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
Medically Reviewed by Dr Jillian Foglesong Stabile
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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 a great place and it can really help you get better.
Trevor Stewart
3 weeks ago
Symetria in Hurst is full of loving and caring individuals who go above and beyond helping you in any way you need while navigating your best self, if you're slightly thinking about checking it out, I highly reccomend it, will change your life for the better!!!
Vernon Godsey III
3 weeks ago
ALL OF THE STAFF IS AMAIZINGGGGG!!!! Even during emergency I didn’t get my dose because of bad weather Deborah was calling me and calling me(I didn’t answer)😭but then she made SURE I got it by letting me dose at the hospital she was a lifesaver and that’s just what u can expect from this location they really take care of u like your family!!
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.
Very helpful for mental health. I will say you get as much out of here as you put in. My therapist and the staff have been wonderful and I’ve learned a lot of useful tools for my life moving forward. I’m not fixed, but I have more balance.
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.
Nice place, spent 3 weeks. Staff was helpful, polite etc. Focus on your detox and you will have a solid decent experience.
William Spencer
1 week ago
Highly recommend - this was my first time going to a rehab and it was extremely daunting, but the staff are absolutely fantastic. Everyone makes you feel extremely welcome and are there for you 24/7. My experience has been life changing and the help provided was above and beyond what I could’ve ever expected. It will be sad leaving as it’s amazing meeting people that genuinely care and want to make a difference but I’m now excited for my next steps based on what the Haven have done for me!
Jack Wagstaff
1 week ago
This has been one of the greatest places I’ve ever been!! I’m so grateful to have been able to have the opportunity to be in this program. This place genuinely saved my life. They made sure through the whole detox that I was comfortable and they made sure to give the proper medication to make the process painless and easy. The staff goes above and beyond with all things. They are all so caring and they genuinely listen to you. If you’re on the edge about coming let this be what brings you in. This is an amazing place!! If your ready to change your life, this is the place that’ll do that and help you on your journey to sobriety.
This is an ad and Never Alone – Adolescent Addiction Treatment Center is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More
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.
Great place for a “reset” of with quality help that cares!!!
Especially Jenn & Natalie and Liz-
Mahalo-Jett
Jett G
2 months ago
This place is amazing the staff was willing to help at all times. I would send my mother here. If you need detox or residential I did both it was amazing. Rachel at detox Allen the therapist at residential and the doctor Alex who is over both was top notch. Highly recommend this place if you need help.
Shout out to ash and tay as well the bht’s both dudes are super solid.
TJ Northrup
2 months ago
This place is amazing the intake coordinator or Director of intake. Christina Freeman is amazing at her job. She understands what people are going through and she’s really empathetic and has a lot of compassion. We need more people like her in this world.
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
3 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🖤
Person
5 months ago
good attentive staff that will help you get the help you need.
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.
The staff was amazing, very helpful in recovery, and, and supportive of my personal needs. Vert confidential of my well being, and the mesical staff / nursing,was outstanding the food, incredible, great variety. I would recommend spring hill to anyone neesing tratment.
Derek Moretti
1 month ago
Spring Hill was one of the nicest css programs I have been to. You are treated like a real human, not locked behind doors all day. Being able to be outside made all the difference in the world for me. I finally feel like I made good progress on my recovery.
Sober Motors MA
1 month ago
I had such an amazing experience here. The staff were all so welcoming, the groups were fun, and the people really made it feel like a community. I feel very hopeful about the continuation of my recovery process.
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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.
Fountain Hills has provided excellent and customized treatment for my husband. We chose this facility because they have experience with Autism which can make him difficult to direct. They provided him with a lot of extra time and resources and communicated daily with the family. I feel like the therapists and staff out now part of our family.
Melanie Jay
4 months ago
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
10 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.
Id love to give these guys a 5 but recently I was dropped due to insurance. ( I have medicaid. Which makes me less fortunate then others who pay for there insurance) so after about a year and a half. Outside of that the groups are excellent the facilitators truely care, and the people who are the ones that really make the groups they are great. I thibk due to the telahealth aspect people are more willing to dig into there traumas and passed. I can only hope they 1 day accept medicaid again not only for me but all the other addicts and alcoholics who cant afford insurance to 1 day be able to receive treatment in the same manor I did.
Travis
6 months ago
Choice point was such an amazing place to focus on my recovery they helped me so much to focus on my recovery helped me stay clean and also helped me become a better person I will definitely miss this place ❤️thank u to my counselor melisssa Darrien and my peers in group and all the counselors and staff at choice point for helping me be me again ❤️best rehab I ever been too ❤️thank u so much
Yahaira Medina
8 months ago
Helpful and great experience overall couldn't have asked for a better program. They gave me all the tools needed to continue my life in the right path. Forever grateful.
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.
Great people who provide invaluable support to families.
Geralis Rosario
3 days ago
I had a great experience with this place , the environment is friendly and everyone was very welcoming
T'chelle Lockhart
1 month ago
A younger family member of mine has gone through here and my experience with this inpatient rehab for youths has been incredibly positive. The leadership team is compassionate, professional, and truly committed to helping the kids succeed. The clinical team is knowledgeable, supportive, and treats each client with dignity and care. The direct care staff go above and beyond every day — they are patient, attentive, and genuinely invested in the well-being and recovery of the youths they work with. You can tell there is a strong sense of teamwork throughout the program, and the environment feels safe, structured, and caring. I’m very grateful for the support and dedication this team provides to both the clients and their families.
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
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
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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.
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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.
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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