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.
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.
Wellpoint is a health insurance company that offers individual and family plans in multiple state Insurance Marketplaces. They also offer managed Medicaid, Medicare Advantage, and Medicare supplement plans. Wellpoint used to be called Anthem, Inc. and in some states was known as Amerigroup. They changed their name to Wellpoint in 2024.
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.
If you’re reviewing treatment centers or looking for programs that accept your plan, you can also learn more about rehab options to explore facilities that match your needs.
By Michelle Tavares
Medically Reviewed by Dr Jillian Foglesong Stabile
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
1 month 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
2 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!
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
This place gave me my life back! If you are ready to change & have a new chance at life this is the place to come.
Gabriel Lavigne
2 weeks ago
This place really does go above and beyond for people. I have never felt so understood and heard before. They made it feel so personal and real. They allowed me to find myself and really heal. Shout out the angel Cruz for all his help as well ✌️ I owe you guys my life.
T’was an Honor to have had the pleasure to meet and learn from these Beautiful People I’m glad that their are still Some Good Hearted People in this world that are making a difference in peoples lives by being real and using their life’s experiences to help others the Work Ethics and Professionalism at Scottsdale Recovery is Truely the Best the effort in their dedication and commitment they make to servicing People of all walks of life is full of Top Level Care and some good old fashioned TLC I took the Peer Support Certification Class and successfully completed the course I have received my certification and achieved this along the side of some Awesome Men and Women whom I get to Network with and be of Support of these new Relationships I can’t wait to see where this road takes me I’m looking forward to the journey of continuous growth in personal experiences and helping others by extending all my support to service others with compassion understanding and using a nonjudgmental approach with respect and wisdom
Thank You Scottsdale Recovery for the opportunity!!
Celeste Pearl Jackson
1 month ago
Celebrities in recovery lol love this place so much. They helped me a lot with getting going in the right direction and what to pursue out of life. I was able to surrender my past and move on from my old ways through their programming.
Conan The Barbarian
3 months ago
Scottsdale Recovery has changed my life. If you or someone you know needs detox and/or treatment. This is the place. The staff is strategically handpicked by professionals; peers who have been through addiction and have come out the other end. The resources and services they provide are phenomenal, I would highly recommend SRC a million times over.
From day 1 to graduation, they guided me through, to a complete life changing transformation.
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
2 weeks 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
2 months ago
They Ubered me to the clinic when my car broke down and even they stayed open late because of the bad weather. These people always go the extra meter to take care of me no matter what. Five stars!!!
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
1 week 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
1 week 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.
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
3 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
4 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.
The experience with Never Alone was a breath of fresh air. My 16 year old son completed his journey 11/19 and came home with a whole new perspective on life and his future. His clinical technician Karissa was a wonderful aide in the process dealing with my son. The family sessions were a great opportunity for me, my son and his mom to work on communicating with one another which was hard to accomplish before our sessions but Karissa helped navigate that and allowed us to grow through our sessions. The weekly parent groups were a very helpful resource and tool as well. I appreciate all the support and encouragement the staff at Never Alone gave to my son and salute them for taking their time to guide my son through his journey.
Simione Corbett
2 weeks ago
My daughter spent over 2 months at Never Alone on her recovery journey. We can't say enough great things about the staff and the facility. The staff communicated well and provide support for the entire family. They have been the biggest step and help in her recovery, they provided her with tools she can use in her daily life to stay on tack to help cope with hard things that happen in life. She says now that this was the best thing that could have been provided to her while in addiction.
Lucy Vilamaa
1 month ago
Never Alone brought back the child that was lost in drugs and addiction. We can't say enough about the staff and the facility. They loved and cared for her so well provide her with all the things she needed in her recover and helped her find herself again and provided her with the knowledge she needed to start her recovery. The staff cares about their jobs, care for the kids their wellbeing and their success in recovery and it shows in their dedication and interaction with the kids. Never Alone has provided her a new opportunity at life.
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
1 week 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.
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program
Self-Pay OptionsPrivate insurance
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
8 months 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
10 months 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
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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