Rehab Centers That Accept Carelon (Beacon) Insurance

Most well-known and popular insurance firms offer some amount of coverage for alcohol and drug addiction treatment services, and Carelon Insurance is one of these providers.

Carelon Insurance, formerly known as Beacon Health Options, is a private insurance company that provides Medicare and Medicaid plans. As of March 1, 2023, Beacon Health Options officially rebranded to Carelon Behavioral Health. This change was part of a broader effort by its parent company, Elevance Health, to rename and reorganize its behavioral health division. Some plans previously known as ValueOptions Insurance under Beacon may now be administered by Elevance Health. Today, Carelon focuses primarily on mental health and substance abuse treatment services.

The change in name and direction of services may be confusing for people who are seeking substance abuse treatment. If you are interested in the types of addiction treatment covered by Carelon Insurance or locating addiction programs covered by your health plan, keep reading below.

Yes, Carelon Insurance provides coverage for drug rehab through its assorted health plans.

According to the Mental Health Parity and Addiction Equity Act of 2008, insurance providers must treat mental health treatment the same as any other medical treatment, and they are required to provide the same coverage for addiction treatment programs.

The MHPAEA was amended by the Affordable Care Act (ACA), a law designed to make health insurance obtainable to people who may not have been able to afford or access health insurance. The modification made addiction and mental health disorder treatments more readily available in the United States.

Substance use disorders fall under the classification of mental health disorders, which means Carelon Insurance is mandated by law to offer coverage for addiction treatment. Nevertheless, the amount of coverage you receive will depend on your plan type.

When you or someone you love is searching for addiction treatment centers, a key aspect to look for is the type of programs your insurance company covers.

There are many different evidence-based treatment programs for treating addiction that Carelon covers. These various programs include inpatient and outpatient treatment programs, as well as medical detox and medication-assisted treatment.

Carelon Insurance provides at least some amount of coverage for medical detox with their insurance plans, a crucial first step in addiction recovery.

When you first join an alcohol and drug rehab program, they will have you start a medical detox. During this period, you will be supervised by a doctor, nurse, or other medical practitioner. They will observe your vitals, such as your blood pressure, temperature, and heart rate.

To be confident that your insurance policy will pay for medical detox, you should examine your plan and contact your representative with any questions.

Carelon Insurance covers inpatient treatment programs, at least in part, for those who need more intensive supervision while fighting their substance use disorder. Inpatient treatment (also known as residential treatment) is generally the first step after completing medical detox.

Whether long-term or short-term, inpatient treatment consists of frequent doctor or medical professional monitoring, group and one-on-one therapy, and other evidence-based treatments.

Carelon Insurance observes the policies for treating alcohol and drug addiction set by the National Institute on Alcohol Abuse and Alcoholism. These policies suggest beginning an addiction treatment program by spending at least two weeks in an inpatient treatment facility.

You will need to call your insurance representative to determine how much your plan will cover.

Most Carelon Insurance policies offer partial to complete payment for outpatient treatment programs.

Outpatient treatment programs are created for individuals who have successfully concluded an inpatient treatment program and for those who do not need a higher level of supervision.

Outpatient programs are supposed to be used in a step-down manner, with the intensity of treatment decreasing as you move through the levels. Outpatient programs are comprised of partial hospitalization programs (PHP), intensive outpatient programs (IOP), and general outpatient programs.

A fee for outpatient treatment programs is usually required each time you go in, a copayment instead of a one-time lump sum payment. These fees will depend on each patient’s individual insurance policy.

Medication-assisted treatment (MAT) programs are generally covered, at least in part, by Carelon insurance policies.

MAT is one of the most successful techniques for treating substance use disorders. Medications help reduce the intensity and sensations of withdrawal and improve the odds of successfully quitting an addiction.

The following standard MAT medications may be at least somewhat covered by your Carelon insurance plan:

• Methadone
• Suboxone (buprenorphine)
• Vivitrol (naltrexone)

For a complete list of treatment options covered by your insurance provider, you will need to read your policy. You may be required to have prior authorization in some plans.

Most Carelon Insurance policies offer some type of coverage for behavioral therapy and counseling. Usually, this coverage is expanded to the inpatient or outpatient program that provides the therapy.

Counseling and therapy are critical parts of long-lasting recovery. Sobriety can be more successful when the underlying issues and trauma have been taken care of.

Some of the most typically used forms of therapy include:

• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Motivational interviewing (MI)
• Individual therapy
• Family therapy
• Group therapy

Carelon offers coverage for an assortment of aftercare programs, or a form of continuing care for people who have finished their initial treatment program.

