Addiction Treatment Covered by EmblemHealth Insurance

EmblemHealth is one of the largest not-for-profit health insurance companies in the United States.¹ The company serves more than 3 million customers in the New York tristate area.¹

EmblemHealth offers a wide variety of insurance plans for individuals, families, and employers. The company also offers Medicare and Medicaid plans to those who qualify.²

As an EmblemHealth member, some coverage may be provided for drug and alcohol addiction treatment. The amount covered depends on the type of plan you have.

While the company primarily operates in New York, New Jersey, and Connecticut, members might be able to use their plans in Florida for substance use disorder treatment. EmblemHealth is in-network with some local facilities, including Recovery First Treatment Center in Hollywood, FL.

Read on to learn more about the addiction treatments EmblemHealth may cover and what to expect when using health insurance to pay for rehab.

Does EmblemHealth Cover Substance Abuse Rehab?

Most EmblemHealth plans offer coverage for drug and alcohol rehab in some capacity. But the amount of coverage will vary based on the specific policy and extent of treatment required.

Under the Affordable Care Act, treatment for substance use disorders is one of the 10 essential health benefits that must be covered by plans sold on the Health Insurance Marketplace.^3,4 That said, employer and large group plans are different than Marketplace plans and governed by separate standards.

Additionally, the Mental Health Parity and Addiction Equity Act mandates that mental health services and addiction treatment are covered at the same level as primary care and surgery.⁵ This helps ensure some capacity of coverage for drug rehab through EmblemHealth and most other private insurers.

Recovery First may accept EmblemHealth plans from members who live in the tristate area and Florida. As a first step to getting the addiction treatment you need, to verify your insurance benefits and learn more about your rehab coverage.

Addiction Treatments Covered by EmblemHealth

Addiction treatments covered by EmblemHealth will vary according to a person’s individual needs. There is no one-size-fits-all approach to recovery.⁶ Most quality, evidence-based programs offer different levels of care, including detox, inpatient, and outpatient treatment options.

Treatment at Recovery First is covered by some EmblemHealth plans. Call the number on the back of your insurance card to learn more about your benefits.

Or for immediate help, contact us at . One of our admissions navigators can verify your insurance coverage over the phone and discuss your options, so you can get the care and support you need.

How to Use GHI Emblem Insurance to Pay for Rehab

To use your EmblemHealth insurance to pay for rehab, here a few steps that might ease the process:

• Visit your doctor. Make an appointment with your primary care physician to discuss your struggles with addiction. They can help you determine what type of treatment you need and ensure you get the optimal care.
• Get pre-authorization. Some EmblemHealth plans require pre-authorization before coverage kicks in for rehab and addiction treatment. This means a doctor or other qualified healthcare provider must deem that rehab is medically necessary.
• Understand your coverage. Find out exactly what is and isn’t covered by your health insurance plan—before you begin treatment. Having a financial plan will allow you to focus on recovery instead of worrying about the cost.

At Recovery First, we know that looking into rehab options and navigating the world of insurance can be overwhelming. You don’t have to go through it alone. We’re here to help. Our admissions navigators are available 24/7. Give us a call at , so we can answer all your questions and get you on the path to a better, healthier life.

If you’re ready to begin treatment, complete the form below with your contact and insurance information. We’ll email you right back with details about your coverage and what to do next.