Bright Health Insurance Coverage for Rehab and Detox
Using Bright health insurance to cover some or all of the cost of drug or alcohol rehab can help you begin your journey to recovery.
- Access to licensed treatment centers
- Information on treatment plans
- Financial assistance options
Bright Health Insurance, which is part of Bright Health Group, provides various types of health insurance plans, ranging from Medicare Advantage to individual and family plans.1 Bright Health Insurance works with a curated network of doctors, clinics, and hospitals across the country to help covered members receive their needed health care services at an affordable price.1 As a result, you may be able to use your Bright Health insurance plan to cover some or all of the cost of addiction treatment.
Where is Bright Health Insurance Available?
Currently, Bright Health Insurance is only available in the following 14 states:1
- New Mexico
- New York
- North Carolina
- South Carolina
Does Bright Health Cover Rehab Treatment?
In the U.S., almost all health plans, including Bright Health plans, are required to provide some level of coverage for mental and behavioral health services.2 According to the federal health care law called the Affordable Care Act (ACA), nearly all plans must cover essential health benefits (EHB), and mental health care is considered to be an EHB.2 Specifically, behavioral health treatment, inpatient mental and behavioral health services, and treatment for substance use disorders (e.g., rehab) must be covered at some level under your plan.2 However, coverage may vary as plans are all designed differently. Be sure to check your insurance benefits before seeking care whenever possible.
How to Check Your Bright Health Coverage for Rehab
There are a few different ways in which you can check your coverage under your Bright Health insurance plan. First, you can call the number on the back of your insurance card to speak to a customer service representative. Or you can log in to your Bright Health online member account and view your Summary of Benefits and Coverage to see what is included under your plan. Finally, you can usually check with the detox or rehab provider directly, asking whether they accept your insurance at their location.
Types of Treatment Covered by Bright Health
The types of addiction treatment covered by your Bright Health plan will depend on the plan you have. Every plan is different, which underscores the importance of checking your benefits before seeking care whenever possible. Some common treatment types or aspects of addiction treatment programs, which are listed below, may be covered under your Bright Health plan:
- Medical Detox: Detox, which is the process in which the body rids itself of substances (e.g., drugs and/or alcohol), is often the first stage of addiction treatment.3 It’s generally done in a medically supervised setting, and often with the administration of medications, to manage the acute and potentially life-threatening side effects of stopping substance use.3
- Inpatient Care: Inpatient addiction treatment refers to treatment that is administered in a facility where the patient stays 24/7 for a set amount of time. Medical detox may be administered in an inpatient setting, as inpatient programs allow for round-the-clock medically supervised care.4 Inpatient programs also offer behavioral therapies and other treatments.
- Outpatient care: With outpatient addiction treatment, a patient attends 1 or 2 meetings a week for care, which usually involves therapy or going to meetings. There is no overnight stay component to an outpatient care program.4
- Aftercare and Sober living: Any care that is rendered after rehab is complete is referred to as continuing care or aftercare. Sober living, where patients live with other recovered patients and there is a zero-tolerance substance use policy, is an example of aftercare.5
How to Use Bright Health Benefits for Addiction Treatment
Depending on your plan type and where you’re seeking care, you may need to submit a form for prior authorization with Bright Health. A prior authorization is a request to have insurance cover your health care services. Bright Health has an Authorization Navigator tool, which can help you find out whether you need to submit an authorization prior to care, and walks you through the steps if that is the case.6 You may also be responsible for paying any out-of-pocket cost-sharing requirements (e.g., your deductible, copay, or coinsurance), depending on your plan. Be sure to check your benefits and plan details before seeking care to avoid surprise medical costs.
Do Rehab Centers Need to Be In-Network with Bright Health?
In most cases, you will need to attend a rehab center that is in-network with your Bright Health insurance plan to receive the highest amount of coverage possible.7 In-network providers are those who are a part of Bright HealthCare’s plans, and who have negotiated services for agreed-upon rates.7
Seeing an in-network provider typically results in lower bills, while seeing an out-of-network provider (particularly when it isn’t an emergency or hasn’t been preauthorized by Bright Health) is generally more expensive.7
How Much Can Bright Health Cover?
Coverage for addiction treatment will vary based on the plan you have, the type, intensity, and length of treatment you need, and where you seek care. Additionally, where you seek treatment, and whether it’s in-network or out-of-network with your Bright Health plan will affect how much coverage you will receive. Other factors that may affect coverage include the rehab’s accommodations and amenities offered. Luxury rehabs may cost more, which may translate into higher out-of-pocket costs for you depending on how your Bright Health plan covers such stays.
Types of Bright Health Insurance Plans
Bright Health Insurance offers four tiers of individual and family health insurance plans. These 4 plans are called Bronze, Silver, Gold, and Catastrophic plans.8 Catastrophic plans are designed for those who are under 30 years of age and don’t have many medical expenses; it provides low premiums but minimal coverage.8 Bronze plans are the lowest tier of traditional health plans, providing low premiums but higher out-of-pocket costs.8 Silver plans are mid-tier plans, offering moderate premiums and out-of-pocket costs, but lower deductibles and more benefits than a Bronze plan.8 Finally, Gold plans provide the highest levels of coverage but are the most expensive in terms of premium payments.8
Does Bright Health Offer Medicare Coverage?
Bright Health also sells Medicare Advantage plans, which are a specific type of Medicare plan.9 Bright Health’s Medicare Advantage plans are available to specific people, including those aged 65 and older.9 While Original Medicare is available through the federal government, Medicare Advantage plans are sold by private companies like Bright Health.10” Bright Health’s Medicare Advantage plans include coverage for prescription drugs and impose an out-of-pocket maximum limit per plan year, helping you save money.10
Finding Rehabs That Take Bright Health Insurance
If you or a loved one is ready to get treatment for substance use disorder and addiction, one of the first steps to take is to find a rehab center that takes Bright Health insurance. You’ll also want to reach out to your doctor to determine medical needs. To check your benefits and find a covered facility, you can call the number on the back of your insurance card. Or you can call rehab centers directly and ask whether they accept your plan.
Alternatively, you can use online resources, like the SAMHSA treatment locator to help find local covered addiction rehabs. Or you can call the American Addiction Centers’ addiction helpline, which can help connect people with critical addiction care services. AAC staff can also assist in checking your benefits and coverage right while you’re on the phone. Don’t hesitate to reach out to us today at or through text.