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.
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.
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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 to tools to do it thanks to the amazing groups here.
I leave here confident in my sobriety & recovery! I will seek connections with others in recovery because I’ve learned that absolutely nobody can do this alone.
Thank you Springhill Recovery for giving me a chance at life again!
Jackie Loewen
2 weeks ago
Amazing! Take everything they give you! Make connections with your peers! Day by day! Spring Hill is where recovery begins and you will leave with serenity, courage, and so much more.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult Program
Private InsuranceSelf-Pay OptionsMedicaid
Excellent treatment, awesome staff! This was true not long ago, now it's run by people who could care less about helping people with this horrible disease of addiction, 😞
Brad
1 month ago
Highly recommend this program. I've been to a few CSS's and Washburn House is a great program with caring staff that will help you as much as they can, and they will meet you where you are at mentally.
Justin Oneill
2 months ago
Literally, it's the one of the best rehabilitation treatment centers in the country. I highly recommend it to anyone seeking a positive experience.
This place works! Every piece of this place is perfectly designed to work in tandem. Maple Mountain saved my life.
Bethany Burns
2 months ago
Maple Mountain Recovery in Utah completely exceeded my expectations. From day one, their team created a highly personalized treatment plan tailored just for me—every session felt tailored to my needs.
What really sets them apart is the way they seamlessly blend healing with genuine care and enjoyable experiences. Between therapy sessions, I had options like yoga, cold plunges in nature, art therapy, acupuncture, and many therapeutic adventures. It felt like real recovery, not just treatment.
The staff is amazingly attentive—every single team member knew my name, remembered my goals, and checked in regularly to see how I was doing. They made sure I felt supported 100% of the time and built an environment that was both professional and warm.
If you’re looking for a recovery center that cares deeply, customizes your journey, and injects a dose of fun and relaxation into the process—Maple Mountain Recovery is it. Highly recommend!
Lexi Verschoore
2 months ago
Wonderful place with great staff and fantastic programming. I rediscovered myself while there.
This is an ad and Banyan Heartland is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More
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 👍🏽.
Green Mountain Treatment Center saved my life. I was sick and scared when I arrived, but the transformation that occurred for me during the 80 days I spent on the mountain was nothing short of a miracle.
I quickly recognized that hard work on my part needed to be done, or I'd be miserable and missing out on the gifts of the program. Thankfully, there is an incredible staff in place who walked with me through the introspection I had to do and showed me that recovery was possible. I marked 5 months sober yesterday and I truly believe that God removed my alcoholic obsession while I was on the mountain.
Everyone's experience is different and I can only speak of my own, but I personally could not see myself succeeding as I did in any other facility. I'll be thankful to Green Mountain for the rest of my life.
Courtney
8 months ago
GRC changed my life for the greater good!
Justin Haskins
8 months ago
The most caring recovery team that works there. Awesome accomodations. All around though really good program. First time to rehabilitation center and was my favorite stop on my recovery road. Glad I choose to go there. Hands down best place to go for real recovery survivors 100%
I had an amazing, amazing stay. The dining staff made delicious food, especially the desserts. My only drawback would be that the facility is understaffed as far as techs go, but their drive, empathy, and kindness more than made up for it. I would especially like to thank Christine for being an ANGEL on Earth, and Annemarie for her dedication and care. The nursing staff did everything they could to ensure a comfortable, safe experience. I would recommend this facility to anyone experiencing a mental health crisis.
Riley Sweeney
1 week ago
Such a great place! From the moment I very nervously, and hesitantly walked in I was treated with compassion and respect. I was in real trouble, my drinking was out of control for a long time, and my health and family were suffering. Serenity got me safely detoxed and sober, and then taught me how to stay that way. As I write this review I’m 14+ months sober. Thank you, Serenity! If you or someone you love has a substance use disorder, I highly recommend Serenity.
Michael Bevilacqua
1 month ago
Super sweet staff and provides great treatment plans
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
I started my recovery on October 26, 2021 in drug addiction. I had put myself into detox and they had her originally sent me to another place for IOP. Needless to say that didn’t work out for very long. It wasn’t a good fit so, I requested a different facility. By the grace of God I found Aftermath in December of 2021. At this time in my life, I had low self-esteem and literally hated myself for the things I had done. I barely have any contact with family, and I was dealing with all the trauma from my past. The very first day at Aftermath I knew this was the place for me. The owner Matt and my counselor Nikki and the rest of the staff made me feel so comfortable and welcome. I was very shy at first but, I was able to open up quicker than I thought would ever happen. By the time my insurance wouldn’t cover anymore of the treatment ,I was still on a deferred disposition through the courts and Matt was willing to let me stay until it was completed which might’ve been another six months or so without getting any pay. Without this program, I don’t think I would’ve succeeded. October 26, 2026 will be four years. Thank you to everybody at Aftermath for everything you have done. I love you all 💙💙
Maura Eaves
1 month ago
Honestly best treatment center I’ve been to. Everyone is very welcoming and down to earth. I like all the staff they have become like family to me and I love them all. 10/10
Maple moon has been a God send! Can’t express my gratitude for the care and compassion they’ve given me. Came into this Austin with so much resistance and they made my stay feel like home. From the food to the staff everything was Top Tier. If they had more stars I would give them 10. If you out a loved one is looking for a recovery center with integrity and a high degree of care, you’ve found the right place.
Bernard Rackley
1 month ago
I had the privilege of coming here for detox and couldn't be more appreciative of the staff and accommodations here. I stayed for 2 weeks and was constantly catered to by all of the staff. Truly a 5 star experience while going through the worst time of my life. The people here truly treat you like their own family. I don't know how they manage to deal with several emotional people all day every day and still manage to give everybody specialized individual attention but they do. I came in there like a wrecking ball and they still took great care of me. Even the chefs cater to everybody's personal needs. I'll be 200 days sober in 2 days and probably wouldn't be alive if it wasn't for this place. A very delayed review, but anybody questioning if they should stay here or not should have no question about it and choose Maple Moon for their recovery.
BG Brancucci
1 month ago
aple Moon Recovery feels like home while helping you do the hard work of healing. The staff truly care, the programs dig deep into the “why” behind addiction, and you leave with real tools for life. If you’re on the fence about recovery—this is the place that can change everything.
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Frequently Asked Questions
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.
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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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