Wellpoint Health Insurance Coverage for Addiction Treatment

Explore Wellpoint’s addiction treatment coverage, including Medicaid and Medicare plans. Find the right care for your recovery journey.

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Wellpoint Health Insurance Coverage for Addiction Treatment

Explore Wellpoint’s addiction treatment coverage, including Medicaid and Medicare plans. Find the right care for your recovery journey.

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Addiction Centers That Accept WellPoint

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    The Haven Detox – New Jersey

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    Sewell, NJ
    5.0
    (388 reviews)
    Check iconClaimed
    They say that if the idea of a project or a journey intimidates you, you should break it into smaller tasks and do the easy ones first. The problem with addiction recovery is that the first step, detox, is the steepest hill of the journey. That’s why The Haven Detox is here: to level out that hill and give your recovery a smoother, more comfortab
    View Website (856) 259-0959
    The Haven Detox – New Jersey has no reviews yet. Leave a review.
    19
    19
    1
    Top 10 in Wellpoint
    Rehab Score
    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.
    8.80 / 10
    5.0
    (66 reviews)
    Symetria – Hurst Outpatient Rehab and Suboxone Clinic in Hurst, Texas, is a private drug rehabilitation clinic for adults. One of the best outpatient rehab centers in Texas, Symetria offers various withdrawal medications to help clients get started with their recovery journey. You’ll also have access to treatments such as the intensive outp
    Symetria is unbelievably amazing!!! The Hurst staff is phenomenal!!! I can't imagine that another location has a better staff. A special shout out to Deborah, Benjamin, and Samantha of course. You all are doing amazing, amazing, selfless work. You all are very special to so many!!!
    Vernon Godsey III
    6 months ago
    Huge shout out to the team at symetria who make me feel like family I appreciate everything they do and huge shout out to Osagie for helping me! He is AWESOME!!! I love you symetria❤️❤️❤️
    Chloe Roseman
    7 months ago
    BEST PLACE EVER. I have tried various other doctors/clinics and none of them even begin to compare to this one. The staff here is absolutely amazing. I can’t even make a single complaint. Dr Son is the best as well. He explains everything and you truly feel like he understands you. I can proudly say this, this place saved my life. If you or someone you know needs help getting off opiates do it right the first time and come here. You won’t be disappointed. If you are specifically struggling with fentanyl please don’t waste your time with other ways. I have tried 6 other methods from lazer therapy to having the earpiece to suboxone. Methadone is the key to our current fentanyl crisis. This clinic makes recovery possible again!
    Mason
    7 months ago
    Symetria Recovery - Hurst TX 76054
    5
    5
    The facilities at Symetria Recovery - Hurst in Hurst, TX 1 The facilities at Symetria Recovery - Hurst in Hurst, TX 2 The facilities at Symetria Recovery - Hurst in Hurst, TX 3 The facilities at Symetria Recovery - Hurst in Hurst, TX 4
    2
    Top 10 in Wellpoint
    Rehab Score
    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.
    8.66 / 10
    4.7
    (840 reviews)
    Check iconClaimed
    Indiana Center for Recovery offers leading detox and addiction treatment services for adults in Bloomington, Indiana. They provide various treatment services such as detox, outpatient rehab and residential rehab. The facility is accredited by the Joint Commission and has been A Diverse Range of Amenities One of the things I like most about this fac
    Indiana Center for Recovery is an amazing facility that helped me rediscover myself. Transitions between levels of care are a bit rough but the group facilitators are all excellent and if you stay the course and complete the full treatment you won't regret it.
    Karah Schutz
    4 days ago
    The staff at ICFR are all very kind and helpful throughout the entire process of being at the recovery center. The facilities are very well maintained and clean. There does seem to be a lack of communication between staff members as there was often confusion when questions were answered. Overall I had a fantastic experience at IFCR and would recommend to anyone seeking treatment.
    Ry
    5 days ago
    Place is great. I was in a pretty bad way coming in, and have been for a while, because t feel like I have a new outlook and perspective on sobriety. Staff are caring and helpful. Coursework is current and applicable and the accommodations are comfortable. If you come with an open mind and some willingness you can get what you need.
    Matt Trudo
    6 days ago
    31
    31
    3
    Top 10 in Wellpoint
    Rehab Score
    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.
    8.64 / 10
    4.6
    (402 reviews)
    Check iconClaimed
    The Haven Detox in West Palm Beach, Florida, treats adults18 and older who are experiencing addiction issues. They offer a personalized approach to meet you where you are now. They also provide bilingual detox for those who aren’t fluent in English. It’s more than a medical detox, it’s a sanctuary to start you on the path to sobriety. At one
    The Haven was a great facility for detox and the residential portion of my rehab process. The entire staff was extremely kind. The nursing staff was very thorough. The techs were so cool and caring. The administration team was extremely helpful seeing me through the process. And in my opinion,, the food was great which is always a bonus. I would recommend the Haven to a friend in need with no hesitation.
    Roberto Vidal
    1 week ago
    Anthony and Nick made my stay at Haven Detox Center genuinely comfortable. Their professionalism, kindness, and attention to detail helped ease a stressful time. Grateful for the care and support they provided.
    dylan bliss
    1 week ago
    The haven is the best
    D
    3 weeks ago
    22
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    The Recovery Team – New Jersey

