Explore how Medical Mutual covers drug and alcohol rehab, including inpatient and outpatient options. Learn about eligibility and plans.
Medical Mutual of Ohio Coverage for Drug Rehab
Explore how Medical Mutual covers drug and alcohol rehab, including inpatient and outpatient options. Learn about eligibility and plans.
Medical Mutual is a family of companies associated with the parent company Medical Mutual of Ohio. Most Medical Mutual health insurance plans are located in Ohio but there are some in certain counties of Kentucky, Florida, and Indiana.
Medical Mutual of Ohio, where the company started and is headquartered (in Cleveland), serves 1.6 million customers throughout Ohio. They have more than 43,000 primary care and specialty providers in their HMO network, located in every Ohio county. Medical Mutual of Ohio is a mutual health insurance company, which means that it is owned by its policyholders. Insurance coverage is provided to members at or near cost and profits and investments are shared with members.
Does Medical Mutual Cover Drug and Alcohol Rehab?
The 2010 Affordable Care Act requires most health insurance plans to cover mental healthcare and addiction treatment. Therefore, most Medical Mutual plans should cover some forms of drug and alcohol treatment.
There are exceptions to the law, however, and services will vary according to the policy you have. Before starting rehab, it is important that you verify with your insurance company the details of your coverage and the treatment options available to you.
It’s important to note that insurance coverage is based on medically necessary care which usually means that a primary care physician has diagnosed you with an alcohol use disorder (AUD) or a substance use disorder (SUD) and has created a treatment plan for you to address it. You will want to work closely with your doctor to ensure the treatment plan meets your needs.
Hello im Ashley and im an addict. My whole life has been filled with chaos and trauma. Some from my own doing and some that wasnt my fault. There is not a single bad word i can say abouy my experience at Beachway Therapy Center. My time there was cut short thanks to my own self-sabotaging behavior. Even then Beachway still treated me with compassion and the desire to help me. My situation was a unusual one. I came into the trauma program with a clean date of April 16th 2014. So at 11 years clean i was dealing with bipolar disorder, intense anxiety, a very unhealthy toxic relationship and an intense desire to break generational curses for my children. My history is one that involves homelessness, street drugs and a street mentality. Beachway took on the challenge of helping me work thru that trauma. I opened up to the program and other woman like never before. I had an amazing counselor, amazing case manager, and amazing staff that were there anytime i had moments of high anxiety or worry. I am so disappointed i ruined my chances of having a chance at going thru a trauma program with Beachway. Just in the short time i was there i did gain a small sense of self back. If you were like me and worry about making friends with the other clients because they wont understand you or like you, that is not even close to true. I found a sense of community that i couldnt find anywhere else in my life. If i manage to find a magic lamp, one of my wishes would definitely be used on looking young forever after that id wish to feel the peace and serenity i felt at Beachway. Thanks to them i had just enough courage to get me and my kids out of my bad situation. Now my goal is to continue with trauma therapy. Do not be me and let your past dictate your future. No matter how clean you are from drugs that trauma will creep up on you and when it does use tools like Beachway to seek help instead of the alternative, and please for the love of your higher power get out of your own way and accept their help before you get kicked out like i did. I am forever grateful. Thanks for letting me share my expierence, strength and hope.
Ashley Wilburn
1 month ago
My experience at Banyan was very good. The staff was very helpful, the therapy was extremely beneficial , and the food was great! Like with all rehabs, it is what you make of it. If you go there thinking everything is perfect, you’ll be disappointed, it’s not. If you go for simply a social experience, it’s not a resort. If you go because you’re serious about your recovery, it’s a great place to take the first step !
Brian Koppen
1 month ago
Loved Beachway. I was extremely anxious with everyday panic attacks, and the medicine was no longer working. At Beachway I found a way to control my attacks and anxiety. It is not easy and sometimes I felt like it wasn’t going to work.
We worked through my childhood traumas and I learned techniques on how to defuse my anxiety.
Loved Dina’s honest and hardcore classes and also Gigi’s trauma class.
From the intake department, to the counselors, security, kitchen staff, Directors, Nurses and everyone that worked there I thank you. ❤️
Prosperity Haven/ Wellbrook Recovery is such a wonderful place that helped me get sober. From the moment you walk in, everyone is so warm and welcome. When looking for a facility, WRC covered all the bases with being male only with fewer patients than a traditional set-up.The group instructors are diverse and will push you to be vulnerable and work outside of your comfort zone. There are all different types of therapies that are used to help you heal.The entire place/ program is about fellowship. Seeing the alumni come through the doors and support the guys in the house was huge for me.10/10 would recommend this facility to anyone seeking sobriety!
