Beacon Health Insurance Coverage for Drug Rehab

Beacon Health Options is now Carelon Behavioral Health. They offer behavioral health services for insurance plans and employers along with government agencies and medical providers. They don’t run insurance plans themselves.

You might see Carelon listed as your provider for mental health and addiction treatment services. They also offer specialty care services and crisis support along with a wellbeing program and support for military members and veterans.

The company offers insurance plans access to over 115,000 medical providers and they serve over 61 million members across all 50 states.

Does Beacon Health Options Cover Drug and Alcohol Rehab?

Beacon Health/Carelon provides behavioral health benefits which include addiction treatment and mental healthcare. However Beacon/Carelon doesn’t decide the actual cover levels — the insurance plans do. So it’s important to understand the details of your insurance coverage even if you see Beacon/Carelon as your behavioral health provider.

All health insurance plans focus on covering medically necessary care so you’ll want to start by working with your doctor to create a treatment plan for your substance use recovery. This will help you focus on what specific types of care you need and will be used by insurance to prove medical necessity.

What Specialty Services Does Beacon Health Options Offer?

Beacon Health/Carelon offers several specialty services, including programs for substance use disorders and serious mental illness.

Its addiction programs include Changing Pathways which provides medically assisted treatment for opioid use disorder and Resilience through Information Support and Education (RISE) which is a case management intervention program.

Another specialty service Beacon Health/Carelon provides is for autism spectrum disorders (ASD) and includes medication management, peer specialists, proactive crisis planning, and care coordination.

They also have care for eating disorders and peer support programs to help you get through challenges by relying on the wisdom of those who have been where you are.

What Inpatient Addiction Treatment Does Beacon Health Options Cover?

Beacon Health/Carelon can connect you with inpatient addiction treatment programs through various insurance companies. However, Beacon Health/Carelon doesn’t control the coverage levels or requirements of your plan so be sure to review your plan before you start rehab.

While most plans cover medically necessary inpatient care, coverage levels will vary. You’ll want to work with your doctor to get a treatment plan that will show what’s medically necessary in your case. Your doctor may do an ASAM assessment to determine the level of care you need.

The most common inpatient care includes medical detox and inpatient or residential care. Medical detox provides medical oversight to help you manage withdrawal symptoms during detox. Residential care allows you to focus on recovery without distractions.

What Outpatient Rehab Does Beacon Health Options Cover?

Several different treatment options for outpatient rehab are available through Beacon Health/Carelon. Outpatient rehab may involve individual, group, or family therapy sessions, either in person or virtual.

Partial hospitalization programs (PHP) offer the most intensive outpatient rehab and usually require you to spend several hours a day in a treatment center five to seven days a week. Intensive outpatient programs (IOP) involve therapy sessions for nine to 19 hours per week. As you proceed along the path to recovery, you’ll transition to general outpatient treatment, attending counseling sessions once or twice a week.

Make sure you understand your insurance coverage and any referrals or preauthorizations you need before you begin treatment.

Does Beacon Health Options Cover Methadone & Suboxone (MAT)?

Medication-assisted treatment (MAT) combines counseling with medications like methadone and Suboxone to treat opioid and alcohol addiction. MAT can be used during medical detox to manage withdrawal symptoms and during longer-term treatment to help you stay stable during rehab.

Changing Pathways is Beacon Health/Carelon’s MAT program for treating opioid addiction. It uses medication along with peer support, education, and quality management assistance.

Does Beacon Health Options Cover Other Mental Healthcare?

Many insurance plans cover mental health as required by ACA but it’s still important to check your plan for specific coverage. Beacon Health/Carelon helps health insurance plans offer options for treating addiction and other mental health issues but it doesn’t determine coverage limits.

Mental health coverage allows you to get counseling for mental health disorders like anxiety and depression along with bipolar disorder and other diagnoses.

Underlying mental health concerns often accompany substance use disorders, so it’s important to address these co-occurring disorders along with addiction for you to be successful in your long term recovery.

How Long Will Beacon Health Options Cover Rehab?

Your specific insurance plan determines the length of rehab treatment, not Beacon Health/Carelon. Addiction treatment can be a long process and it’s essential to embrace the process and complete all the steps along the way. The length of your rehab depends on your individual needs.

Inpatient or residential treatment can range from one to three months. Outpatient programs are about 10 to 12 weeks but can be shorter or longer, depending on your needs.

Does Addiction Treatment Need to Be In Network?

Many insurance plans require you to use in-network providers to get coverage. If out-of-network providers are covered, you will pay a much higher cost in deductibles and copayments.

To get the most out of your insurance coverage for addiction treatment, it’s best to stay in-network if possible. Review your insurance plan to determine your exact coverage before using a non-network provider.

How to Verify Coverage With Beacon Health Options

You can verify your coverage by contacting your insurance company through its customer service phone number or online. When it comes to your mental health and drug rehab coverage, your insurance may have the information available or may direct you to call Beacon/Carelon.

If you have a specific treatment center in mind, you can ask representatives at the center if they accept your particular insurance plan. Insurance plans vary on the services they will cover so when asking a treatment center what insurance they accept make sure you use the exact plan name — not just the insurance company name or Beacon Health/Carelon.