Rehab Centers That Accept MultiPlan/Claritev Coverage

MultiPlan, now operating under the name Claritev, isn’t a health insurance company. It’s a third-party healthcare network that collaborates with insurers and medical providers to lower healthcare costs and increase access to care. Therefore, addiction treatment costs vary based on the underlying insurer and individual plan.

Coverage levels, out-of-pocket costs and approval requirements often depend on a rehab’s network status. Understanding MultiPlan rehab coverage makes it easier to get the care you need without the frustration of denied claims and unexpected medical bills.

MultiPlan/Claritev doesn’t provide insurance benefits. It works with participating insurers, so coverage details depend heavily on your plan’s design. Carriers set their own out-of-pocket costs, restrictions and preauthorization requirements. However, MultiPlan expands access to providers and helps reduce costs by negotiating rates and facilitating partial coverage for out-of-network care (if applicable).

Expanded Coverage Due to Legal Changes

Under the Mental Health Parity and Addiction Equity Act (MHPAEA), insurance providers must offer mental health and substance use disorder coverage that’s comparable to their medical and surgical benefits. This means they can’t impose higher cost-sharing requirements or limit the number of treatment days more strictly for mental health services than they do for medical ones.

Just 2 years later, Congress passed the Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare. The ACA expanded access to care by listing addiction treatment as one of 10 essential benefits insurers must cover. Many employer-sponsored plans are ACA-compliant, making it easier to get the care you need if your insurer works with MultiPlan.

Understand and Verify Your MultiPlan/Claritev Coverage

While laws such as the ACA and MHPAEA increase access to drug rehab coverage, they don’t require insurers to cover specific services or pay for a certain amount of mental health care. Your insurance company decides what’s covered and how much it costs you out of pocket.

Many MultiPlan/Claritev-affiliated plans have cost-sharing requirements, which may include:

• Coinsurance: This is the percentage of a covered service you must pay. Coinsurance levels of 10% to 40% are common, but the exact amount depends on your plan.
• Co-pay: Co-payments are fixed amounts for covered services. For example, you may have to pay $10 for generic prescriptions, $50 for brand-name prescriptions and $25 for therapy sessions.
• Deductible: If your plan has a deductible, you have to pay the full amount before your insurance company starts to cover any of your care.

Your plan may also require preauthorization for certain services. This is when a provider or facility asks your insurance company for permission to provide medically necessary care.

Verifying your coverage is simple. You can use the provider search tool on your insurer’s website, call the customer service number on your insurance card or speak directly with your preferred treatment center for more information.

You can also use RehabNet, which has trained recovery specialists available to help you find in-network facilities. Call our free, confidential helpline or complete the online contact form to get started.

Understanding what types of addiction treatment your insurance covers is essential. Paying out of pocket can be financially overwhelming, especially for those already struggling.

Fortunately, MultiPlan-affiliated insurance plans include coverage for both mental health and substance use disorder services, offering a range of options to support your journey.

MultiPlan Detox Coverage

Detox is an important first step in recovery. As the body eliminates addictive substances, it’s possible to experience serious and even life-threatening withdrawal symptoms. Access to medically supervised detox is crucial during this phase.

Claritev detox coverage typically includes professional support, although the level of coverage varies. Your plan may require preauthorization or regular reviews to determine if you still need this level of care.

Inpatient Rehab with MultiPlan/Claritev

Inpatient or residential rehab is a common next step after detox. It involves living at a treatment center and participating in daily therapy and other activities. The intensive support of inpatient care may be appropriate for individuals with severe addictions or those who need help recovering from co-occurring disorders.

While many MultiPlan-affiliated insurers cover inpatient treatment, the extent of coverage depends on the plan. You may need to obtain prior authorization or undergo concurrent reviews to determine whether your insurance company will continue covering your care.

MultiPlan Outpatient Addiction Treatment

MultiPlan outpatient addiction treatment includes several flexible options:

• Partial hospitalization programs (PHPs): Also known as day treatment, PHPs provide at least 20 hours of rehab services per week, such as outpatient therapy and addiction education.
• Intensive outpatient programs (IOPs): IOPs provide a solid middle ground between the intensity of a PHP and the flexibility of general outpatient care. Patients receive fewer than 20 hours of care per week, enabling them to fit mental health treatment around work or school.
• General outpatient treatment: General outpatient care offers the lowest levels of structure and supervision. Patients may attend just one to two sessions per week.