Brock Spurling
3 months ago
Prosperity is an excellent facility. They have an amazing and knowledgeable staff there to support clients throughout their stay that show a genuine Interest in client long term success. They do a fantastic job of making sure needs are met, including helping with coordination of any after care. I highly recommend this facility to anyone seeking to improve their situation.
Brandon Epp
3 months ago
I worked at Prosperity Haven for two years. Working here was a truly transformative experience, both personally and professionally. The leadership at Prosperity Haven was exceptional supportive, open to feedback, and always striving to provide the best care possible. The culture of compassion and respect that permeates the facility is remarkable, and it s evident (in everything they do) that the staff is fully committed to the mission of helping individuals heal and thrive. If you're looking for a place where you can start or pick up your recovery journey in a supportive and compassionate environment, I cannot recommend Prosperity Haven Treatment Center highly enough. The success stories I got to witness were genuinely life changing and my time there was an experience I will always cherish.
I had a wonderful experience here. Michelle and Jenna were incredible and made this process so much easier.
Even being away from home I felt comforted and cared for.
Sheryl S
1 month ago
This place was amazing best treatment I ever had staff was always friendly never had no problems with any of them they was always very supportive always was there when you needed them Rollie,Chris,shakara,Joey,vlad,Cierra,ms.b.gabriella was my favorite people ever always joking laughing having fun was very interactive they just made it so much fun and made the day go by so fast they are such amazing people
Justo TheMenace
1 month ago
The staff at Allure are great. The facility is clean and updated. Felt comfortable and safe the entire time. Addiction therapy was put in a way that made sense and felt empowering. Definitely won’t forget my time there.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay Options
I didn’t them a five because they don’t offer virtual therapy options. Other than that, they offer great care and really helped me in my recovery. The staff was super supportive and used evidence based methods, which helped with the combo of addiction and mental health stuff I’ve been dealing with. Their women’s groups felt safe and afirming, which made a huge difference for me. I’m grateful for the help I got
Marlene
2 months ago
I cannot thank this recovery program enough for the impact it's had on my life. It has been my rock, my greatest source of support, and the foundation of my journey to healing and growth. The program provided me with structure when I needed it most, guiding me step by step toward a brighter future.Through its compassionate and empowering approach, I found the confidence I thought I'd lost. It showed me how to rebuild myself from within and, most importantly, how to love myself again. This program is more than just a resource; it's a life-changing experience that has helped me rediscover my strength and worth.To anyone considering this program it's a gift you can give yourself, one that has the power to transform your life, just as it did mine.
Javanna Ly
3 months ago
Being there for detox and recovery has completely changed my life! I can't say enough good things about the medical staff, and the counselors! I was there for 38 days. I went in as a broken person and came out a new man. My counselor Jake was amazing and helped me in many ways. The chef there makes every meal amazing. On the administration side of things Janet was super helpful to me and my Wife. The Saturday family meetings/visits were very beneficial for us. If you in need of a place for inpatient recovery this is a great place to go.
Great support and accountability, staff is friendly and reliable. Rick was amazing to work with.
Toby Bell
3 months ago
Highly recommend attending outpatient for anyone struggling with addiction or coming out of in patient treatment. The longer term support is essential to staying accountable, being with your peers, and building the life skills to stay sober. Lakeside is attentive and flexible in order to meet your needs; I ve had a really positive experience being in their care.
Kind and professional, provided more care and understanding then I've seen in awhile. Was able to assist in the exact way that I needed it.
Huerta Layne
2 months ago
Best doctor I’ve ever talked to. Very knowledgeable and made me feel comfortable and heard.
Phelps Martin
2 months ago
Excellent providers, they are here for you, to make sure they do all they can to meet your needs. I was treated with great respect and friendliness. I will be recommending and this is my practitioner from now on. Thank you guys for the awesome attention to your patients.
I had a great experience here at Swift River. I detoxed else where, but when I arrived here I was very nervous how everything would play out. All of the staff and peers I had around me were very welcoming and comforting in my transition process. I completed the full program, and although I have a good form of nervousness to leave I am quite excited to continue on my sober journey.
Jack Langley
2 months ago
Beautiful location very helpful wonderful staff
Nina Marie
2 months ago
Had an awesome experience here! It wasn't my first rehab but it was definitely the best program, an enjoyable program and everyone was extremely nice! Would definitely recommend it to a person in search of recovery!
Amazing alcohol and substance program that is tailored for every person who walks through the front door! Five star meals, along with kind and caring staff, make your stay here more than welcome! If you or a loved one is struggling with addiction, I highly recommend they come to Williamsville wellness and recovery.
