Discover how Tufts Health Plan covers addiction treatment, including rehab options, medication-assisted therapy, and mental health services.
Tufts Health Plan Insurance
Discover how Tufts Health Plan covers addiction treatment, including rehab options, medication-assisted therapy, and mental health services.
Tufts Health Plan is a nonprofit insurance company that started in 1979 and operates out of Massachusetts. They provide health insurance to a half million residents of Massachusetts and Rhode Island. In 2021, Tufts Health Plan merged with the nonprofit Harvard Pilgrim Health Care and rebranded as Point 23 Health. They provide insurance to people of all ages and take part in community-based programs, such as food assistance initiatives.
If you’re exploring different rehab facilities or confirming plan requirements, you can learn more about rehab options to look at programs compatible with your coverage.
By Eli Wood
Eli Wood is a content writer and content strategist specializing in healthcare, mental health, and LGBTQ+ sexual health and wellness. They have written for American Addiction Centers providing health insurance resources and information, as well as writing and reviewing detailed medical insurance and product pages for various platforms.
Medically Reviewed by Anna Spooner
Anna has 10 years of experience in insurance and has been a content and copywriter since 2011. She strives to make all of her writing approachable and easy to understand while drinking copious amounts of tea. Anna writes about accessing addiction treatment, insurance, and finance.
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Self-Pay OptionsPrivate insurance
The trauma group runs three times a week, Tuesday, Thursday, and Friday. I'd been to programs that mentioned trauma-informed care and then gave it maybe one session. Here it was built into the schedule in a real way, with a dedicated trauma therapist. That frequency made a difference because you actually had time to open something up and then come back to it before too much time passed.
Daniel Harrington
1 day ago
Overall great faculty, would definitely recommend patients to commit to PHP IOP here, all the facilitators are super helpful and hold very informational groups, Dr Nicole and Pastor Dan played a big role in my recovery and pushed me to do better every step of the way I highly recommend seeking help advice and opinions from them as well.
Robert Mckasty
3 days ago
Thirty-nine clients. That's the max here. South Florida has a lot of rehabs and a lot of them feel like they're processing people in bulk. This one didn't feel that way.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Spring Hill is an excellent recovery center. I would recommend Spring Hill to anyone seeking addiction recovery.
Stephanie H
2 weeks ago
I am truly grateful for Springhill Recovery. Immediately I was made to feel at ease, safe & secure. I quickly realized that I was in competent, caring hands with all of the staff that I met.
I learned so much about myself here! I can see where I need to work on a few things and I now have some of the tools to do that, thanks to the amazing groups, clinicians, RS staff & case managers at Springhill.
I leave here confident in my sobriety & excited to continue my recovery program. I will seek connections with other people who are also in recovery because I’ve learned that absolutely nobody can do this alone!
Thank you Springhill Recovery for teaching me how to like myself again! I am forever grateful for the gift & privilege of my new life ahead of me.
Jackie Loewen
2 weeks ago
Spring Hill is amazing! They have great staff, and programming. Everyone is kind, compassionate and caring. I am blessed to have had the opportunity to receive treatment here.
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Glad I came here to get help with my mental health. Employees really care about everyone and want to help you get better. The facility is clean and very nice. Highly recommend
Patrina Avila
2 weeks ago
nice and friendly staff who put client care first and super nice and clean facility
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis
Adult ProgramProgram For MenProgram For WomenYoung Adult Program
Private InsuranceSelf-Pay Options
Great place to find yourself. Great staff that truly cares.
Steve Humbarger
1 day ago
My brother did their faith-based program and still talks about how much the chaplain helped him. Everyone from the counselors to his case manager genuinely cared.
Charlotte Bellmore
1 day ago
Attentive nurses during detox, warm counselors through the rest of treatment. Felt cared for the entire stay.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay OptionsMedicaid
The Washburn House program from the ATS (Detox) to the CSS program was incredible. I honestly will not be able to put into words how much this Program helped me so much in many different ways. The food, I did not have a bad meal in the 28 days I spent there. The camaraderie between most of the gentlemen and some women was amazing. Also, the staff. I could write a book on how helpful, thoughtful, caring, supportive, and genuinely there to help the clients in any way they could. So I wanted to share the first names of the staff members that made an impact on me. In no particular order: Jess, Kara, Cheryl, John, Cesar, David, Nick, Andramada, Chris, Matt, Ryan, June, Ronnie, Mark, Dave, Angel, Kristal, J, Peter, Mike, Lucia, Ronnell, Nicole. I just graduated there on 9/1/2026. I really hope someday I could possibly do a commitment, or anything to give back to this community of great people. Thank you so much! DD
The Verdict’s Voice
1 day ago
This program is wonderful and it really helped me throughout my recovery and I'm grateful they allowed me to come back a 2nd time to continue my treatment just want to say thanks to everyone at washburn
jordan Fowler
1 week ago
Washburn house is wonderful! I highly recommend for anyone struggling. The staff is great and the facilities are cozy. By far the best place in Worcester and probably all of Massachusetts!
