A substance use disorder impacts many areas of a person’s life from their mental health, their relationships, and even their physical health and more. Treatment for a substance use disorder can help, but even this can be a challenge financially. In 2022, 262,000 Arizonians received this lifesaving medical treatment. For many of these people, they relied on the help of their health insurance, such as Carelon, to help them pay for these often expensive treatments. Wolf Creek Recovery works with Carelon Insurance for the addiction recovery services that they offer. Learn more below on the options you or a loved one might have when it comes to recovering from this medical condition.
About Carelon/Beacon
Carelon Health, formally known as Beacon, is a healthcare company that has over 150 years of experience. According to their website, their capabilities span multiple healthcare services from “pharmacy, behavioral health, palliative care delivery, medical benefits management, payment integrity, care navigation, research, and operations and technology services.” The company aims to uncover evidence that allows it to achieve both improved outcomes and lowered costs that result in better whole-person health outcomes. This includes treating substance use disorders.
Carelon is a payer-agnostic subsidiary of Elevance Health and has over 40,000 associates that help many people in all 50 states solve complex challenges when it comes to their overall health.
Does Carelon Cover Rehab for Substance Use Disorders?
People who have Carelon Behavioral Health coverage will be happy to know that they do cover treatment for many conditions “from anxiety to substance use disorders (SUD) to behavioral crisis care and beyond,” as this aligns with their whole-person approach to covering healthcare. Behavioral health care services they cover include specialty services, behavioral clinicians, crisis intervention, programs for veterans and military, and the Employee Assistance Program (EAP).
Rehab for substance use disorders would fall under the specialty services that they offer. Common types of specialty services that Carelon will cover when it comes to substance use disorders include:
- Detox – Detox is the first step toward healing for many people with a substance use disorder. During detox, a person will stop taking the substance and their body will naturally remove it from the body. This process often comes with many different and uncomfortable symptoms. The purpose of detox is to provide a safe space where professionals can help keep them as comfortable as possible throughout this process, and it might include the use of certain medications aimed at relieving different symptoms.
- Inpatient treatment – During this level of care, people stay at the facility and begin to build the foundation of their recovery. They will receive medication that is aimed at providing stabilizing care and developing skills and tools that allow them to understand and heal from their substance use disorder.
- Partial hospitalization – This level of care is often the next step for many people after inpatient treatment. It continues to build upon the tools and knowledge learned during inpatient, and it might involve fewer hours of care, though this is dependent on a person’s unique treatment plan.
- Intensive outpatient – Following partial hospitalization, many people will transition to an intensive outpatient level of care. This treatment occurs 3 days a week.
It is important to keep in mind that contacting your insurance company and speaking to a Carelon representative is a great way to learn more about what your exact plan will cover when it comes to substance use disorder treatment. Not everyone has the same plan that will cover every possible service, and they will be able to provide you with more information.
Does Carelon Cover Rehab Out-of-Network?
To know exactly whether your Carelon coverage covers rehab out-of-network depends on which plan you have. There isn’t a one-size-fits-all answer to this question. However, discussing this with a Carelon representative or filling out Wolf Creek Recovery’s insurance verification form can provide you with a better understanding of what your plan covers for out-of-network rehab facilities.
The truth of the matter is that even if a center is classified as not being in network with Carelon, they might still cover some of it. Keep in mind that out-of-pocket costs for out-of-network rehabs might be more expensive or require deductibles to be met before they receive coverage. To learn more about your specific plan, Carelon representatives are the most qualified to discuss your options.
Will Carelon Cover Multiple Rehab Stays?
Sometimes, treatment for a substance use disorder requires more than one stay, and Carelon understands this is possible. You will not be prevented from receiving coverage if you need additional treatment after they have covered your first stay. That being said, if more than one stay is necessary, it might be best to let Carelon know and have confirmation from doctors that further treatment is medically necessary.
Getting Addiction Rehab Through Carelon at Wolf Creek Recovery
If you are ready to find healing from a substance use disorder, Wolf Creek Recovery provides engaging treatment options that help you create a healthier future. Our outdoor therapy options allow you to experience new ways to have fun without the use of substances. To get started today and learn if your Carelon insurance policy will cover your stay, contact us today at 1-833-732-8202 and build a life you love.
