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.
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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
4 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
Making the decision to go to Beachway was, by far, the most positive and impactful experience of my life. The entire staff was incredible, as was the community as a whole. I felt safe, seen, and supported throughout my stay, and even now, as I continue my healing journey at home. I was completely set up for success in my healing journey thanks to Beachway, and I will forever be grateful.
Beth Hagan
3 weeks ago
My experience at Beachway was a 100/10. The life skills I learned are priceless and that’s putting it lightly. Beachway was the third treatment center I had been to, following the sudden loss of a loved one. I had prior sobriety before beachway and was convinced that I was only there because of a death, and that that was why I was spiraling. The staff at Beachway saw I needed much more help than that. They all knew before I did that if that death didn’t happen, I probably wouldn’t have stayed sober anyway. There was still much more therapy to be done, and more to learn.
The staff took a genuine care in doing so, and looking back at their clinical process they are nothing short of a power house of a team. I never felt so cared for as a human being by people that just met me. The staff quickly became my family, cheering me on while also taking it extremely serious. They are unapologetically honest, which in my experience is the #1 thing needed in recovery. Many of the things they said to me during my time there still stick with me (a year later) and help me navigate life!
I tell anyone that has a loved one with Substance abuse or mental health issues about beachway.
There is no other place like it🤍
Patrick Kelly
3 weeks ago
I owe Beachway my life for sure. I won’t lie and say that I loved every minute of it because I didn’t. A lot of it was very painful, because confronting inner demons is painful. It was a lot of group therapy (especially given how afraid of people I was going in), but they truly helped me gain sobriety and face down my trauma. And they put up with a lot of my crazy behavior while I was going through withdrawals in detox. Like any rehab, you’ll get out of it what you put into it. Surrender to the process for best results. Rehab isn’t a magic wand that makes problems vanish. Rehab gave me the opportunity to accept the ways in which I cause my own suffering instead of blaming everyone around me, while surrounded by professionals who prevented me from hurting myself while my dried out, and helped me identify the underlying causes of my addiction. It will be tough. It will be scary. It will be worth it. I wish I’d gone sooner. The staff there are wonderful and don’t get enough credit. Thank you Beachway.
I have had the opportunity to refer folks to Wellbrook. The facility is first rate. It is clean and welcoming. the staff is extremely professional and knowledgeable. The facility is small so individuals get a lot of hands on encouragement. They stay with you after your discharge. First rate !!!
Mark Saffran
3 weeks ago
Very good environment, Great Staff, Proud to be a part of this program. Helped me alot to find myself and reconnect.
Aj Crisostomo
3 weeks ago
Tour the facility as an employee of another recovery facility and I must say I was thoroughly impressed with the clinical staff, Curriculum and amenities that is offered by Wellbrook tontheir clients! Their alumni support is above and beyond as well!
The staff is unbelievable especially Diana trauma therapist, Gerry, Mo and Brandon in PHP. As far as the beach goes you can only try to get on a list after detox approximately 7 days. They drive 11 people to the beach. There is a list for bowling once a week. A free 15 minute massage is offered if you get on the list once a week. You need to pay for the hour massage, acupuncture, sound therapy and Reiki. The pool is great but can't be used until after detox. It has set hours. You Can’t bring anything with alcohol like perfume and mouth wash. The facility runs pretty cold so bring warm clothes. They hold your razors/ sharpes, suntan lotion and phones plus anything on their list where the techs are located. No phone unless you have a business it’s a set 2 hours that you pay for. It’s from 3-5 or 6-8. The food is okay but remains the same except for the specials. Smoking and vaping is allowed outside in certain areas but sometimes done in no smoking areas. Music is outside but controlled by the techs. The massage chairs are nice but there are only 2 that work out of four. People are late to meetings and constantly go in and out plus hardly ever on time. Activities are often canceled. They just hired a person to run activities. Hopefully things will get better. Overall the residents are welcoming, supportive and caring. If you have a positive attitude and want to learn it will be fun and you won’t want to leave. PHP is a step forward to getting on the right track and re emerge into society. Do the work and you will benefit. This was my first rehab. It was very clean and classes where good. If you want to learn you will. Go in with a positive attitude and you will do great.
Christine Minutoli
1 week ago
Beachside gave me a an opportunity to restart my life and I will forever be grateful. Thank you guys!
Jax Junge
2 weeks ago
Having never gone to a Rehab facility I wasn't sure what to expect.