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Great place. Learned a lot. Very good staff. If you are serious about changing your life, this is an amazing place to start.
Joshua Lang
2 weeks ago
Eagle Creek Ranch Recovery in hands down the most effective treatment center in the country. The detox was comfortable. The programming, groups and clinical staff are top notch and truly helped me discover who I am. Adventure outings were incredible! The chef and his cooking are extraordinary and that guy should have his own restaurant! The setting is beautiful and all of the staff were amazing. The owners were hands on day in and day out and truly care about the whole person. If you or a loved one is looking for help, make the call, please!
Corey Smith
2 weeks ago
Best treatment facility ever ❤️ amazing food, caring staff and a great couple of owners.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
El mejor lugar para tratar la adiccion de un ser querido. Un excelente grupo de profesionales que hacen mas q su trabajo, es su vocacion. Recomendado al 100% El mejor centro en Puerto Rico. Mi agradecimjento a Josefina q fue la persona contacto en Puerto Rico, quien con mucha paciencia y amor nos facilito llegar a este lugar maravilloso
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
This program offers amazing resources, a tool box for sobriety, and a sober community. If you are struggling or know anyone who is. I highly recommend this program. It all starts with asking for help and being honest, open minded, and willing.
Maykel Garcia
1 week ago
Adcare has been amazing. I've never experienced everybody being so nice and not judgmental, very helpful and understanding. Everybody has a smile on their face.And whatever you need are willing to help with, whatever I live out of state and they're helping me find meetings out of state. I was very nervous and scared at first, but they made it very easy. I recommend anybody that needs hope please come to adcare. You'll be glad you did.
MIchelle Cox
1 week ago
AdCare is absolute amazing. The best rehabilitation in Rhode Island by far. They are welcoming and attentive throughout. Staff is amazing and help you gain and utilize all the necessary tools to survive in aftercare.
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
This place was the best! I have been to multiple places for my mental health and this thankfully was my last stop. I was recommended this place by another mental health facility. And I truly am grateful for all of the techs, therapist, and doctors! But a big shout out to the personal trainer they have there! And to the lady in the barbershop without the courage from these two I would have went crazy without seeing my family for over a month. Even on days where I felt super depressed the trainer encouraged me to just get on the treadmill and walk. And so thankful that he did that because honestly it made me feel better. And the lady in the barbershop I went to when I was too overwhelmed to do anything with my hair and without judgment she helped. I wish I could remember their names but it’s been almost a year ago. But will be forever grateful for them, and this place!
Haley Pennycuff
1 day ago
Wonderful place full over extremely capable staff. I went in very rough shape, and their wrap-around services expediently straightened out multiple areas of concern and allowed for me to focus on my recovery.
Isaac Andrade
2 weeks ago
My time here has shown me the error of my ways also due to the surrounding of people that experienced the same or similar events
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Frequently Asked Questions
Does Tufts Health Plan Cover Rehab?
Most Tufts Health plans cover mental health and substance abuse treatment, as required by the 2010 Affordable Care Act. This federal law requires most long term health insurance plans to cover 10 essential health benefits, which include mental health and addiction treatment.
However, there are exceptions to the law and insurance plans differ. As a result the options for covered treatment vary widely, so you should check with the insurance company about your specific plan.
The type of treatment(s) offered to you are usually based on your doctor’s assessment and recommendations, which help define what is medically necessary in your case. It’s a good idea to work closely with your doctor because you may also need a referral and/or preauthorization before you begin treatment.
What Are Tufts Health Plans?
Tufts Health provides a wide variety of insurance plans. You may get an individual or family plan through your employer or your state’s Insurance Marketplace. Tufts also offers Medicare and Medicaid plans to those who qualify.
An individual or family plan is generally one of two types. With a Preferred Provider Organization plan, (PPO), you can choose your own doctor and treatment facilities, with no referral needed. However you’ll generally pay a higher monthly premium for these plans.
A Health Maintenance Organization, or HMO, plan usually has lower monthly plan fees but they may have higher deductibles and copays. HMOs generally require you to use the provider network for care if you want insurance coverage. Often you will need a referral from your primary doctor to see a specialist, such as a psychiatrist or addiction specialist.
Tufts Health Plan offers Medicare Supplement and Medicare Advantage plans. Medicare supplement plans help you manage the costs of Original Medicare. Medicare Advantage plans (or “Medicare part C”) are a full replacement for Original Medicare and often include extra benefits, like prescription drug coverage and vision and dental care.