Victor Burgdoerfer
2 months ago
Delicious food and a relaxing place indeed! Highly recommended!
Thomas Trimble
3 months ago
Choosing Williamsville was the best decision of my life! They offer personalized support for substance abuse and gambling issues. A perfect place for help. Thanks for everything!
I've been going here for 6months and before that I was at the VA. There's a few differences between them both but most of all I can tell the Care. I have had 2 Counselors which is understandable considering the work load they have. Since the begining I have been happy and impressed how easy they made my transferring. I started just where I left off at the VA.The only thing I don't agree with or understand is when getting an increase u have to pick up for 3days before getting ur tak homes. I can understand this policy when u a starting out. But it doesn't make much sense after that. I can also say when there was a problem with my pick up (ther Mistake) my councler fixed and had all my bottles in 30mins. All I can say is If u work the program it works. Thank you
Kevin Armstrong
4 months ago
This is the only MAT program clinicnive ever been to but they have been amazing. If you are serious about your recovery they most definitely are going to help you. I've had a couple friends go to other clinics and from what was said FCCR is more strict and that's so important. Especially if you are serious about your recovery and do really want to better yourself and your life. The office staff is amazing there. The nurses are wonderful. I've had 3 different counselors due to 2 of them moving on to better their lives, but every counselor I have had has been wonderful. Very helpful. Easy to talk to. Thank you FCCR for being there and helping me better myself and my life. "It works if you work it"
Micaela Tarr
1 year ago
IT'S A GREAT PLACE IF YOU'RE SERIOUS ABOUT REMAINING SUBSTANCE FREE. MY COUNSELOR IS THE BOMB!!
All the staff is great. Very helpful place. I would recommend for someone who is going through a rough patch in life
Anthony Mazzamuto
4 months ago
This place saved my life jeff is amazing nitza and john are the BEST therapist's I've ever had Erica and shifra are the BEST nurses ever Abraham will Talia Ms Janet art Robert Austin are the BEST techs ever Dr k Felicia Tyler kitty are the BEST group facilitaters ever if your struggling with addiction pick up the phone and come here this place is absolutely life changing I'm becoming a new person because of these amazing people who care so much absolutely the best center
Nicholas Duvall
5 months ago
My experience at Transitions was a positive one. The staff was helpful and courteous. The techs really make the difference Abraham the Housing Director was great & should be applauded for the techs he hired especially Will, Talia, Rob, Austin, Art and Janet. I would highly recommend giving this place a try. The new Clinical Director, John was amazing therapist to me while I was there together with Nitza. My favorite group leader was hands down Dr. K. & Kitty. Thank you Transitions Family for all you ve done for me. God Bless.
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Frequently Asked Questions
What Are Medical Mutual Plans?
Medical Mutual offers a variety of plans. They offer individual and family plans through the Ohio Insurance Marketplace. You might also have one of these plans through your employer. Medical Mutual plans are Health Maintance Organizations (HMOs), which means you’ll need to get care within the provider network. You’ll also need a primary care doctor that will give you referrals to specialists such as addiction counselors.
If you qualify for Medicare, you can also get Medicare plans through Medical Mutual. If you have Original Medicare, you can get a Part D prescription plan and/or a Medicare Supplement plan. Another option is to replace Original Medicare with a Medicare Advantage plan. Advantage plans offer the same coverage as Original Medicare but generally include additional benefits as well, such as vision, dental, and hearing coverage. However, you will likely need to use the plan’s network providers and you might need preauthorization as well.
Finally, Medical Mutual offers add on plans such as separate dental, vision, accident, and life insurance.
What Inpatient Addiction Treatment Does Medical Mutual Cover?
Medical Mutual will usually cover inpatient addiction treatment if it is a medically necessary part of your treatment plan. You may need preauthorization and/or a referral from your primary care physician, depending on your insurance plan.
Inpatient treatment often takes place in a hospital or clinic. But sometimes it is provided in a residential facility that offers a more home like setting. Inpatient care provides around the clock monitoring in a structured environment. Treatment is provided by credentialed staff and living accommodations and food are included. Inpatient or residential care removes you from the temptations faced in everyday life and allows you to fully focus on your treatment. In cases of a severe addiction or a dual diagnosis or another health issue requiring close monitoring inpatient or residential rehab provides a good option.
During inpatient treatment medical detox is often available. This process gives you medical care to manage withdrawal, including medication-assisted treatment (MAT). During MAT FDA approved medications aid withdrawal and reduce physical symptoms that are associated with it helping you be safer and more comfortable while going through detox treatment.
