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.
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.
AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Self-Pay OptionsPrivate insurance
All in was a great program! The staff was amazing. Very helpful in my recovery! They were very attentive.
Mike Garcia
1 week ago
This place helped me when I felt like no one could, 5 stars to the techs, 5 to the therapists, and 5 to case management will love you guys for ever.
kyle Buchmaier
1 week ago
My experience at All in Solutions was absolutely the best it could be given the situation. The staff were absolutely amazing. With this course of recovery I've been given the keys for a bright future. It's up to me to put my training to work in in my life.
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 was amazing! I love all the staff. They were definitely wonderful to be around. Jess being one case manager for all the clients is beyond unbelievable and she is truly a God send!!! ❤️ 😍
Michelle Mullen
4 weeks ago
My experience with All in Solution was life changing. I went through detox and residential to prepare me for on going therapy. I had great nurses techs and patient support through tough days and such support for the family atmosphere I experienced. I am grateful for everyone that helped me there and would recommend to anyone that wants to get sober and learn how to stay sober through their program
Lisa Lunn Green
4 weeks ago
All in solutions is the best , if you need to get straight , it's the place to go , I highly recommend it 👍
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Self-Pay OptionsPrivate insurance
All In Solutions truly changed my life in ways I didn’t expect. From the beginning, I felt supported, respected, and genuinely cared for. My counselor, Jason, was amazing! He was patient, knowledgeable, and truly invested in my recovery. He made it easy to be honest and helped me grow in ways I never thought possible. He really related to my struggles and helped me not only want to get sober, but also find lasting recovery.
Debbie, the director, consistently goes above and beyond for clients, even when she doesn’t have to. She truly shows up for people and advocates for them, which says a lot about the heart behind this program.
Anthony was instrumental in ensuring a smooth and supportive transition into sober living. He is genuinely invested in each client’s safety and well-being, and it truly shows.
Zee, the alumni coordinator, is always there - she consistently follows up with former clients and makes herself available in times of need. If you call her, she WILL answer.
The entire staff at AIS is incredible. They don’t treat recovery like a box to check, they treat you like a person. Their support and genuine care made a huge difference in my recovery, and I’m beyond grateful and thankful for EVERYTHING they’ve done.
Jenn
6 days ago
The staff in the facility were amazing my counselor Jason changed my life for the better
Slow Poke
1 week ago
All In solution’s was the best decision I’ve ever made they helped me get my life back together. And got me back on the right track again. My counselor Jason was very helpful and was very supportive of my recovery. Even though I’ve completed the program ASI Still reaches out to me. Brandon my case manager was very helpful in getting all my paperwork done. I’m forever grateful to AIS and all the staff and techs.
My experience at ICFR was great. The facility was nice. My therapist was excellent. The only thing negative keeping the from 5-stars was the lack of communication. I gained more about the place and where I needed to be from my peers rather than receiving instruction from faculty.
David Carpenter
3 days ago
I have been to this place twice and would highly recommend to anyone struggling with mental health or substance abuse. Staff is great and so is the brother and sisterhood you will build.
Shauna Wolfe
6 days ago
Good people... Both the other clients and staff were supportive and caring...the food was terrible...and communication between departments could be improved. I feel my needs were met adequately and I was giving the tools and resources to continue in my recovery
I had a great experience at The Haven Detox center. All of the staff were very friendly,helpful and I was treated like I was the best person there, The nurse practitioner Jessica Percites was very helpful,Roni, the Administrator was so helpful. Kerry, Nesha, Lauren, Stephanie, Harriet, Jose, we’re always helping me with anything I needed. Anthony, the client Care Coordinator was amazing, Shawn, another Client Care Coordinator was extremely supportive and helpful withe all of my needs.
If I ever needed to come to a treatment center again, I would definitely come back here.
I made many friends and will keep in touch with all of them.
Jean Jordan
1 day ago
Such a awesome rehab I love it learned a lot Anthony is amazing sweet and very helpful and very humble Lauren was amazing and sweet and Ashley was great getting me into where I need to go and she Always made me feel welcome and omg Jason was the best therapist ever he made my heart warm and he's funny and sweet I loved all the staff and Shantel and Henny are amazing and shaggy and also jose was great always has a amazing love you all and thank you xoxo 😘
Corinne Nelson
6 days ago
I had an excellent stay at Haven !
The facility was very clean and the staff there
Was very Professional and Concerned about our needs !
Drug AddictionAlcoholismOpioid AddictionDual DiagnosisMental Health and Substance AbuseSubstance Abuse
Adult ProgramYoung Adult ProgramSeniors ProgramProgram For MenProgram For WomenLGBTQ Program
Private InsuranceSelf-Pay OptionsMilitary InsuranceFinancial Aid
Exceptional staff and facility. Definitely one of a kind tailored treatment for people struggling with substance abuse!!
Charlie Hite
1 month ago
The staff and clients at boca are incredible. Joe leads the most incredible meetings; I wish I could virtually sit in on them. Bri was such a strong supporter. If you have an opportunity to go here, give it a chance and go!! It works!
Krista Calabrese
1 month ago
This place was amazing! The staff has also walked in shoes similar to my own so it made relating to them much easier! I was able to get a good head start in sobriety here! The residents were also amazing! If I had to refer anyone needing help I would definitely refer them here! It’s a great place to start your sober journey!
It was an amazing experience and wonderful days spent.
Saul Tracy
5 months 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.
The faculty and staff are very helpful and caring!
jeremy batchelor
1 month ago
The Indy facility is the best rehab ever gone to outta more than I can count on my fingers. The staff there are super caring and will do everything they're allowed to help u get thru the process. The director there is one of the most understanding people I've ever met in all the rehab community. I would recommend going there. Most rehab I wouldn't send people I don't like to them but not here.
Seth Brown
1 month ago
Had an emergency they listened and willing to help. Thomas was great he called, sent text to make sure we were safe and able to make the next step.
To whom this may concern my name is Jamie Johnson I was a client at the Haven in West Memphis Arkansas I would just like to stay that the staff that they have there are top-tier crew everyone down and up from the nurses the bht's housekeeping dietary medical assistant case management and they have talked to your staff as well my experience there has changed my whole life I will tell anyone if you are going through anything mentally physically emotionally or even if you're going through a drug problem of addiction The Haven in West Memphis will be the best place for you to go I personally myself would like to think the whole staff from the top to the bottom because every last one of y'all have been a top-tier people for me God bless you all and God keep you all JJ.
Jamye Johnson
1 week ago
John Paul, I had a great experience here at the haven west Memphis!!! If you need a quite therapeutic medical detox from alcohol or substance, I highly recommend this place!! You have your own room with privacy , tv, nothing is required your meals are brought to you they have a kitchen with 247 drinks snacks ect! Like I said this isn’t the “old days” where they lock you in a room with know meds .. you are medical detox you see a dr every day what else is there to say .. it truly is a therapeutic environment with the kindest staff I’ve met in any facility , also they got me lined out with a sober living home and php my 3 rd day !!! So if yall are struggling please contact the haven west Memphis they will even come get you and drop you off ! Thank you haven west Memphis John p
John Paul
3 weeks ago
This place really is a nice vacation if you let yourself see it that way. Great, friendly staff. Good food. Really helpful in learning healthy communication and coping skills, and learning how to utilize them in the real world going forward. Only 4/5 because I had some mix ups with my meds but nothing too serious. I highly recommend the Haven.
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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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