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.
By Michelle Tavares
Medically Reviewed by Dr Jillian Foglesong Stabile
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
1 month ago
Entire staff was friendly, helpful and supportive throughout the whole process from reception to nurses to counselors
William Maddux
1 month ago
The nurses at the hurst location and also Samantha the receptionist are all so kind and compassionate!! They all go above and beyond the call of duty. They should all be praised for their hard work and their kindness to their patients!!
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
2 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.
Zachary Adams
2 months ago
I just hit 3 years sober. This was the detox center that helped me. Just overall an amazing place with incredible staff. If I could give 10/ 5 stars I would. Absolutely PERFECT place to detox at.
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
3 weeks 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!!!
Gwen R
3 months ago
Everytime I come here the staff are beyond amazing very personable no judgement passed on and extremely helpful always quick and easy Cynthia is still my favorite though ;)
I am truly grateful for Springhill Recovery. Immediately I was made to feel at ease, safe & secure. I quickly realized that I was in competent, caring hands with all of the staff that I met.
I learned so much about myself here! I can see where I need to work on a few things and I now have to tools to do it thanks to the amazing groups here.
I leave here confident in my sobriety & recovery! I will seek connections with others in recovery because I’ve learned that absolutely nobody can do this alone.
Thank you Springhill Recovery for giving me a chance at life again!
Jackie Loewen
3 weeks ago
Amazing! Take everything they give you! Make connections with your peers! Day by day! Spring Hill is where recovery begins and you will leave with serenity, courage, and so much more.
I was in their 2 week Relapse Prevention Program in 2003. I have been clean ever since! Facility was scenic and serene, staff was beyond amazing. Their overall approach offered total holistic focus treating the INDiVIDUAL. Diversity in spiritual accommodations including Native American. When my two week program was complete I wanted to stay longer simply because the entire experience was so profoundly healing....I WANTED more, rather than NEEDED more.
valorie duvall
6 months ago
My name is Jason I had the pleasure to stay at olalla. This place is great if you are in for the right reasons. Put in the time and it works. The food is great and lots of it.the counselors are great and don’t take your shit!! I’m biased but heather is the best🤙
Jason Berry
8 months ago
Absolutely Loved my stay at Olalla! Great meals everyday 🙌🏼 coffee too(if ya get up early enough). The staff I had during my experience were some of the best counselors & people you’ll meet! Counselors will definitely call you on your BULLSHIT & keep you accountable(Can’t bullshit a bullshitter, they say). So good luck trying to skate by or just faking it to make it. I got down to some good core roots I never thought of before, got a lot of “Dark Things” out in my time here too. Also not too bad of classes either! With a slightly more stoic approach one could say maybe, lots of good new info! Also, when you get towards the end of your stay, if you’re feeling not quite ready to leave, you can ask for extension(s) too. 🙌🏼
This place is really about their patients, as groups tend to be no bigger than 6-12 people, so, plenty of questions to be asked, searched for, & answered!!! I was in the Falcon Group, our group never got bigger than 6-7 people. And it’s males with males & females do there daily groups with just females, allowing for a little more comfort/support when sharing personal matters. Absolutely love Olalla & would recommend this inpatient facility to ANYONE struggling with addiction!!
10/10 ⭐️’s
🩶💛🩶
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
6 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
8 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
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult ProgramLGBTQ Program
Private InsuranceSelf-Pay Options
Northpoint has helped me so much. Deciding to go here was the hardest and best decision I could make. The leap was hard, but meeting the people, taking the classes, and finding the support I need has helped me become someone I'm proud to be.
James Beck
3 weeks ago
Great experience, Good Facility, Fantastic Support Group.
Eddie Reeves
3 weeks ago
Overall pretty good, food is good the people there were friendly we went on cool outings. I just had one issue with a couple staff members and I found the classes pretty repetitive. But still better then any other place I've been to.
From the very beginning I’ve had such an amazing experience. My counselor Sam is beyond exceptional and the kindest person I know. She answers my calls and questions and has truly guided me through my journey. I would also like to give a shoutout to the front office coordinator who is so welcoming and supportive and has helped me so much as well. Thank you Sam and Leo for all you do!
Mohamed Laib
1 month ago
Choicepoint has been a really wonderful option for me after waiting to seek treatment for a long time. Since being in the program for 2 1/2 months, I can already see a lot of changes in myself that I didn't anticipate happening so quickly. The team is very knowledgeable and good at explaining medical terminology around addiction into easily understandable language that was easy for me to digest. The group sessions were particularly helpful as they provided an opportunity to share time with others who are going through the same experience, which is not something I have in my "real" life. I had Darien and Sam for group, and both are very kind and good at creating a safe and friendly atmosphere where people that start as strangers feel comfortable sharing private things about themselves. Darien took time out of his day to help advise me once on natural remedies for anxiety, and Sam has a great candor and humor which makes group a pleasant experience - something I never would have expected going into the program. Joanna, the nurse at Choicepoint, is very kind and takes time to explain to you different options for MAT without pushing you in one direction - she explains everything so well that you feel very confident in whichever option you choose. Gina, who I had as a counselor, also helped me process how I make decisions and the behavior behind my actions, which has helped me to understand myself better. It's been a great thing for me and I really recommend it to anyone.
Melanie is cool in my opinion. She is knowledgeable in mental health and we talked about narcissistic abuse and recovery.
Ron Delmo
1 year ago
I m grateful for the results I ve been getting at this location. The staff is awesome and always willing to answer my tough and sometimes annoying questions. I really appreciate it and will recommend to anyone seeking help.
Sean
1 year ago
Great IOP program! Allison was a wonderful therapist and Gabby, the case manager, was an absolute delight! 10/10, would recommend!
I really enjoyed this place,very excellent experience! Very cleanly and staff and all is very luxury
Amanda Basquez
3 weeks ago
The morning talk with Dr Bradley was amazing. He explained in plain English what drives addiction from the science aspect. He was very informative and funny on top of that.
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.
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