What Outpatient Rehab Does Medical Mutual Cover?
Addiction treatment delivered in an outpatient setting is covered by most Medical Mutual plans in line with ACA requirements. Your insurance company can verify details about your plan’s specific outpatient addiction treatment coverage.
Outpatient treatment does not provide overnight care. You return home following your treatment sessions. This allows for more flexible scheduling so that you can accommodate work or family obligations. But since you will still be in an outside environment you’ll still face the stressors and temptations that are present there. An outpatient treatment program works best for people with mild to moderate addiction or those who have recently completed an inpatient or residential program. Outpatient detox can also be helpful for those who have a low risk of experiencing severe withdrawal symptoms.
Outpatient treatment can include a partial hospitalization program (PHP) with at least 20 hours of treatment per week that is scheduled over 4 to 7 days and lasts 3 to 4 weeks. Or it can involve an intensive outpatient program (IOP) that provides between 9 and 20 hours of programming a week and lasts 4 to 8 weeks.
The least intensive option is a regular outpatient program (OP) that meets once or twice a week for one to 1.5 hours, or up to 3 to 4 hours, each day. The length of outpatient programs differs by facility but 30 days is a typical program length.
Does Medical Mutual Cover Suboxone & Methadone (MAT)?
Medication assisted treatment (MAT) involves prescribing medications such as Suboxone and methadone to treat withdrawal symptoms during detox and to manage cravings during rehab.
Longer term MAT is for those who struggle with opioid or alcohol misuse. It’s generally paired with evidence based treatment so you can build a strong foundation for ongoing recovery. Managing cravings helps lower the risk or relapse and overdose. Over time you’ll taper off the medication support so you can live truly substance free.
MAT may be covered by your Medical Mutual plan. However, it’s important to verify your coverage before you get your medication. You may need a referral or preauthorization to ensure you get the coverage you need.
Done Medical Mutual Cover Other Mental Health?
Mental health treatment is covered by Medical Mutual health plans. It’s important to find an in network provider to take advantage of this coverage. Medical Mutual members can visit the company’s website to find appropriate mental health care professionals who are covered by their plan.
Mental and behavioral health services are covered by Medical Mutual plans. These services include treatment for substance use disorders as well as anxiety, depression, and other mental health concerns. Both inpatient and outpatient treatment are covered by Medical Mutual plans, as well as telehealth options. Copays may be required. Members should refer to their Summary of Benefits and Coverage to learn more.
Does Addiction Treatment Need to Be In Network?
Most Medical Mutual plans are HMO plans that do not offer out of network coverage. A few Medical Mutual plans may offer an out of network option. But these plans would usually involve greater out of pocket expenses such as higher costs for deductibles and copayments.
Using an in network provider will likely be your most cost effective option. But if you choose to go outside of your network carefully review the details of your insurance policy to compare the service options and expenses involved.
How to Verify Coverage With Medical Mutual
You can verify your healthcare coverage by calling the customer service line at Medical Mutual or by logging onto your online Medical Mutual account. This will give you details about your coverage and help you find in network providers.
You could also call the addiction treatment center that you’re thinking about attending and ask if they accept your specific insurance plan. In that case you’d need to make sure that you correctly state the exact name of your plan. There are many different plans and some may have similar names.
What to Do if Medical Mutual Won’t Cover the Cost of Rehab
If your insurance plan doesn’t cover the cost of your rehab, you still have options. There are ways to pay for treatment without using insurance.
Many treatment centers have reduced fee payments based on a sliding scale. This allows you to pay less depending on your income and household size. Using this sort of treatment center can make rehab much more affordable. However you will want to make sure they are properly accredited and have licensed clinical staff.
Affordable government funded substance abuse treatment programs are available in almost every state. Some addiction treatment programs are run by county governments as well. You can find information about these programs by visiting the official government web pages for your state or county. You can also visit your state or county’s Mental Health Department’s website. Addiction treatment offered by government subsidized rehab facilities may be free or at least available at a very low cost.
Another free option is the Salvation Army Rehabilitation program which allows you to exchange work in one of their facilities for the cost of treatment in their addiction program. Visit the Salvation Army website to find links to their rehabilitation centers which are located in many states.
Other options include applying for a grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA addiction treatment grants are available in all states. Financial assistance may also be available through scholarships or grants offered by some advocacy groups or churches.
Finally, you might consider using a credit card to pay for your rehab treatment. CareCredit is a company that markets credit cards for specific use for healthcare needs. Or you might borrow money from your family or friends. What’s most important is to get the rehab you need so be diligent when searching for funding options.
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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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