First Health Network Insurance Coverage for Addiction Treatment
Explore First Health Group’s comprehensive provider networks for addiction treatment and mental health services. Get the support you need.
First Health Network Insurance Coverage for Addiction Treatment
Explore First Health Group’s comprehensive provider networks for addiction treatment and mental health services. Get the support you need.
First Health Group is a wholly owned subsidiary of Aetna. They provide national and regional preferred provider organization (PPO) medical networks to national and regional insurance carriers as well as employer groups and more. They also offer a national dental network and have solutions that help insurance plans reduce the cost of non network care.
First Health serves more than 260 clients who pay for healthcare and their 1.4 million members. They are able to use Aetna’s pricing power and credentialing process to provide access to high quality providers at an affordable cost.
Does First Health Cover Drug Rehab?
First Health Group doesn’t provide insurance coverage so they do not decide what services are covered or at what level. However most insurance plans are required to cover mental health and addiction treatment and First Health may provide the medical networks that you use to get care through your insurance provider.
First Health offers access to multiple provider networks, including a primary PPO network that has more than 5,700 hospitals and 52,000 other medical facilities. The networks provided by First Health will have professionals who can help you address addiction and mental health concerns.
Every insurance plan is different so be sure to verify your coverage details before you begin treatment. For example you may need to get a referral or preauthorization depending on your plan.
When reviewing possible treatment centers or checking plan compatibility, you can learn more about rehab options to explore providers that align with your coverage details.
This place is amazing, they will show you how to redirect you life for the better. Don't knock it until you have tried it
Courtney Weaver
1 week ago
Avenues is beyond amazing!!💗🙌🏼 The support, both staff & clients is amazing. The curriculum is so life changing centered around your addiction as well as mental, emotional & physical health. I finally understand it all which really helps finally knowing what to do!!
Sara Eddelman
1 week ago
Avenues Recovery center is a very good place love the staff love the facilitators love the case managers there's a lot of good help here
This has been my first time in organized recovery and I must say. It has been an absolute delight. The staff is amazing and really work with you on a different level. Foods great and the beds are comfy. I finally see the light diminish on my addiction I have the tools to define my journey
Jason Bonesteel
2 days ago
came to Fort Wayne Avenues utterly lost and fundamentally broken. The journey from Indianapolis was the final, agonizing stretch that delivered me to my absolute rock bottom.
The moment I truly needed help, I received it. I remember that phone call in the middle of the night—a promise kept, followed by the immediate, compassionate arrangement of a ride. Standing there in the rain, awaiting an unknown fate, I was filled with dread, yet something shifted upon arrival.
I was instantly greeted not just by staff, but by warm smiles and palpable high vibrations. The entire team was immediately welcoming and understanding. I won't lie; there were many times I considered walking away. But I stayed because of the extraordinary intervention of some of the best staff members I have ever had the privilege of knowing. For the first time, I felt genuinely heard and understood. It was a powerful realization that so many of you were in long-term recovery yourselves, carrying years of clean time and wisdom under your belts.
Thank you, from the deepest part of my heart, for believing in me when I couldn't believe in myself, and for giving me the tools I needed to finally tame my beast.
I am walking away from Avenues feeling confident and determined. I know I can do this. I am now confidently charting my course toward the beautiful, fulfilling life I truly deserve.
With endless gratitude, Thank you, Avenues.
Anjellise Summers
2 days ago
This was a much better experience than I could ever have anticipated. The staff was very understanding and helpful. They have an alumni program that keeps you connected and informed with meeting and outings and check up on you periodically to make sure you're still doing well. They embrace you with open arms and there's zero judgement. If you're considering a place for treatment or to heal, I highly recommend Avenues.
White Sands is the best treatment center. They truly care about every patient. The therapists are top notch and address every areas of concern. The entire staff has integrity , are kind , caring and honest while no one is watching. I took away the tools to help me fight this ugly disease. I pray I never have to return, but if I did they would welcome me with open arms. Thank you to everyone that assisted me with recovery.
MPS stevenson
1 week ago
Recovery is not a linear process and White Sands has been there to break my fall. There’s undoubtedly something special about it , like it’s got God’s anointing. Every single BHT/ counselor/ therapist/ doctor/ even the cleaning crew are the most pleasant and want the best for you. When a lot of the patients resolve to wanting to work here one day is a common trend you know they’re doing something right. I cannot say enough good about White Sands, and I’ve been given all the tools I need to not return! Those who are searching for their place to find treatment - your search has ended.
I can't thank Ashwood enough for all of the tools and knowledge they gave me to successfully continue through my recovery journey. All of the staff is very attentive to your needs and I was actually sad to graduate. Big shout out to the entire team and the sober community I created!