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    Mountainside, NJ
    5.0
    (22 reviews)
    Check iconClaimed
    The Recovery Team has a reputation for the most advanced addiction and mental health care in the country — with 5 locations and hundreds of positive reviews online. The programs are built on a foundation of science and mental wellness. Many of our innovative options are simply not available at most other treatment centers.
    View Website (888) 270-7241
    The Recovery Team – New Jersey has no reviews yet. Leave a review.
    4
    4
    Top 10 in Wellpoint
    Rehab Score
    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.
    8.58 / 10
    4.9
    (61 reviews)
    Symetria - Lewisville Outpatient Rehab & Suboxone Clinic is located in Lewisville, Texas. They offer intensive outpatient treatment and mental health treatment. Insurance is accepted. Symetria Recovery in Lewisville, Texas  specializes in opioid and alcohol use disorders. The clinic offers outpatient programs that combine a variety of proven metho
    good attentive staff that will help you get the help you need.
    John Carter
    5 months ago
    This place is so well managed and organized! The staff is seriously amazing!! Front desk is amazing!!!! Everyone is so kind and actually cares about you and your recovery!! I LOVE THIS PLACE. Legit the best if you need help!
    Juliet Newton
    5 months ago
    These people have helped me recover from the worst point in my life to become a much better happier person today. I owe my life and my family to this place. Especially Leia, Cynthia, and Mary. But I want to thank everyone else for being a part of this process.
    Daymond Johnson
    7 months ago
    Symetria Recovery - Lewisville TX 75057
    4
    The facilities at Symetria Recovery - Lewisville in Lewisville, TX 1 The facilities at Symetria Recovery - Lewisville in Lewisville, TX 2 The facilities at Symetria Recovery - Lewisville in Lewisville, TX 3
    5
    Top 10 in Wellpoint
    Rehab Score
    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.
    8.56 / 10
    4.8
    (284 reviews)
    Spring Hill Recovery is a luxury alcohol and drug rehab on a 70 acre campus in Ashby, Massachusetts. It’s a coed program with separate male and female residences. They treat adults 18 years and older. Here at one of the leading women’s rehabs in Massachusetts, most of the day in their program is structured with therapeutic activities. They
    Absolutely changed my life for the better. I went in arrogant and with my head on backwards. They supported me through every step of the process and when you leave you really do “get your power back”, the choice to make the right decisions. If I ever had to go to rehab again I would choose this place again immediately. Hats off to Lead RS Justin and my clinician Sandrea for they gave me the deepest level of support and I wouldn’t have made it the full program without them. Thank you Spring Hill.
    nick capparella
    5 months ago
    This is one of the greatest recovery centers to regain control over your life. The groups are very informative and welcoming. The criteria was open and well covered. The RS go above and beyond to make the clients feel comfortable. I would highly recommend anyone to come here and experience the healing vortex that surrounds Springhill
    Corey
    5 months ago
    I’ve never been in recovery, or in any form of rehab and being here / making this decision saved my life entirely. As a first timer, I was overwhelmed with the amount of support that I received during my stay here, everyone is more than nice & outstanding individuals. From the staff, to the maintenance crew, to the phenomenal chefs AND Maybel the therapeutic pup everyone here is there to help you during your sobriety journey! I didn’t want to leave, this place WILL change your life.
