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.
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
Michelle Tavares is a registered nurse with over 15 years of experience in mental health nursing. She has worked in inpatient and outpatient settings as well as in bedside and administrative roles. She is a fighter of stigma and an advocate for getting people the mental health services they need.
Medically Reviewed by Dr Jillian Foglesong Stabile
Jillian Foglesong Stabile is a board-certified Family Physician who enjoys the full scope Family Medicine, including obstetrics and women’s health, along with caring for children and adults of all ages. She manages a number of health conditions, including mental health and those with a history of substance abuse.
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Symetria is like a second family for me now and Mrs. Debrah , who runs the center is always awesome and also Mrs. Callie is my counselor and a great one at that! Come to Symetria if you need help you’re not alone they will treat you like your one of them. And the front desk lady Michelle is so sweet that she won’t let you miss a does so she calls every patient everyday in case you forgot so u don’t suffer!
Krystina Hubbell
3 weeks ago
I have been in the DARKEST place for so long. Symetria was my saving grace. My counselor Callie (my saving grace) showed me that I actually really do matter and gave me a sense of belonging for the FIRST time in my life! She truly cares and has helped me in so many ways that I can't thank her enough. If it weren't for her, I'm not sure where I'd be in life right now without her. Ms Callie, if you see this, thank you again. To all of the concerned mothers/fathers out there, I promise you, this is the best methadone clinic in the United States. Thank you for taking the time to read my comment, I promise I wouldn't steer you the wrong direction. <3 Please take into consideration coming to Symetria. I finally have hope.
Madi Murphy
1 month ago
This place is great. The entire staff had always been excellent
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.
21 years of addiction. 4 years in prison. 4 complete rehab stays in other facilities. It took me going 5 hours from home, fighting the entire way, to make it to harmony ridge. When I tell you, these people were there for me the minute I stepped out of the car. Someone told me that day (as I was starting to withdraw) "You never have to use ever again." Something so simple, but so powerful. I spent 11 days in detox and 28 in the regular program. I graduated and walked out of there more proud and prepared then I've ever felt in my life. I now have just about 18 months clean, and Harmony Ridge in Barboursville is how that was made possible! Special thanks to Mikey, Rooster, Matt (our spades buddies)
Junior, the AMAZING cooks (the food ROCKS btw) my counselor, Jenn, for being there for me when I missed home, who noticed when I wasn't quite myself,and who let me cry multiple times in her office, even when I was afraid to go home, and my case worker Tiffany who was super new but she rocked it and made sure I had transportation, a great sober living house, and even a dentist appt for when I went home!!! Theres so many of yall I cant remember the names, but plz know even 18 months later u guys have ALL made an impact on my life. Thank you from the bottom of my heart. LOVE YALL!!!
Miranda McDonald
1 month ago
Harmony Ridge helped save my life!! Such a wonderful program đź‘Ź The staff is brilliant beyond words!! They have REAL life experiences in addiction,and humor,compassion,and the willingness to help us win! I strongly suggest them to anyone still sick and suffering, They're one phone call away. Don't let one call prevent you from a new prosperous life!
Samantha Morton
1 month ago
If you or someone you know are thinking about going to a treatment center I’m happy to say the staff here have created something special. From the second I called I’ve been treated with love care and empathy by everyone at the facility. Even after completing the 28 program staff members like Joshua Haskiell reach out to check in on me regularly. They don’t make anymore money to do those things they are just genuinely good people with big hearts who have earned my trust. The main guy the director of operations Jacob May was there in the flesh 6 days a week with his door literally open all day. A man in his position doesn’t have to make your problems his problems but that’s exactly what he does for anyone needing help. He personally helped me with seemingly little things but important to me and he didn’t act like they were little he acted like they were important to him. That’s the kind of care you can expect to get at this facility top notch.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
I found the staff,the facility, and surroundings. To be educational as well as extremely informative. Would recommend to others!!!!
Dustin Esau
2 weeks ago
SRC really is the best. I went through detox and im currently at the residential and its amazing here. All the facilitators genuinely care and the BHT's. The pool,basketball court, volleyball court and putting green are a plus. They teach you so much here. Kelly. Natalie, and Genesis, are amazing. There's not 1 thing I can complain about. This place is teaching me how to love myself despite all the shit ive done. I recommend this place to everyone who needs help. Lee the CEO is awesome. Josh from admissions is cool and he helps tremendously. Genuine people!!!