Medicare Advantage plans are offered as either a PPO or HMO, similar to the individual and family plans described above.
Tufts Health Plans has Medicaid plans in Massachusetts and Rhode Island. These state sponsored plans help provide coverage for lower income individuals and families. These plans cover addiction treatment along with doctor and specialists’ office visits and some additional benefits, such as eye exams and eyeglasses.
For people who have both Medicare and Medicaid, there are Special Need Plans that are based on age (21-64 or over 65) that include all the benefits of Medicare plus additional benefits such as a case manager if needed.
You can learn more about Tufts Health Plan’s coverage options on their website.
What Outpatient Addiction Treatment Does Tufts Cover?
During outpatient rehab you’ll live at home or in a sober living environment and attend treatment part time.
Outpatient programs include partial hospitalization (PHP), intensive outpatient (IOP), and regular outpatient (OP) programs. In a partial hospitalization program, you would attend treatment during the day and return to your home at night. PHP programs typically run for 4-8 hours a day, three or four days a week, and last for 30-90 days.
Intensive outpatient programs typically offer 9-20 hours of treatment each week, spread over 3 to 5 days per week. A total of 90 days of treatment is typically recommended for IOP programs.
In general outpatient programs, you would visit a clinic or rehab facility one or more times each week. Group counseling and education on addiction and relapse prevention are provided, and individual counseling sessions may be offered when needed.
What Inpatient Addiction Treatment Does Tufts Health Plan Cover?
Most insurance plans focus on medically necessary treatment, highlighting the importance of creating an individualized treatment plan with your doctor.
If the detox process is expected to be difficult you may undergo an inpatient detox process where a licensed healthcare professional oversees and monitors your progress, ensuring your safety. A group of therapists and nurses as well as doctors and clinical staff watch for complications. You may also receive medication to help with detox symptoms.
Inpatient or residential care is one of the most intensive ways to battle an addiction. With these programs you live in the rehab center and take part in targeted treatments to help address triggers and develop coping mechanisms. With inpatient treatment you benefit from peer support and a structured schedule as well as around the clock support and a reduced relapse rate. Inpatient centers often help ease your way back into society with sober living facilities after treatment ends.
Does Tufts Health Plan Cover Methadone & Suboxone (MAT)?
Over the last decade, much research has been done to develop medications that help people fight addiction through both detox and the ongoing treatment process. This is called medication-assisted treatment (MAT) and may involve the use of methadone or suboxone.
Methadone is used to treat opioid addictions. It helps reduce cravings and blocks the effects of opioids.
Suboxone is one of the most common medications used to treat addiction. To avoid misuse suboxone contains naloxone which blocks the euphoria that comes from getting high.
Studies show that MAT greatly reduces the death rate of those living with addiction, and a majority of patients maintain sobriety for two years. Every situation is unique so it’s important to discuss medication with your doctor and consult your specific healthcare plan to make sure medications are covered.
Does Tufts Health Plan Cover Other Mental Healthcare?
The Affordable Care Act requires that most insurance plans offer mental health care. However there are some exceptions so it’s important to always check your plan before you receive care.
Mental illness and substance abuse often go hand in hand and long term care is vital to staying healthy. With the right plan you can use your insurance to obtain an integrated treatment program that works to combat both problems. That may look like attending an integrated program or ensuring that your healthcare providers are communicating regularly.
Does Addiction Treatment Need to Be In Network?
HMO plans don’t cover out of network care. PPOs generally will but the cost is often higher for the patient, including higher copayments and deductibles. If possible you’ll want to find a provider within your network to get the most out of your insurance coverage. If you do opt for an out of network provider research your insurance policy thoroughly and speak with office staff and your doctor to make sure you fully understand how much of the treatment cost you will have to pay.
It may be worth the extra money if an out of network provider has a higher rate of success for treatment or you feel more comfortable with them, but make sure you understand the costs first.
How to Verify Coverage With Tufts Health Plan
To verify that you have coverage for specific treatments you can contact your insurance company directly. A treatment center’s staff may have general guidelines for what policies they take but they can’t guarantee exact numbers like your insurance company will.
You can verify coverage by logging into your online account or contacting the customer service number found on the website or your insurance card. Speak to a representative from the company about what is covered and what’s not before you start a program. Not only does this set you up for uninterrupted treatment, but it also relieves the stress that comes from unexpected bills when you’re trying to get back on your feet.
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.
Calls to numbers on a specific treatment center listing will be routed to that treatment center. Calls to any general helpline could be forwarded to SAMHSA or a verified treatment provider.
If you wish to connect with non-sponsor centers, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.
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