    gio
    5 months ago
    The facilities at Spring Hill Recovery Center in Ashby, MA 1
    5
    5
    The facilities at Spring Hill Recovery Center in Ashby, MA 2 The facilities at Spring Hill Recovery Center in Ashby, MA 3 The facilities at Spring Hill Recovery Center in Ashby, MA 4 The facilities at Spring Hill Recovery Center in Ashby, MA 5
    6
    Top 10 in Wellpoint
    Rehab Score
    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.
    8.43 / 10
    4.5
    (124 reviews)
    Fountain Hills Recovery is a drug and alcohol rehab in Fountain Hills, Arizona. They provide luxury residential and outpatient addiction treatment. Treatment options at Fountain Hills Recovery include top-rated inpatient addiction rehab, a partial hospitalization program (PHP), and an intensive outpatient program (IOP). The luxury inpatient program
    I don't even know where to start!! From speaking with Sandy at intake to all the staff at both residential and PHP everyone was amazing!! I was so nervous coming in and not knowing what to expect but if you stick with it and stay you will not regret it!! Everyone who works here is amazing and deserving of 5 stars!! Their kindness, attentiveness, knowledge, passion, and enthusiasm topped the charts!! I found my tribe here and I cant say Thank You enough!!! Makes me cry just typing this out because this place and all the staff, the entire team is phenomenal!! I miss my family here and I am and will forever be grateful for their help and the difference they have made in my life!!! This journey for me is one I am proud of and I hope if you are considering Fountain Hills you take the leap of faith and call them! Do it for YOU!! YOU are worthy of the life you dream about!!
    Whitney Pearce
    8 months ago
    Despite my obstinate reluctance to participate in this type of therapy, the staff has been extremely confident and flexible in finding a way to help me. I am still surprised and very grateful for their commitment and sincerity. They really have helped in a direct and tangible fashion in a very short time. I never would have guessed that I would end up with such gratitude and respect for the people and process I have been gifted with. I offer my best wishes for all those who sacrifice so much to help and serve to foster recovery and wellness for others. Somehow, even I seem to be worth the effort from such generous folk. My inability to fathom anything that could justify the time spent with me by such wonderous people does not diminish my gratitude for the effects of the education, caring and results achieved.
    Jeff
    9 months ago
    I was a client at Fountain Hills Recovery at the beginning 2025, and I felt compelled to leave a review about my time there. During my stay, I received treatment for Alcohol and actively participated in all components of the residential treatment program, including group therapy, individual therapy, and psychiatric therapy. The staff was extremely knowledgeable in all aspects of taking back control of your life, and their care and kindness was well above what I expected to receive. The home I stayed in was always well stocked with food of your choosing, and the meals that were provided were well balanced and hit high marks from the chef that prepared them daily for us. Besides the great accommodations in place, the treatment I received was highly beneficial and had led me to know reach a 6 month milestone of living a sober and clean life. I am thankful for my decision to choose Fountain Hills and would recommend it to anyone who is serious about making decisions that will shape their future for the better.
    Joel Fenton
    9 months ago
    Fountain Hills Recovery AZ 85268
    6
    6
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    The Haven Detox – Arizona

