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
Published on August 15, 2024
Medically Reviewed by Dr Jillian Foglesong Stabile
I AM SO THANKFUL FOR SYMETRIA AND THE GREAT STAFF.They are very helpful with any questions or concerns you may have about the program They make you feel at easeThey don't judge you it's a really great and safe place to began recovery. I highly recommend symyetriaTo all staff : thanks so much. N.B
Nolan Brown
3 months ago
Symetria saved my life in more than one way. Each member of this team deeply cares about the patient without judgement. Vannah is such an incredible Clinician who truly listens, is an advocate for her patients, and is helping me work through my trauma to heal in a healthy way. I am forever grateful for this entire team: Samantha, Vannah, Dr. Son, the wonderful nurses. Thank you for saving my life and helping me heal.
Symetria of Lewisville is a great place to all those in recovery. The entire staff is super friendly and helpful. They re there to help. Trust me. Special thanks to Cynthia and Ashley. Keep up the great work!
Ross
2 months ago
Costello is my SAG name. My name is James Dupee. I have been visiting the clinic for over a year and have been very pleased. Adam is the best Counselor/Therapist I have ever confided in. He is personable and understanding as well as straight forward with his advice. Cynthia is the most amazing face of a company I have ever met. She is kind and professional yet makes me laugh every time I stop in. The nurses are equally professional and personable. 5 Stars from me.
Jimmy Costello
2 months ago
Symetria Recovery saved my life!! I was driving down the highway suffering major withdraw from opioid addiction. I found Symetria Recovery and they had me in the very next day. When I got tested, I was positive for Fentanyl, which had to of come from something off the street. I nearly had a panic attack thinking about my life ending, leaving behind my wife and 3 beautiful children. I've been here for about 18 months clean and sober and have never been happier. It feels great to be "me" again. Addiction causes you to lose yourself. With the help of the staff at Symetria, you CAN be saved!! Come get saved at Symetria Recovery!!
I loved it here. Such a great experience!! They are so nice and very helpful!!
Hailey Pyenta
1 week ago
A wonderful experience, the entire staff attended to all of my needs so I could focus on me while I was here. ❤️🩹 I’m fortunate to have found Spring Hill, they helped guide me in my treatment and getting ready for the next step. Thank you all!!!!!
Ryan O'Connell
4 weeks ago
This is an excellent residential program where you are not locked onto a unit. There is full access to the absolutely stunning campus. The staff is kind and can relate as most are also in recovery. The food is fantastic with home cooking by Matt, Jon & Eric. I received the best treatment through group therapy, individual therapy, family therapy & case management. The nursing staff is top notch & available 24/7. I highly recommend Spring Hill for the best substance abuse recovery experience out there.
they are very helpful and compassionate and I had a great experience. however the program is only 2 weeks long when they advertise a 30 day program.
Jeff Wagner
3 months ago
This place is amazing. The admin coordinator Christina was extremely patient and helpful with my situation and all the help I have received from everyone else has been life changing. I can't thank them then enough!
Brienne Curry
3 months ago
I love this place, you feel like u have a cozy home to work on yourself. It's very comforting and the staff are people that have been thru addiction as well so they can relate to you which makes it so much easier.
Everything about this place is amazing.. this is the first rehab that I ever been to and I was blessed to find white sands....from all the bht's, to the therapist, to the nurses and doctors... If I could rate it 100 stars I would.. they truly care and help out anyway possible and I'm thankful and appreciative for everything that they done ... They truly helped and changed me and cared... Not just a little but a lot.. I recommend white sands to anyone thats looking for rehab... Thank you white sands for helping me, and getting me back on track...WHITE SANDS IS THE BEST...HANDS DOWN
Eugene Harris ll
2 months ago
Danny my case manager. made me feel like I was the only person on his case load. His attention to my needs were breath of fresh air. He legit made my stay here amazing. My box spring had broke and he didn't rest until it was replace and he actually stayed late to get it done. If you struggle with addiction whitesands is the place to go. I highly recommend Shay to be your therapist and Danny to be your case manager. Also I can't forget the BHT team. Keith , Elijah, O'Shea, Anthony, Dominic, Vanessa, Joey, Rose, Rachel, Dasiah you guys made me feel safe and kept me in line and last but not lease my best friend Ryan who made sure I got to my doctor appointments between all of them they've made a great impact on my recovery I can't express truly how much you guys helped me throughout my struggles. I mean this with my whole heart. THANK YOU ALL!! But most of all I want to thank Heather. She has talked me off the ledge more times than I can count. Heather always lends her ear and with her infinite wisdom calls me on my bullsh!t, and never blew smoke up my butt. I've never met anyone who cares about patients like she does. I highly respect everyone I mentioned and I hope that if you're struggling with addiction you get the opportunity to meet these amazing humans and find your path to sobriety.
