Carelon Behavioral Health Insurance Coverage for Drug Rehab
Discover how Carelon Behavioral Health covers addiction treatment, mental health care, and more. Learn about their specialized programs and verify your coverage today.
Carelon Behavioral Health Insurance Coverage for Drug Rehab
Discover how Carelon Behavioral Health covers addiction treatment, mental health care, and more. Learn about their specialized programs and verify your coverage today.
Carelon Behavioral Health is a health insurance company specializing in covering mental health and addiction treatment. You may know them as Beacon Health, which was their former name.
When the Mental Health Parity and Addiction Equity Act passed in 2008, many health insurance companies didn’t have enough mental health and addiction coverage to comply with the law.
The solution for many was to subcontract for their mental health and addiction services. Carelon is one of the main companies that provide this service to other health insurance carriers around the country. They also contract directly with some employers.
Does Carelon Behavioral Health Cover Addiction Treatment?
Yes, in fact, it’s what they specialize in, but there’s a caveat. When they’re contracting with another health insurance company, many aspects of the coverage may still depend on that other company’s policies. That company can make decisions about what types of services they want in their network.
Many of their plans have residential drug rehab coverage. The characteristics of the network may depend on the plan they’re contracting with. If you’re considering a health plan that uses Carelon as a subcontractor, and you’re wondering what’s in network with that plan, you can look. They let you check their network coverage by the company through which you’re getting your main health plan.
By Michelle Tavares
Published on August 16, 2024
Medically Reviewed by Dr Jillian Foglesong Stabile
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Had a great experience there with everyone from the techs to the instructors
jeremy k
1 month ago
This place has save my life in so many ways I love all the techs. This isn't jus a recovery center this is a family love you all at evolve indy
-Amar
Amar Stevedores
1 month ago
This place is a great place to go if you need help with substance abuse or just mental health as well. When I went, I unfortunately didn’t take it very seriously but the people that did take it seriously have been very successful. Kyler was a great mentor while I was there, and he along with the other techs all seem very genuine and honest and willing to help in anyway they can. I am extremely grateful for this place, as well as Kyler especially. I don’t think I would be where I am today without him as a mentor.
I have been to several Rehab centers. This the best Rehab I have been too, the Counselors, are excellent. The Clinical Director Donna, is Great. She has a zero tolerance for Foolishness. The groups, are engaging and deal with the coor of the clients addiction.
Edward Woods
4 weeks ago
Attending extensive care at Avenues Metairie has been very beneficial for my recovery. I have learned so much from the groups and I feel like I've been challenged in positive ways that will help me stay sober and maintain a healthy lifestyle.
Jessica Sciortino
4 weeks ago
Counseling and group therapy are the best things about this place in my experience. The staff is friendly and supportive. If you apply yourself and are willing you will be able to learn a lot. An except first step in recovery. Nursing and mental wellness are some of the best I’ve received. Very caring and supportive. 10/10
The clinicals were great smaller groups and the teachers have real life experience! Staff makes the place. Great food and you can vape!
Zach Rumell
4 weeks ago
Great program and facility. The staff goes above and beyond!
Savannah Tessmer
1 month ago
1st Time client, in which I'll be graduating this week and I'm going to a 6 month program at avenues complete in Philly. I've had a tremendous experience here in Clarksville Indiana God bless everyone.
Soberman’s estate saved my life and the staff was tremendously amazing. I deeply appreciate their commitment to assisting individuals battling with depression and other addictions. Thank you Brady, Trish, Janice, Jody, Allen and the entire staff.
Japhet Niyizigama
3 months ago
My partner spent 9 weeks here last fall. Having tried other inpatient and outpatient programs, I can say that Soberman's truly helped him discover what life was worth living for. The staff and the care they provide are top-notch. I think this place truly saved his life. From a family perspective, I really appreciated how they included me and others in his family in his care. The family support calls and the ability to do family therapy sessions helped me understand his journey better, but to also understand my role in all of this. Overall, I can't recommend Soberman's enough; we are grateful to be a part of their community!
Jenny Martin
4 months ago
Soberman’s Estate was everything I needed for my recovery. The staff, the program, physical activity and culinary experience were top notch and essential. The program is well designed and works better than I expected. My time there and being removed from alcohol for five weeks was everything I needed to remove my craving for alcohol. Soberman has changed my life in ways I never could have imagined.
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FRC was a place that they care about you and your not just a number they care about your health along with your mental wellbeing I can’t say enough on the staff they help you out best they can I would recommend this place to anyone that needs to get clean
Jim Fanson
4 weeks ago
Had a great experience there with everyone from the techs to the instructors even a great nursing staff
jeremy k
1 month ago
Frc is a really good facility, it was very beneficial for me, it's a really good program. Some of the best advice I got was from the people I met here. Corey one of the techs here was very helpful and supportive while listening to me and helped me get through my time here.