Robin Kroencke
2 weeks ago
Ashwood is great, they are there to help in whatever way you need. Push you to exceed your own goals to see you do your best.
I’ve referred some of my closest family, friends and other professionals to Acqua and had an amazing experience across the board. They have an incredible team and make treatment truly accessible for everyone. Highly recommend!
Catie Cartisano
3 weeks ago
Acqua is a wonderful place to learn to love yourself again, and get the tools you need to lead a happy life of freedom from the challenges of addiction and mental health. Everyone deserves a chance to experience self love and happiness and connection. The opposite of addiction is connection and you can find that at Acqua Recovery.
Joede Dudley
1 month ago
This is where my sobriety journey began, though I did not complete my month here and stay sober I have now been sober for two and a half years and I would love to work for these guys one day.
Very satisfied !!
My experience was amazing. all staff and therapist was very concerning, and caring..
I would recommend anyone who is considering Woodland recovery center It's a great decision. Hope to see you soon. !!
Kenneth Walker
3 weeks ago
The staff work very hard and care as much as they can doing it! The food is good thank you very much yall. The counselors are very good. The nursing staff is good as well and I always felt safe. I highly recommend this detox center.
This place is amazing. Amazing staff. Attractive facility. Very therapeutic. Attention to everyone's needs. Highly recommended. I wish I knew about this place 4 treatments ago.
Marco Hernandez
6 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
Coastal was tough and fair…they prepared me for the real world!
The food is fabulous and the staff is wonderful!
peter haines
1 week ago
I just want to thank all of you from the bottom of my heart for the care and compassion you showed me during my stay .You helped me through one of the hardest times in my life with kindness, patience and understanding . Because of your support ,I found hope and strength again .I'll always be grateful for the way you helped me start this new chapter of my life . With love and gratitude you gave me freedom back from addiction to freedom after 15 years of being on opioids . Thank you for the true blessings I've received . Loretta
Loretta Slone
4 weeks ago
These people go over and above the gold standard of treatment in South Florida!
Manicured detailed excellence from the owners, chefs, medical staff, BHT's, and housekeeping!
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Frequently Asked Questions
What Provider Networks Does First Health Group Offer?
First Health offers multiple provider network options to clients. Some are primary networks that can be used as a foundation for care while others are supplements that help improve a plan’s network and fill gaps in care. Along with these national networks, First Health offers regional networks in Michigan and the Midwest.
The main offering is the First Health Primary Network. It’s a PPO network with more than 993,000 professional providers across the country. It can be used by plans that want to have a single high quality network and by plans that have a local network and want to add national coverage through First Health.
They also offer First Health Complementary Network, which is a national network that helps insurance plans expand their primary network while still saving money on care. A plan can pay these providers through an in network arrangement or an out of network setup.
For non-US residents who come to the U.S. for care or are visiting the United States and need healthcare during their visit, the First Health International Network can help. Companies that offer travel insurance most often use this network.
The First Health Limited Benefits Network is available for clients who want to offer limited health coverage that doesn’t include major medical. This network can also be used for minimum essential coverage which only covers preventive services in the Affordable Care Act (ACA) and CMS requirements.
Finally the First Health Share Plan Network is available for cooperative health share plans where members pool money together to help pay for each other’s medical needs. These plans are not insurance and coverage is not guaranteed but the Health Share Plan Network can make it easier to offer members affordable providers.
Does First Health Cover Mental Healthcare?
There are a variety of mental health care options when you are diagnosed with a mental health condition. This can include various behavioral therapies such as cognitive behavioral therapy and dialectical behavior therapy as well as motivational interviewing. Other care options include medication management and lifestyle coaching to address changes like nutrition and mindfulness as well as exercise.
Mental health treatment can be administered as an inpatient or an outpatient and in individual or group therapy settings. Support is typically offered by psychiatrists or psychologist or licensed counselors. Mental health conditions may occur independently or as co occurring disorders. Treatment of co occurring disorders requires integrated and simultaneous care for both conditions to increase the potential for successful treatment.
Most healthcare plans provide coverage for mental health treatment as regulated by the Affordable Care Act. This is for individual mental health conditions or co occurring disorders. However there are exceptions so you must check your insurance coverage with the insurance company to determine your benefits. Since First Health does not provide insurance coverage they also do not make decisions about benefits and limitations.
What Inpatient Addiction Treatment Does First Health Cover?
Many insurance plans offer benefits for inpatient addiction treatment. First Health has a network of providers with whom your insurance plan collaborates to provide care. You must use a provider within the First Health network to receive in network benefits. Some insurance plans offer out of network benefits, but you typically pay more for deductibles and co-payments.