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    Green Valley, AZ
    4.8
    (67 reviews)
    Check iconClaimed
    Stepping away from the people, places, and things that remind you of life in addiction can be transformative. Pair that with innovative therapies and compassionate care from renowned clinical and medical experts, and you’ve arrived at The Haven Detox. Holistic Healing Meets Modern Science in Green Valley Our latest treatment center in Green Valle
    View Website (520) 363-2704
    The Haven Detox – Arizona has no reviews yet. Leave a review.
    14
    14
    7
    Top 10 in Wellpoint
    Rehab Score
    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.
    8.29 / 10
    4.7
    (45 reviews)
    Check iconClaimed
    Never Alone is an alcohol and drug rehab center for adolescents located in Hurley, New York. They provide residential treatment services to help you overcome your addictions and find hope on the other side. Teens experience a lot of changes that can be stressful and confusing. Unfortunately, sometimes this leads them to abuse drugs and alcohol. Lo
    As a mental health provider, I feel confident referring patients with substance use challenges to Never Alone. Feedback from former residents consistently highlights the quality of the staff, clinical care, and overall environment. The facility offers a well-rounded program that combines a variety of therapeutic groups with meaningful recreational activities, supporting both recovery and personal growth. I highly recommend Never Alone, both personally and professionally, to anyone supporting a teen struggling with substance use.
    Alexis Lima
    3 weeks ago
    I highly recommend Never Alone for young adults navigating substance/mental health issues. The staff were attentive, caring and knowledgeable of the issues that affect the youth and their families.
    Mary Shea
    3 weeks ago
    Very good place and very supportive with the youngest one. We need more places like this one.
    Nick Espindola
    3 weeks ago
    29
    29
    Olalla, WA
    4.0
    (79 reviews)
    Olalla Recovery Centers provides substance abuse treatment for adults. They offer inpatient (IP) services at this location but can refer those needing more flexible options to their outpatient (OP) program area. You’ll find ‘em out in Olalla, Washington. Your recovery starts with a thorough assessment to determine your unique needs before ent
    An excellent facility with amazing caring staff your not just a number or a patient your a guest!! Amazing treatment alternatives that will guide you on your journey. A secluded facility with breathe taking views
    Jack Irwin
    5 months ago
    I went to the visitors class and thought they did a good job of explaining addictive behaviors and a little of the brain science behind it without it being overwhelming. I recommend it to anyone, whether they've already had experience with loved ones in recovery or not. We are always learning new things about the brain and modalities to help us deal with it. The counselor was great and made me feel welcome.
    Kaye Allard
    6 months ago
    This place is amazing! I highly recommend!!!!
    Trina
    6 months ago
    Olalla Recovery Centers
    4
    The facilities at Olalla Recovery Centers in Olalla, WA 1 The facilities at Olalla Recovery Centers in Olalla, WA 2 The facilities at Olalla Recovery Centers in Olalla, WA 3 The facilities at Olalla Recovery Centers in Olalla, WA 4
    Corona, CA
    5.0
    (14 reviews)
    Caring Hands Recovery is an addiction treatment facility located in Corona, California. They offer addiction treatment for individuals struggling with alcohol and drug abuse They do accept most private health insurances. Every treatment program is customized. The admissions process consists of a list of questions that must be answered. By answerin
    Caring Hands is amazing. Thanks to Shey for staying on hold for a 4 hour phone call with me, so that my loved one was able to get the approval and urgent care they needed. The staff was wonderful and I can not thank you enough for the care you provided.
    Gayle Alvarado
    1 year ago
    This place is perfect. Shey and Tina are the kindest most patient people I’ve ever met. They had such an impact on my life that I think of them regularly. 😇❤️
    Will Danielss
    1 year ago
    I have been with Caring Hands Recovery for five years, witnessing countless clients, come in and receive treatment for various challenges, including childhood trauma, substance, abuse, and family issues. Our dedicated team works tirelessly to help individuals, rebuild relationships, and find forgiveness, allowing them to move forward. In addition to providing emotional and therapeutic support the staff here at Caring Hands‘s will assist each client in maintaining any legal issues to ensure that they are meeting their obligations as well as assisting the clients in applying for FMLA and SDI if they are employed. If you are looking for a family like environment we are the recovery home for you
    Tina Gagnon
    1 year ago
    The facilities at Caring Hands Recovery in Corona, CA 1
    5
    5
    The facilities at Caring Hands Recovery in Corona, CA 2 The facilities at Caring Hands Recovery in Corona, CA 3 The facilities at Caring Hands Recovery in Corona, CA 4 The facilities at Caring Hands Recovery in Corona, CA 5