The staff was friendly, the therapist great and the clinical crew were awesome. The environment is clean and the food is good. I feel the 30 day program was a good fit for me.
Transitions Recovery Program in Miami didn’t just help me get sober it gave me a life beyond my wildest dreams. I walked in lost, broken, and unsure if real change was even possible. What I found was a deeply compassionate and structured environment that not only supported my recovery, but challenged me to grow in ways I never thought I could.
The staff is incredible many of them are in recovery themselves, so they get it. They met me where I was without judgment, but also didn’t let me stay stuck in old patterns. The clinical team, the group sessions, the one-on-one therapy, and even the everyday accountability they all played a part in reshaping how I saw myself and the world around me.
What really sets Transitions apart is that they don’t just focus on staying sober they teach you how to build a meaningful, fulfilling life in recovery. They helped me reconnect with who I really am, helped me process trauma, build healthier relationships, and most importantly, believe in myself again.
I’ll never be able to fully put into words how grateful I am for this place. Transitions helped me reclaim my life and then some. If you’re struggling, if you’re feeling hopeless, please know that change is possible. This program showed me that.
Chaston karr
3 months ago
Transitions literally saved my life. It’s like no other rehab I’ve ever been at before, I’ve been to over 20 different rehabs and this one will definitely be my last lol. The staff here treat you like family and really care about you here. The outings were always so much fun, the groups were great, and I love how it’s a reality based program. 10/10 if you are thinking about coming here do it. Shout out Abe, Will, Shiffra, Josh, and Austin 🐐🐐🐐
Camille Greenwald
3 months ago
Very great program, if you want to better your life, get on track mentally and physically, here is the place to go. Abraham is the best. Mark my words!!
This place is amazing! From the community to the staff and the nurses! If anyone needs help with addiction Swift River is the place to be ! Thank you !
Much love
Thomas McMaster
Thomas McMaster
1 month ago
Great place great community, great staff, all around great experience
This is the only place I know of that will truly help you if you are in crisis with addiction. Brad, Joey, Thomas, and Jenelle are the best care team I have ever met. I love you all!!!!!!
Mark Clausius
1 month ago
I just left allure and it checking myself in and staying there to complete the residential after detoxing was the best decision I’ve made in decades. The clinical director Brad and the operations director Joey have an amazing staff around them. Most are in recovery and they UNDERSTOOD me. Going to treatment can be nerve wracking and their team made sure I was comfortable and welcomed. I spent over 3 weeks there and not once did I feel out of place or unsafe. They helped me work through all of the problems i had in my life when I admitted myself in the wake of my active addiction and I left with a purpose and the guidance and aftercare I needed to remain sober in the future. There’s no magic pill or wand to cure sobriety but they genuinely care and motivate you to put in the work and learn the tools to stay clean. If you’re tired of the consequences and pain/suffering from active addiction then find a way to get into allure right now. They’ll save your life and help you build a new one.
- Derek
P.S. HUGE shoutout to all the tech and therapists at the center, you guys make that place. All the nurses and the medical provider, Chris, Joey, Brad, Phillip, Janelle, Beth, Michael, Erica, John, Sam, Anthony, Tim, Richard, Barbara, Larry, Michelle, and every other tech was amazing. Sorry if I didn’t list you but all yall rock. I’m sober bc of you
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay Options
I am very grateful for New Life Recovery Centers for giving me all the support, care,love and treatment I very well needed. I am very well on my way to a very prosporous and sober future. I want to thank all the Counselors and staff for understanding my addiction and giving me the all the tools necessary to overcome it. I want to thank Jake who was my counselor there very much for his support. Thank you for everything. You are all my Hero's. God Bless you all.
Javier Sanchez munguia
2 months ago
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
5 months ago
At first I was nervous and scared. I felt rehab was like a hospital ward. Once I arrived from the intake coordinator Janet was so caring, helpful and compassionate. Gregg who drove us to center and Dr Calloway office eased my nerves. Both had a lot of good conversations. Once I got to the center. I was welcomed by my sober mate which I still keep in contact and others. My counselor Jake was amazing very informative, compassionate. All of the counselors including Cdtechs as well. I literally cried when I left I felt it was my second home. Chef Shilpa always made amazing meals that I ever had. I felt very spoiled. My time there was very structured, educational and informative. Provided the tools for me to stay on my sobriety journey. There is so much more I could express about my experience. All I can say I was very blessed, grateful for New Recovery 🙏🏼💖🙏🏼
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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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