Insurance coverage focuses on providing medically necessary treatment. A treatment plan from your physician or completion of a comprehensive tool from the American Society of Addiction Medicine (ASAM) can help document medical necessity. The ASAM assesses your needs across six factors including emotional and behavioral issues and relapse risk as well as intoxication and withdrawal potential and readiness for change. The assessment helps clinicians determine the appropriate level of care.
Your addiction treatment may begin with medical detoxification. This is often provided in an inpatient or residential care setting where you receive 24/7 supervision and support. Medical detox may be accompanied by medication assisted treatment (MAT), including FDA cleared prescription medications to reduce symptoms of withdrawal.
Once addictive substances have cleared your body you transition into evidence based therapies that address addiction triggers and negative thought patterns as well as help you develop healthier coping strategies. These can include cognitive behavioral therapy and motivational interviewing as well as patient centered therapy. Your highly structured and customized treatment programs provide you with long term benefits that promote sobriety and sustainable recovery.
What Outpatient Rehab Does First Health Cover?
First Health offers a comprehensive network of providers for outpatient care. Using a provider within the First Health network helps maximize your insurance benefits but it’s important to contact your insurance company to get full details before starting treatment.
Outpatient therapy may begin with a partial hospitalization program (PHP) that provides a highly structured and intensive therapeutic environment during the day but allows you to return home in the evening. Many PHPs offer the same level of care as you receive as an inpatient and are ideal when you do not need 24/7 support and supervision.
An intensive outpatient program (IOP) has more flexibility than a PHP. Some centers offer IOPs during the morning or afternoon or evening hours to allow you to meet other family and work or school obligations. After a comprehensive evaluation to determine the necessary level of care you may be admitted into a PHP or an IOP to start your outpatient rehab.
As you progress through the program you usually graduate to a general outpatient treatment program that provides care once or twice weekly. Aftercare programs help provide support in your recovery journey. Aftercare can include weekly or bi monthly therapy along with 12 step community programs, vocational training and educational support.
Does First Health Cover Methadone & Suboxone (MAT)?
MAT is an effective strategy for both medical detoxification and ongoing treatment of opioid and alcohol use disorders. In the initial medical detoxification FDA cleared prescription drugs can help reduce withdrawal symptoms and prevent some life threatening complications associated with detoxification from certain drugs. MAT is also useful for ongoing treatment to reduce the risk of relapse and the risk of overdose.
Typical medications are methadone and buprenorphine as well as naltrexone and Suboxone. Methadone and buprenorphine are prescribed solely in opioid use disorder. They are opioid agonists — activating the same receptors as opioids without producing the euphoric high. Naltrexone is used in opioid use and alcohol use disorders to reduce the risk of relapse. Suboxone is a combination drug of buprenorphine and naltrexone.
MAT is generally combined with evidence based treatment to help you establish a solid foundation for long term recovery and then you can slowly stop using the medication support and live a fully substance free life.
Does Addiction Treatment Need to Be In Network?
The First Health network is a preferred provider organization (PPO). When your plan uses First Health providers you may also have coverage for out of network care as well. However using out of network providers increases your out of pocket expenses and will cost you far more than using an in network provider.
Most out of network providers do not file insurance paperwork. This means you pay the cost of care up front and must file the paperwork to your insurance plan to be a reimbursed at a lower rate. When you receive care from an in network provider you pay the co-payment up front and the provider completes the rest of the paperwork. You can maximize your insurance coverage by finding high quality in network providers for inpatient and outpatient addiction treatment.
How Long Will First Health Cover Rehab?
Your insurance provider limits the duration of your coverage for drug and alcohol abuse treatment based on medical necessity. First Health does not determine coverage benefits. An initial comprehensive assessment that includes the substance and severity of addiction as well as your home environment and any co occurring mental health conditions helps determine medical necessity. This information may also be used to determine if inpatient or outpatient care is required.
Most treatment centers have residential care programs that last 30 or 60 or 90 days. Outpatient treatment programs can last for a similar time. The length of your program is determined by your initial evaluation and by ongoing assessments to determine your progress. It’s important to embrace your treatment program and complete all the steps. This gives you the best chance at achieving sustainable long term recovery.
How to Verify Coverage With First Health
There are several ways to verify your coverage for drug and alcohol addiction treatment. First Health does not make decisions about insurance coverage so it’s important to verify your benefits and limitations directly with the insurance plan. You can contact their customer service or member services phone number or login to your online insurance account. These resources can provide you with information about what your insurance plan does and does not cover.
You also want to identify the healthcare providers and treatment centers that are in your plan’s specific network. Each insurance provider decides how they use the First Health network.
Most treatment centers can verify your insurance coverage and determine your estimated out of pocket expenses by speaking with your insurance provider. The treatment center requires the insurance provider’s name and the specific plan as well as your member or group plan numbers for accurate information.
Calls to any general helpline will be answered or returned by a paid advertiser.
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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