Alyssa
1 month ago
Everything about Scottsdale Detox and Recovery is top tier. The level of care by the staff, the facility, and aftercare is exceptional. I was a patient here several months ago and also proceeded to their residential program and the level of care I received there was exceptional. Highly recommended
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult ProgramLGBTQ Program
Private InsuranceSelf-Pay Options
Northpoint is the best place for my start of sobriety. I have been shown love, kindness, patience, pure help and for that I am forever grateful. Thank you Truly Northpoint Community for all your support. I’ve learned an amazing amount about myself and learning how to be sober in a safe environment.
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.
ICFR was just what I needed to learn about my addiction and learn about ways to recover successfully. The clinical staff and support staff are outstanding in every way. The accommodations are comfortable and they do everything they can to address your needs.
Michael Pritchard
1 week ago
Great place would recommend to anyone in need.
Joseph Hickman
1 month ago
Really changed my life. Feel like a completely different person leaving than when I first got here. The group facilities are fantastic and really are able to help you on a deep level. The community overall is phenomenal and recommend it to anybody who is struggling
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
I use to go to denton clinic last year and even years ago and I was honestly struggling very hard to keep up with payments and Im not here to bash... I blame myself for not communicating better. At the time I was forced to leave my denton home and stay with family in the colony and had to drive every day Mon thru Fri to denton. I finally tried looking for some place closer and thank the Lord He led me here. I called and they asked about insurance which I gave all my info about. I seriously had doubts that it would be of any help. Years ago methadone wasnt covered easily by insurance...
But they made my day when they told me yep they take my insurance which is through marketplace. AND I would not have to pay anything out of pocket!! I was singing and dancing. Been here ever since. Even when I messed up and missed open enrollment, they still worked with me without insurance... i was so worried but everyone reassured me that they would find a way to help me here and they did. Everyone is SO NICE also. Love it here.
Anita
7 months ago
I absolutely love this place from the front staff all the way to the back staff. Everybody is so amazing and so kind. The office manager helped me find a location where I could get my dose since I missed it on Saturday and I was so grateful for him to reach out because I finally got my dose I needed Because THEY CARE! I recommend this place to anybody struggling with opioid Use disorder or pain. Don’t be afraid to pick up the phone and call. Everybody is so nice and you’ll be taken care of🖤
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
I absolutely love the staff at Spring Hill! The campus is gorgeous and healing. The ability to walk around and socialize in an open space is wonderful. I really felt cared for by the clinicians, case managers, nurses and RSes.
CORPORATE, however is obviously very greedy unfortunately. You are a number to them. It’s a common problem but something you should know. Do not listen to promises of recruiters, there are many things said to try to get you signed up (commission) that are untrue (ex/ pool, trails, what you can bring or not etc)
Know your rights. If you are sent for detox at BEDROCK, DO NOT LET THEM TALK YOU INTO STAYING. Go to Spring Hill and don’t waver
Sarah Landstrom
2 weeks ago
Springhill Recovery Center is absolutely the best! The staff are amazing. The facility is beautiful and tranquil. I left feeling confident and ready to begin a new chapter in my life.
Kathleen
2 weeks ago
Spring Hill is a wonderful facility. The staff is knowledgeable and caring. If you come prepared to do the work you will come out prepared to continue your recovery.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Vogues was amazing Angie was amazing helped a lot with my recovery the staff was amazing and the groups did a very good job opening my mind and perspective
Gods Art
2 weeks ago
Very knowledgeable they are there to embed it into you make sure that you know what is what etc they acknowledge your opinions have you voice your opinions as well to make you understand and believe in yourself they help you focus. There is a lot that they d, NOT just Substance Abuse but Mental Health Issues as well. I will always go to them if I ever need help!
Andrea Carrillo
3 weeks ago
So I was enrolled at the vogue house and was there for week or little more and then was in need to go to emergency room then which my hospital admitting cause me to lose my place In program....although everyone has been awesome an met alot of other people going through the same to continue their sobriety as well amazing strong people.....I felt I was treated unfairly because I was in a hospital bed not amusement park and left the facility in an ambulance
I loved seeing and being part of the program but one shouldn't be kicked out do to hospital stay
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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.
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.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
Calls to numbers on a specific treatment center listing will be routed to that treatment center. Calls to any general helpline could be forwarded to SAMHSA or a verified treatment provider.
If you wish to connect with non-sponsor centers, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.
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