the fight or flight mode. I went to acupuncture therapy and found it helpful for my fibromyalgia pain. There were daily evening mediation therapy and 12 step meetings. I got to learn about codependency and CoDA meetings. I also attended ACA meetings. I learned effective coping skills while there. I would recommend this place to anyone that needs help with mental health issues, addictions, grief and loss, traumas, and just need a reset in life.
brooke meunier
2 months ago
They changed my life. Now I have a career helping people who struggle with mental health and addiction as I did.
Thomas J
3 months ago
A great in person rehabilitation center for military members! I finally kicked my main additions for good and have been recovering for almost a year now.
My experience from pre-op to going home a day after surgery was wonderful. The nursing staff was wonderful. Belinda, my night nurse, was beyond amazing. She was very caring, patient and understanding.
mackey
2 months ago
I had a total hip replacement and the entire experience was fantastic. The entire procedure took a day and the pain post procedure was minimal. The staff.
Was wonderful and highly organized. I would highly recommend this hospital for this procedure. My surgeon was excellent and the anesthesiologist and her team were fantastic. I feel like I received the best of care.
Juanita Sharpe
2 months ago
I was recently at this hospital for a stress test and echocardiogram. From the reception staff, to the nurses and any ancillary staff I encountered, everyone was knowledgeable, helpful, friendly and professional. The nurses and technicians explained all testing before it was started and during testing, as well as giving me a chance to ask questions. They made sure I was comfortable, especially since I have back issues. It was a positive experience in every way.
Friendly staff, very respectful and they do their job. I have had nothing other than five star service here at Medmark Hayward.
Casey Bryant
1 year ago
Been coming here for a long, long time Through my recovery I have had many counselors some better than others funny how things happen my husband transferred to Medmark from BAART in Oakland crazy we both ended up on Rich’s case load { R.I.P. RICH another great counselor } so you know we both can’t have the same counselors so of course I got kicked to the curb. Best curb I got kicked to { so to speak. } which is currently Nicole Martinez, the best I’ve ever had , She definitely help me get to where I am now she goes above and beyond helped me in my life so much, I don’t even know what I’m gonna do when we goes our separate ways 😔..I wish I can take her with me. I wish I can give her 20 ⭐️’s but was only given an option of 5 ⭐️.
⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️🙌🏾🙌🏾🙌🏾🙌🏾🙌🏾🙌🏾⭐️⭐️⭐️⭐️⭐️⭐️
Jessica Nero-baisa
1 year ago
Hi I'm Luis and I just wanna say my counselor is amazing her name is katt and I could not do it with out her.love u katt
I get counseling her and it’s amazing I have a great time and I meet with a great person
Mariah Pratt
3 months ago
Knowledgeable, friendly and helpful staff
Tyler Christie
1 year ago
Things have significantly changed since last year. The front desk guy is super nice and works hard & mark v is the nicest sweetest guy!!!
We resovled these issues. 🙏
Dr. Carter and the staff are super. I had to see a specialist and they made it happen like true professionals.
Donald McClary
2 months ago
The office was accommodating to my needs as I am a wheelchair user. The weight was not terribly long. The visit was straight to the point and out of there.
Jessica
2 months ago
A great person and a great listener really really helps me get through things the best. Thank you
The LIV program is the best thing offered! 10/10 recommend. It gives you the opportunity to step out of your comfort zone and pushes you to “Do Hard Shit.” The program changed my whole mindset. It taught me so much. I am doing things I never thought I’d be doing. My outlook on life is brighter than ever. Thanks to the LIV program!
Ryan Tucker
2 months ago
The LIV program is amazing. It changed my mindset and outlook on life. Do hard Shit
It teaches you to push thru the hard moments. LOVE LIV
Joshua Mick
2 months ago
Absolutely loved the therapy I got from doing the Liv program life changing 💜
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. ❤️❤️
Brandi Smith
2 months ago
This place saved my life. Thank you to all the staff there.
Eddie Rosenquist
5 months ago
Beautiful, Spiritual, Healing, Love, Compassion, & Grace is The Abbey & their staff. Best Recovery place of all times.
I want to extend my heartfelt thanks to Able 2 Change for their exceptional support in assisting those battling addiction and mental health challenges. I recently had the privilege of collaborating with them to guide a family member toward treatment. The admission process was both thorough and efficient. The clinical team established a meaningful connection, significantly impacting my cousin's recovery journey. Additionally, the family program provided invaluable education for our family. The alumni support has helped my cousin feel embraced while reintegrating into the community.
Kelli E
6 months ago
while being at able to change the staff made me feel at home. they really helped me on my road to recovery!
Sav Red
10 months ago
Wonderful place to find yourself. Staff is great!
Steve Brewer
10 months ago
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Frequently Asked Questions
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.
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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