The cost of these services depends on your plan’s design. For example, you may have co-pays for therapy sessions and medications.

Medication-Assisted Treatment

Medication-assisted treatment (MAT) combines counseling with FDA-approved medications to reduce cravings. It’s especially effective for alcohol addiction and opioid use disorders. MultiPlan-affiliated insurers may cover MAT, but some plans require prior authorization to demonstrate medical necessity.

Therapy and Behavioral Counseling

Behavioral therapy is the cornerstone of effective addiction care. Your plan may cover ongoing therapeutic care both in person and via telehealth, making it easier to get addiction-related services.

Common treatment types include:

• Individual counseling: Patients meet one-on-one with therapists, providing opportunities to discuss personal challenges and develop effective recovery skills.
• Group therapy: During group therapy, a trained therapist creates a safe environment where members feel comfortable expressing themselves. This type of therapy builds accountability and reduces the risk of relapse.
• Cognitive-behavioral therapy (CBT): CBT focuses on identifying harmful thoughts, feelings and behaviors. People work with their therapists to make positive changes, setting the stage for a successful recovery.
• Dialectical behavior therapy (DBT): DBT helps participants improve their emotional regulation, distress tolerance and interpersonal effectiveness. It also includes regular drug and alcohol testing.
• Family counseling: Substance use disorders often interfere with close relationships. Family counseling helps repair damaged trust and improve communication.

Therapy helps people manage triggers and build healthier habits. MultiPlan/Claritev gives members access to a broad network of mental health professionals trained in these evidence-based approaches.

Rehab Aftercare with MultiPlan

Recovery doesn’t stop when treatment ends. MultiPlan insurance often pays for aftercare, helping members stay connected to therapy, support groups and other services designed to reduce the risk of relapse. Contact your insurer to explore low-cost options tailored to your needs.

One of the key benefits of MultiPlan/Claritev coverage is broad access to its provider network. However, the cost of rehab and the extent of behavioral health coverage through MultiPlan-affiliated insurers can differ based on several key factors.

State-Specific Variations in MultiPlan Coverage

Although MultiPlan operates a national network, there are location-specific variations in coverage. The insurance plans, provider networks and benefits available to members can differ by state or region. Some plans, such as Medicare Advantage, are only available in certain states. Additionally, state laws can affect what health services must be covered, how claims are processed and what cost-sharing rules apply. 

While most provider networks are localized, some MultiPlan-affiliated plans offer travel networks or national access. These plans allow members to receive in-network benefits outside their home states, while others are more geographically restricted.

Plan Type and Level of Benefits

MultiPlan partners with insurers to offer these plan types:

• Health maintenance organization (HMO): HMOs typically have the lowest premiums, but they don’t cover out-of-network care. You also need a referral from your primary provider any time you need specialty services, including therapy and other types of addiction treatment.
• Preferred provider organization (PPO): PPOs are one of the most flexible options, as they don’t require referrals and may provide partial coverage for out-of-network care.
• Medicare Advantage: Medicare Advantage allows eligible enrollees to get their benefits from a private insurer instead of the federal government. Insurance companies may offer extra benefits, such as coverage for dental cleanings or hearing aids, to make these plans more attractive.
• Medicaid: Medicaid is a government program that provides health insurance to individuals who meet financial and other eligibility requirements.

Insurers only cover medically necessary services, so they use clinical guidelines and scientific research to evaluate each claim. Your insurance company may not cover a service that’s performed primarily for your convenience or isn’t appropriate for clinical use.

In-Network vs. Out-of-Network Considerations

MultiPlan supports 1.4 million healthcare providers, making it easy to find in-network options in your area. An in-network provider is a medical professional or facility that has agreed to accept pre-negotiated rates. This keeps costs consistent.

Out-of-network providers aren’t bound by MultiPlan’s negotiated price agreements. Getting care outside your plan’s network often results in higher costs, and it may require additional documentation.

