Beacon Insurance Coverage for Rehab and Detox
WHAT YOU NEED TO KNOW
- Beacon covers a range of addiction treatment, including detox, inpatient rehab, outpatient rehab, and medication-assisted treatment
- Beacon Health Options has served members for more than 30 years and covers roughly 40 million people across all 50 states
- Beacon administers behavioral health benefits for many Medicaid, Medicare, and commercial plans, including certain Blue Cross Blue Shield and Anthem plans
- Staying in-network typically means the most coverage and the lowest out-of-pocket costs
- American Addiction Centers is in-network with Beacon; call or verify your benefits online, available 24/7
Beacon Coverage for Rehab and Detox
Most insurance plans, including Beacon, offer coverage for drug and alcohol addiction treatment. Beacon coverage varies by plan and location, but in general most plans cover at least part of treatment, including detox and rehab.
It is worth noting that Beacon Health Options is now known as Carelon Behavioral Health, so you may see either name on your plan.
Does Beacon Cover Rehab
Yes. Detox is the first phase of treatment, the process of gradually clearing substances from your body. It is not needed for every substance, but it is critical for alcohol and drugs like benzodiazepines, since stopping these abruptly can lead to seizures.
Detox usually lasts a few days and is followed by inpatient or outpatient care. Anyone on your Beacon plan, including family members, can access these services, though authorization depends on what your treatment provider determines you need.
Types of Treatment Covered by Beacon Insurance
Beacon insurance covers a variety of addiction treatment services, including:
Depending on your needs, detox may be followed by either inpatient or outpatient treatment, or perhaps both. Some people go straight to outpatient treatment after detox, while others may go to an inpatient program followed by outpatient treatment as a step-down. Inpatient treatment may last a few days, or in some cases, a few weeks. Inpatient treatment provides 24/7 oversight while you undergo detox, which can offer you emotional support, as well as making sure you do not have any preventable complications during withdrawal and helping you to manage any unpleasant side effects that you may experience. Outpatient treatment typically includes 2- to 3- hour sessions, 2 to 3 days per week. Outpatient treatment may last for months. Again, the authorization of these services depends on your needs as determined by your treatment providers.4
Anyone on your Beacon plan can access these addiction treatment services, whether it is you or your family members who need Beacon detox coverage. Please note you will need to check with your specific plan to see what coverage is available. Any services and authorizations by Beacon depend on what your treatment provider determines you need.
How to Check Your Beacon Insurance Treatment Benefits
The first step in learning what your Beacon plan might offer in terms of insurance coverage for rehab is to contact a Beacon representative by calling the number on the back of your insurance card. You can also visit the Beacon Health Insurance website and login as a member to learn about your specific plan benefits.
You may also contact the rehab provider to verify your coverage. American Addiction Centers (AAC) is in-network with Beacon insurance, our support representative can help you verify your exact Beacon coverage details.
Types of Beacon Insurance Plans
Beacon is a private insurance company that has been in business for more than 30 years and insures approximately 40 million people in all 50 states.1 Beacon offers a variety of plans, which vary from state to state and from one employer to another.
Beacon works with Medicaid and Medicare in multiple states to provide comprehensive behavioral health and drug rehab insurance coverage. In California, for example, Beacon works with Kaiser Permanente in both Northern and Southern California, as well as Value Options of California, which is now called Beacon Health Options. In addition, they administer behavioral health and substance abuse benefits for members on several Blue Cross and Blue Shield plans. Anthem Blue Cross Blue Shield offers both Medicare and Medicaid managed plans.
In New York, Beacon administers Medicaid plans, such as the one offered through the Affinity plan. In general, when you have a Medicaid plan, most services are provided without a copay or a deductible that you must meet to have services covered. Medicaid will typically cover some combination of inpatient and outpatient treatment, though what will be authorized for your treatment depends on your individual needs and what your treatment provider determines that you need. Specifics depend on your state. For Medicare, your plan may require payment of a deductible or copayment and Medicare generally covers inpatient, outpatient, or partial hospitalization programs according to what your doctor believes that you need for treatment.2
Beacon offers specific programs for opioid addiction treatment, for example, and offers benefits and coverage based on research for best practices.
In-Network vs. Out-of-Network
Beacon generally offers the most coverage when you attend an in-network facility that has agreed to Beacon’s pricing to provide quality care.
You can still attend an out-of-network facility, but your benefits may be significantly reduced and your costs higher. It is always worth confirming a facility’s network status before committing.
How to Use Beacon to Pay for Rehab
To use Beacon to cover some or all of the cost of rehab, first determine your benefits by contacting a Beacon representative. You may then need preauthorization, arranged between Beacon and the rehab facility.
Confirming that a rehab is in-network helps you get your full benefits. You can also verify your coverage through American Addiction Centers, which is in-network with Beacon.
How Much Does Beacon Cover?
While the Affordable Care Act (ACA) requires all health insurance plans to provide some degree of coverage for the medically-necessary treatment of mental and behavioral health disorders, this does not mean Beacon Health will cover all costs. While many individuals can expect their Beacon Health insurance plan to provide some degree of coverage, there are several factors that may result in the full cost not being covered. These factors may include:
- Type of Beacon Health insurance plan.
- Where you attend treatment.
- Whether a rehab facility is in-network with Beacon Health.
- The intensity of treatment.
- The length of treatment.
- The accommodations and amenities offered by a rehab facility.
It’s important to reach out to a Beacon Health representative in order to verify your coverage before committing to treatment.
Do Rehab Facilities Need to Be In-Network with Beacon?
Oftentimes, Beacon Health insurance will offer the most coverage to those who attend addiction treatment at an in-network rehab facility. In-network facilities work with Beacon Health insurance plans to provide their members with quality care at a certain price. While you can still attend treatment at an out-of-network facility, you may find your Beacon Health benefits significantly reduced. It’s important to reach out to any prospective rehabs and check if they are in-network with Beacon Health before committing to treatment.
Check Your Beacon Treatment Coverage at American Addiction Centers
Finding Rehabs that Accept Beacon Insurance
At American Addiction Centers (AAC), we offer locations nationwide at which you can receive leading-edge treatment for your substance use disorders. American Addiction Centers works with many insurance providers, including Beacon, to provide you with choices for your alcohol or drug rehab needs. To find a local treatment facility near you, call our rehab hotline at or text us. You will speak to a trained referral specialist who can help you check your benefits and determine how American Addiction Centers can meet your needs for alcohol or drug detox and drug rehab.