    The Recovery Team – North Little Rock

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    North Little Rock, AR
    5.0
    (52 reviews)
    Check iconClaimed
    The Recovery Team, founded 10 years ago, is known as one of the top addiction treatment and mental health rehab centers in the country. 

 The treatment centers provide therapy and medications (if needed) that get to the root of the issue in a welcoming, comfortable environment. Treatment is covered by insurance and backed by hundreds of positi
    View Website (888) 270-7241
    The Recovery Team – North Little Rock has no reviews yet. Leave a review.
    4
    Meridian, ID
    4.8
    (1167 reviews)
    Northpoint Recovery in Boise, Idaho, provides comprehensive substance addiction and mental health treatment. Your recovery begins with a complimentary assessment to determine your unique needs. They have inpatient and detox services available. They offer a unique plan that uses a three phased approach to care, including detox, rehab and aftercare s
    When you are ready for recovery, I highly recommend Northpoint. From the moment I walked in, the staff members were kind, professional, and helpful during one of the most difficult times in my life. Everything about the facility was comfortable. It was not what I expected to say the least. I was treated with respect. I wasn't locked up in a hole. The environment made recovery attainable without making me feel miserable. Because of the welcoming environment, the other community members were equally as pleasant. You get a sense of community in your recovery that lasts past your graduation date. You will be exposed to tools, coping skills, techniques, etc. to assist you during your recovery. Before you leave, they make certain that you have a solid release plan and options for aftercare. If you are at a loss for ways to put down addiction, definitely consider the inpatient program at Northpoint. I finally have confidence in a new life for myself.
    Benjamin Welch
    5 months ago
    Amazing place! So glad I went here. Highly recommend
    Addy Fogle
    5 months ago
    IWOW, I have zero complaints. Never have I seen a staff so attentive and care for the residents, who are probably having their worst time ever. They are patient, persistent and always available for a shoulder to cry on. I am so very lucky I found NorthPoint in Boise, my hometown. I Would give a strong 10 referral to anyone who I know needing a safe place to process an addiction. I am better for it.
    Teresa Williams
    5 months ago
    Northpoint Recovery ID 83713
    4
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    Frequently Asked Questions

    Does Wellpoint Cover Addiction Treatment?

    Most of Wellpoint’s plans are in the Insurance Marketplace or they are Medicare or Medicaid plans. The laws governing these types of insurance, including the Affordable Care Act (ACA), ensure that they include coverage for addiction care, mental health, and co occurring mental health and substance use disorders.

    To use your coverage, you’ll generally need to choose a provider within their network. It’s possible that the treatment center you had in mind might not be covered by your insurance plan but you can find a different one that is. Wellpoint does allow you to check what providers are in their network by looking online.

    Different plans will have different coverage requirements and limits as well as out of pocket costs, such as deductibles and copayments. Many Medicaid plans offer care free of charge. For some Wellpoint plans you might need pre authorization before you can start rehab. Be sure to review your insurance plan to get all the details before starting treatment.

    In What States Does Wellpoint Operate?

    Wellpoint will offer individual and family plans on the Insurance Marketplace in Florida, Texas, and Maryland beginning in 2025.

    If you live in one of these states, you may qualify for one of Wellpoint’s Medicare or Medicaid plans: ArizonaIowaNew JerseyMarylandTennesseeTexas, andWashington.

    Massachusetts residents who are government employees or retirees also have access to Wellpoint plans that are not associated with Medicare or Medicaid. If a government employee or retiree is eligible for Medicare, they can get a Wellpoint Medicare plan.

    What Types of Plans Does Wellpoint Offer?

    Wellpoint’s individual and family plans are either health maintenance organizations (HMOs) or point of service (POS) plans. An HMO is less expensive each month but you’ll need to stay within the provider network for care and you’ll need a referral for a specialist, such as an addiction counselor. A Wellpoint POS plan allows you to see non network providers and you don’t need a referral to see specialists. However if you use an out of network provider you’ll pay significantly more in out of pocket costs.

    For those who qualify Wellpoint offers Medicare plans. You can get a Medicare Supplement plan which helps you pay for out of pocket costs in Original Medicare. Another option is to get a Wellpoint Medicare Advantage plan which replaces Original Medicare and often includes additional benefits. However, you’ll likely have to use the plan’s provider network and may need to get preauthorization for care.

    Wellpoint’s Medicaid plans are available in six states. These plans offer low or no cost care to lower income individuals and families. You’ll need to work with treatment centers that accept Medicaid in order to get the care you need.

    If you’re a government employee in Massachusetts, the types of plans that Wellpoint has for you to choose from are indemnity plans and PPO plans. With an indemnity plan, you can go to whatever provider you would like and it’ll be covered equally at whatever the set amount is for your plan.