Five-Star ReviewChoosing this design for change treatment center was one of the best decisions I ve ever made. From the moment I walked through the doors, I felt a sense of safety, support, and genuine care that I hadn t experienced anywhere else. The facility is beautiful and peaceful, but it s the people who make this place truly special.One of the standout individuals on the team is Tiffany, one of the directors. Her compassion, professionalism, and unwavering dedication to every individual s recovery journey is something you rarely see. Tiffany doesn t just talk the talk she truly walks with you through the process. Whether it was a rough day or a breakthrough moment, she was there offering insight, encouragement, and a calming presence that made all the difference.The program is thoughtfully designed, blending evidence-based therapy with holistic practices, and the staff are all incredibly knowledgeable and supportive. You re never treated like a number here you re seen, heard, and deeply respected.If you re looking for a place that s not only committed to helping you heal but also to empowering you long after you leave, this is it. I m beyond grateful for my experience, and for people like Tiffany who pour their hearts into the work they do every single day.
salim halabi
2 months ago
Deciding to go and stay at DFC was the best thing that happened too me. The staff and counselors are world class. The education and treatment I received changed my life. Care, compassion, & understanding of my disease from the staff kept me focused on my recovery. I owe my future to this program - and it is looking bright!
Angela Simpson
3 months ago
Wonderful and knowledgeable staff. Nick and Adam are substance abuse counselors who really truly care and their experience was invaluable. This place is truly unique within the recovery community.
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.
This place changed and saved my life. I owe the staff and owners everything. They took a dead man walking and gave me hope through God and the 12 steps of Narcotics Anonymous. If you need a way out I recommend you give this program a chance. It is above and beyond a different take on rehabilitation. The staff really care, the groups are small and even the owners really support recovery. It's a blessing from God or whatever your higher power may be. May you find him today...
Christopher Vincent
5 months ago
I completed my treatment at Enlight Treatment Center a year ago, and it was a truly transformative experience. When I first arrived, I was dealing with the aftermath of a broken jaw and the emotional scars from being tortured at a fake detox center, which left me terrified to trust anyone. The staff at Enlight went above and beyond to accommodate my needs, ensuring I received the best care possible.Understanding my dietary restrictions due to the injury, the chef prepared special meals that were easy for me to consume, allowing me to focus on healing without worrying about nutrition. This attention to detail and compassion made a significant difference in my recovery journey.The comprehensive care I received included a tailored treatment plan addressing both my substance use issues and the emotional challenges I faced. The staff's genuine compassion and understanding helped me slowly rebuild trust and feel safe in my environment. Their dual-diagnosis approach was instrumental in helping me manage co-occurring mental health conditions and regain control over my life.I am especially thankful for their expertise in helping me get clean off Suboxone, which was a significant milestone in my recovery journey. The caring environment at Enlight made all the difference, providing me with the support and encouragement I needed to overcome my fears and embrace a new chapter in life.Reflecting on the past year, I am incredibly grateful for the foundation Enlight Treatment Center provided, enabling me to overcome not only my addiction but also the physical and emotional hurdles I faced upon arrival. I highly recommend it to anyone seeking compassionate and comprehensive care.-Nik
Taylor Proechel
8 months ago
My first time here was ever lasting but my Second time here was and is still one of the biggest reasons I am fully committed and connected to finding myself in so many ways. This place is no joke and is very serious about whatever it may be that you need help with. I met amazing people in the process of being there and of course let me not forget to mention how loving the staff is! Thank you so much with all my heart! -Frankie!
Amazing experience. Highly recommended. Shoutout all the staff especially John, Joey, Tim, both Will s, Canada, Gina, Ginger and all the great therapists as well, everyone is super nice
K Z23
3 months ago
From the moment I arrived, I felt welcomed and cared for. Having a private room was a huge plus it gave me the personal space I needed to focus on my recovery while still managing my work and school. The fact that I could use my phone and laptop was incredibly helpful, allowing me to stay connected and on top of everything while receiving the care I needed.The staff were incredible not only professional but genuinely caring. They treated me like a friend, making the whole experience feel much more comfortable. The facility itself is very comfy. Plus, there were plenty of fun outings that kept me active and distracted in the best way possible.If you're looking for a place where you can focus on recovery while still maintaining your responsibilities, I can t recommend this place enough!
Skyler Hermes
7 months ago
I had the privilege of going through detox at this facility. To say this place is awesome is an understatement. They sincerely care about your well being and health. It's a small facility so they can spend more individual time with the residents. They cater three amazing meals a day along with snacks 24/7. If you are truly thinking about changing your life forever, this is the place you want to start your journey. I highly recommend this to anyone needing help. Thank you for reading. Sincerely Anthony W.
This place is very helpful, the staff are amazing, I didn t think it would be this nice, but it s a huge relief to know that everyone here really cares and genuinely wants to help even tho they didn t know who I was, I can tell everyone here really wants me to be sober and they really give you the tools to be sober
Oh Elio
3 months ago
This center is excellent! The staff truly cares about to healing of each individual that walks through the door.