For many people who have completed inpatient and outpatient addiction treatment, returning to their lives can be overwhelming. Sober living was developed to give additional help to those who have successfully concluded a substance abuse treatment program.

These programs can help people as they adjust to their new lives without drugs and alcohol. The most useful way to discover if Carelon insurance will cover sober living is to call your Carelon insurance representative.

When examining and comparing the numerous Carelon Insurance plans, you should be aware that different elements can impact your insurance coverage.

Factors that can impact your Carelon insurance coverage for drug and alcohol rehab:

• Your unique diagnosis
• The kind of health care benefits you will need
• Your plan’s copays and deductibles
• Referral conditions to see a specialist
• The kind of health care provider you need
• Your unique insurance benefits

Yes, Carelon insurance policies do cover out-of-network rehab programs. Nonetheless, you will most likely require a referral or prior authorization before Carelon will cover an out-of-network rehab program.

According to Carelon Behavioral Health’s Out-Of-Network Reimbursement Policy, members can receive medically necessary treatment and health services from a provider outside their network.

In-network signifies that the physicians and treatment centers work directly with Carelon Insurance and have agreed to specific payment rates for their clients.

Typically, selecting an in-network provider is a much more affordable option for people because out-of-network programs require you to pay more out-of-pocket.

If you or a member of your family is interested in enrolling in a Carelon Insurance plan, you have many choices.

These plans must supply the same coverage as Original Medicare, including Medicare Part A (hospital) and Part B (medical) coverage. They also have HMO and PPO plans.

Each Carelon Insurance plan offers varying amounts of coverage for different requirements, such as prescription drug coverage and telehealth (also known as virtual visits) services. Be sure to review each plan thoroughly.

Carelon Insurance provides the following types of plans:

• Individual health plans
• Commercial health plans
• Medicaid
• Medicare
• Medicare Advantage
• Advanced Primary Care
• Palliative Care

Some of the insurance plans you may come across when researching Carelon include:

• Participating Provider Option (PPO) – Patients with a PPO plan can choose where they go for care without needing a referral from their doctor or prior authorization. They do not even need to see a doctor in-network.
• Health Maintenance Organization (HMO) – Patients with an HMO plan are usually only covered for treatment by in-network providers. In most cases, you will require a referral or prior authorization for an expert or specialist.

Carelon does not offer insurance plans that can be enrolled in through HealthCare.Gov. However, the website provides the needed information for enrollment if you are interested in the specific services that Carelon offers.

If you or a member of your family is searching for substance abuse treatment opportunities for a drug or alcohol addiction, you may be interested in what types of addiction your health insurance will cover.

Because substance use disorders are categorized under the umbrella of mental health disorders, many different types of addictions are covered by insurance companies.

The following are some of the addictions that Carelon Insurance covers treatment for:

• Alcohol
• Benzodiazepines
• Opioids
• Methamphetamine
• Prescription drugs
• Marijuana
• Cocaine
• Heroin

If you have any concerns about your insurance provider’s coverage for addiction treatment, call us today. Our addiction treatment specialists are ready to help you get started on your sobriety journey today.

For many people who are looking for drug and alcohol treatment, locating a treatment center that takes their insurance is a critical factor in making a decision. Luckily, deciding which addiction treatment programs actively take your insurance can be effortless.

Here are some ways to look for a Carelon-covered rehab program:

1. Use your insurance card. On the reverse side of your insurance card, you will see a phone number for an insurance agent who can assist you in narrowing down the substance abuse treatment centers in your area.
2. Access your member account. When you sign in to your Carelon account, you will have the option to find providers, hospitals, and treatment centers in your network.
3. Check out our list of treatment providers. We provide detailed information about top rehab facilities in your home state, including insurance and price information.

Since some Carelon Insurance plans need prior authorization to acquire access to substance abuse treatment centers, you may want to check with your insurance agent before making a definitive decision.

If you or someone you care about is seeking treatment to quit an addiction to drugs or alcohol, you can locate substance abuse disorder rehab centers that are paid for by your Carelon health plan.

Carelon provides coverage in Arizona, California, Iowa, Nevada, North Carolina, Tennessee, and Texas. If you are ready to begin your road to sobriety and wellness, help is ready and waiting for you.

Call our RehabNet.com helpline to be connected to an addiction treatment expert who can guide you through understanding your insurance policy and coverage and help you find the right treatment program for you.