    With a PPO plan, you can still go wherever you would like, but if you stay within your plan’s provider network you will have better coverage.

    How Much Does Rehab Cost With Insurance?

    The cost you’ll be expected to cover for rehab varies quite a bit depending on what type of insurance plan you have. Most Medicaid plans don’t make you share part of the cost, so if you have Medicaid, your rehab treatment probably won’t cost you anything.

    For other types of plans, you will need to look at your deductible and what percentage of the cost of the service is covered. You may also want to consider your maximum out of pocket cost. You’ll likely get the lowest costs if you stay within your provider network.

    Types of Inpatient Treatment Covered by Wellpoint

    Depending on your Wellpoint plan you may need to obtain a referral and/or prior authorization before starting residential treatment. Doing this helps ensure that the treatment you’re seeking matches your doctor’s recommended treatment plan — in other words this treatment is medically necessary for you.

    Your doctor will do an American Society of Addiction Medicine (ASAM) assessment. This will determine whether you need residential care or can start with an outpatient program. Residential care may be deemed appropriate if your addiction has taken over your life and you need 24/7 support to break free. It has the added benefit of helping you reset your lifestyle. You can expect to spend large portions of each day doing scheduled activities that contribute to your recovery. The treatment length can range from a few weeks to a few months.

    Depending on what substance you’re using you may need medical detox before you go to rehab. The focus of treatment will be to oversee your safe withdrawal from the substance you were using. Detox is most commonly used to help people off of alcohol or opioids like heroin or oxycodone. A typical stay lasts about three to ten days and allows you to start your treatment program with a fresh slate.

    Types of Outpatient Rehab Covered by Wellpoint

    A partial hospitalization program (PHP) is one type of outpatient treatment that Wellpoint may cover for you. It’s a lot like residential rehab but you go home at the end of the day. With a PHP you’ll usually find that you’re scheduled for programming all day long four or five days a week.

    The next step down from partial hospitalization is intensive outpatient treatment. The program content is similar to partial hospitalization but you spend less time there. You might only be there for two to three half days a week. Partial hospitalization programs are designed to continue to support you while you return to your responsibilities like work or caregiving.

    In standard outpatient treatment you’ll meet with an addiction counselor on a regular schedule. Most commonly you’ll meet once a month but the frequency of your appointments can range from weekly to every few months. If you need medication management you might get that from a separate provider on a similar schedule. Sometimes the same provider can do both.

    If you’re someone who can benefit from medications that treat your addiction, Wellpoint may cover that treatment for you. Medication assisted therapy is also known as MAT. Sometimes it’s integrated into the treatment you’re already getting and sometimes you can access it separately.

    Does Wellpoint Cover Methadone & Suboxone (MAT)?

    MAT is used to treat opioid use disorder and alcohol use disorder and benzodiazepine abuse. Like other treatments this is a therapy Wellpoint may cover for you if a health professional determines that MAT will benefit your recovery.

    MAT can be used to help ease your withdrawal symptoms. MAT can also be used to aid your detox process as an outpatient. The decision whether to treat you as an inpatient or an outpatient would hinge on factors like the status of your health and the severity of your addiction.

    When you’re detoxing from alcohol or benzos the goal is usually to end your physical dependence on these substances. Once you have finished detox there are medications that your provider may initiate to help you stay sober.

    If you’re withdrawing from opioids the goal may also be to end your physical dependence and then prescribe medication that helps you stay sober. Alternatively, the goal of MAT with opioid use disorder may be to reduce your physical dependence and then transition you to a maintenance drug.

    Does Addiction Treatment Need to Be In Network?

    Whether you can go out of network will depend on the type of health plan you have. If you have an individual or family plan or a Medicare Advantage plan look at what type it is. An HMO will generally require you to use in network treatment while a POS or preferred provider plan may cover out of network treatment.

    If you have a Wellpoint Medicaid plan you’ll most likely need to stay in network to get treatment. If you’re a Massachusetts government worker with a Wellpoint plan, you may be able to go out of network.

    Keep in mind that when you use a non network provider your deductible and copay along with your out of pocket maximum could all be higher. If you can stay within the network that’s the best way ot maximize your insurance coverage and minimize your personal cost.

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