Doctors and hospitals negotiate their contracts independently, so it’s possible for two providers in the same network to charge vastly different amounts. This can increase your treatment costs.

MultiPlan-affiliated insurance plans have certain policy limitations, especially when choosing between in-network and out-of-network providers. While out-of-network addiction treatment with MultiPlan is covered, particularly under PPO-style plans, the coverage is usually partial.

This means you’ll likely face higher out-of-pocket expenses than at an in-network provider. The exact amount of coverage and costs depends on your specific insurance plan, the type of treatment you’re seeking, and your geographic location. You may also need additional documentation, like referrals or preauthorization.

If you choose out-of-network care, you or the provider may need to submit a claim to your insurance company. The insurer will then determine how much of the cost they will cover based on your plan’s out-of-network benefits.

Sometimes, they will send the covered amount to your chosen provider. In other cases, they will issue a reimbursement to you. You are responsible for the remainder of the treatment cost.

Some rehab centers assist with verifying your benefits and explaining your reimbursement possibilities. You can contact the treatment facility directly to ask whether they accept MultiPlan-affiliated insurance and to get a clear breakdown of expected expenses or any financial aid options they may offer.

Generally, selecting an in-network facility is the best way to maximize your insurance benefits and avoid unexpected costs. RehabNet can help you navigate MultiPlan policy limitations and connect you with treatment centers that match your recovery goals while keeping your care affordable.

MultiPlan is not an insurer. It does not sell insurance policies or directly pay claims. Instead, it offers services such as provider network access and cost-containment solutions, helping insurers and employers manage healthcare costs for their members.

MultiPlan/Claritev serves over 700 healthcare payors, 100,000 employers, 60 million consumers, and 1.4 million contracted providers, creating a robust network of care options with broad access to behavioral health care, including SUD treatment. However, your actual insurance coverage is provided by your health insurer, not MultiPlan.

This can lead to significant differences in rehab coverage based on plan type. It is critical to verify your coverage before seeking treatment to avoid surprises regarding deductibles, copays, coinsurance, and out-of-pocket maximums.

MultiPlan/Claritev bases its coverage decisions on medical necessity, not on the use of specific substances. This gives members access to a wide range of substance abuse treatment methods. Depending on the terms of your plan, you may need to obtain prior approval or undergo regular case reviews.

Common substance use disorders covered by MultiPlan include:

• Alcohol addiction
• Opioid addiction (heroin, prescription painkillers)
• Stimulant addiction (cocaine, Adderall, Ritalin)
• Benzodiazepine addiction (Xanax, Valium)
• Marijuana addiction
• Prescription drug abuse

MultiPlan-affiliated insurers also cover co-occurring disorders. This is when you have a substance use disorder and another mental health condition, such as anxiety, depression or schizophrenia, at the same time.

Although MultiPlan covers a wide range of addictions, not every in-network treatment center will have the expertise or resources to address your specific situation. It’s essential to find a rehab that accepts your insurance and matches your unique needs.

Using in-network providers can help you maximize your benefits and keep costs as low as possible while accessing high-quality care. 

To identify doctors and facilities in your plan’s network:

• Call the customer service number printed on the back of your insurance card. They should be able to help you verify your coverage and provide you with a list of rehab centers near you that accept MultiPlan members.
• Use MultiPlan’s online Provider Search Tool to browse your options. Filter your options by location, level of care and plan type to find the best provider for your needs. These directories aren’t updated in real time and may not reflect a provider’s current status, so it’s best to use a second confirmation method.
• Call your chosen facility directly. You can verify your benefits and get an estimate of your out-of-pocket costs.
• Use RehabNet’s free helpline or online search tool to find inpatient rehab centers that accept MultiPlan. Our services are 100% free, completely confidential and accessible 24/7.

Addiction affects nearly every aspect of your life, from physical health to financial security. It takes courage to seek help, but doing so early can help you recover from a substance use disorder before it causes serious harm. Comparing rehabs and verifying your benefits puts you in control of the process.

RehabNet has a dedicated helpline and a free online treatment locator to help you find in-network facilities that match your needs. If you’re ready to regain control over your life, now’s the time to act. Reach out to discover the best way to get treatment with your MultiPlan/Claritev-affiliated insurance plan.