Lexi Dykes
3 months ago
If you have a problem with drugs, or alcohol and truly want to stop, this is the place for you. Every employee here has been through the same thing and it they know where you are. They are compassionate and give you time to find yourself. They are eager to answer questions and will help you find yourself and back on the right track!
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Frequently Asked Questions
Does Carelon Behavioral Health Cover Methadone and Suboxone Treatment?
Carelon is a strong advocate for medication treatment for opioid use disorder. Methadone and Suboxone are two medications that treat opioid use disorder, but there are others too like buprenorphine and naltrexone. Most of their plans have this option.
You can also get medication assisted treatment (MAT) to help you overcome alcohol misuse. MAT is generally paired with treatment and counseling to help you lay a solid foundation for long term recovery.
How to Verify Coverage With Carelon
If your insurance company uses Carelon for behavioral health services, the way to check what services they have in their network is to visit Carelon’s website. Then look for the tab labeled “Find a Provider” near the top of the page. From there, they’ll ask you to enter the first three letters of the company you’re checking. When you do that, a list of possibilities will appear. Pick the one that you’re looking for from the list.
This will give you the details you need to understand your insurance coverage and find in network providers. If you have any additional questions, you can always contact Carelon directly over the phone.
What Special Features Do Carelon Behavioral Health Plans Have?
Carelon offers a list of special programs you can participate in. Here are some of the ones that people who have addictions might be the most interested in knowing about.
The Child, Young Adult, and Family Health Program uses care managers to help connect you with the right resources from Carelon’s network. Their goal is to intervene early. They use data to help them figure out who’s at the highest risk and then reach out to you proactively.
Carelon also has a network of certified peer support specialists you can access when you have a Carelon plan. A peer support specialist can support you in your recovery because they understand what it means to recover.
Finally, in the Social Drivers of Health Program, Carelon uses community resource navigators to help connect you with local resources. These might include things like food, transportation and help filing for social security.
What Types of Inpatient Addiction Treatment Are Covered By Carelon?
Carelon may cover several varieties of addiction treatments where you stay overnight to get care. The most common is residential rehab which usually lasts a few weeks. The exact length of stay may vary as your progress is reviewed. Once you get to a point where you’re ready for the next step you’ll move on.
Carelon may also cover medical detox. Inpatient medical detox is another type of addiction treatment where you spend the night at the treatment center. It’s usually shorter than residential rehab lasting about three to ten days. It’s appropriate for people who need help getting through the detox process safely and as comfortably as possible.
Inpatient mental health treatment is another benefit you may get access to through Carelon. This treatment is for people whose psychiatric disorder needs acute treatment. It’s very common for addiction and mental health problems to happen together and some people may need to go to an inpatient psychiatric unit to get help for a mental health crisis. Once you are stabilized you will be able to move to a more long term treatment program.
What Types of Outpatient Addiction Treatment Are Covered By Carelon?
Partial hospitalization and intensive outpatient programs are outpatient treatments that Carelon may cover if they’re appropriate for you. In these types of treatment, you spend a part of each day at the treatment center participating in therapy and support groups but you go home at the end of the day.
Standard outpatient treatment is also a benefit that most plans include when they contract with Carelon. This includes regular appointments with a counselor and with a provider who can do your medication management. You may also participate in group therapy sessions.
Does Addiction Treatment Need to Be In Network?
The answer to this question depends on your specific plan. There are many plans that won’t pay for services you get outside the network. For example an HMO generally does not cover care that is out of network. Also, your health insurance plan may only access part of Carelon’s network, so it’s important to verify your coverage before using a service.
There are some plans that allow you to go out of network for treatment. Usually, going out of network means you’ll have to pay a higher deductible and you may also have higher copayments as well. These costs can be much higher than staying in network would be so you would want to be aware of your plan limits before you make a decision to go out of network.
Does Carelon Cover Other Mental Healthcare?
Carelon specializes in covering mental health treatment. The benefits and programs they can offer are comprehensive. They have case management services to help people coordinate mental health treatment from several different providers. They can also offer you help proactively if they see that you’re likely to need a certain service based on your health data.
Does Carelon Have Specialized Support for Military and Veterans?
Carelon works with the federal government to connect military members and their families to a wide range of mental health and substance use treatment services. They also connect plan members to services that are sensitive to the needs of people in the military that aren’t traditionally considered health services but nonetheless support the special needs of military service people and their families. These include support for deployment and reintegration, non-medical counseling and lifestyle coaching that’s specific to military families.
Can I Get Carelon Through My Employer?
There are many employer sponsored health plans that contract with Carelon for their behavioral health coverage. Since this usually happens behind the scenes you may have Carelon and not know it.
You might realize you have Carelon if your employer is offering one of their employee assistance programs (EAP). An EAP supports you in areas of your life that aren’t always health related but that may get in the way of your work.
For example the Carelon EAP can help you with finding childcare or care for elderly relatives. They can connect you with free legal advice and financial counseling too.
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