Shawn Alday
2 months ago
Where to begin?? This place saved my life. If I could rate WS 9 stars I would. (Nobody's perfect) 99% of the staff here are tremendous!! From day 1 I was treated with kindness, compassion and respect. Ms NICOLE....such a sweet spirit. I'll miss your enthusiastic smiles and attentive ears. DENNIS, you know how to pull things out of a person that helped me recognize a destructive trend i need to work on. DEB, SHAY, HEATHER, ERIC, ANNE MARIE, SHANNON.....THANK YOU. MISSY...Thanks for the great conversations and fantastic coffee.The Behavioral Health techs were awesome.Shout outs to GLEN, AUDREY, NEAL, ROSE AND ANTHONY.As with everything in life, if you sit on your ass and put nothing in you'll get nothing out. If you open up with your therapist, participate in the classes, get out of your comfort zone and TRUST THE PROCESS White Sands Will change your life for the better.
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I m extremely thankful for NPR. You all have tuned my life around for the good. You guy s gave me the tools to motivate me towards my sober lifestyle now. I would highly recommend this place to anyone that is wanting to make a new life of sobriety. The staff, counselors nurses are awesome.
L.R. Laursen
2 months ago
Great techs. Supportive of early recovery patients. The food was plentiful and good. They listen to criticism and react to it.
William Schreiber
2 months ago
Northpoint is great. All the staff, nurses and environment are inviting. I bonded with a lot of other clients Which was extremely helpful for my recovery. And the food is great I would recommend Northpoint to anybody looking for help.
To say that ChoicePoint saved my life would be an understatement. ChoicePoint didn't change me, it brought back the REAL me. If you are struggling with addiction, I can't recommend this place enough. Super friendly and knowledgeable staff that take you on the journey to sobriety from a mental-health perspective. The groups run in the mornings andat nights, which gives you the opportunity to share and learn in a safeenvironment. Ask for Lisa, Jeff, Gina or James- each played a pivotal role in counseling me to recovery.
Dan
4 months ago
Choice Point offers excellent mental health services with group and individual therapeutic sessions. When I began the program, I was assigned to Jeff Gish. As I worked the program and had inevitable difficulties, Jeff went way beyond his counselor role and engaged me as a friend. That was the turning point for me that helped ensure my recovery. Everybody shoots straight here and you truly know how much they care about your mental health oh, and the medical services are equally valuable. They helped me find medications that worked for me and were always attentive when I called. I can t say enough about Jeff and Choice Point. They helped me turn my life around and that deserves all the stars in the heavens.
Shawn Kell
4 months ago
CHOICE POINT helpful and wonderful people my council Sam and all the other Counselors are the best very friendly and helpful and I ve been sober since and continue to be sober with their help
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program
Self-Pay OptionsPrivate insurance
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
3 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
Tina Gagnon
4 months ago
Caring Hands Recovery is a place of healing. It has changed so many lives and given people a second chance to become who they really are. The staff is knowledgeable and kind, they walk with you through every step. Addiction can take away everything you love, Caring Hands can help you get it all back. I highly recommend getting treatment here, it is safe, and they get to the root of the problem so that you never have to pick up another drink or drug again.
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
2 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
3 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
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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