Does Beacon Health / Carelon Cover Inpatient Drug & Alcohol Rehab? Yes — Evolve Handles the Process for You.
Verify your insurance coverage for drug and alcohol detox.
Does Beacon Health cover rehab? Yes. Individuals with Beacon Health/Carelon insurance can typically get their treatment covered at Evolve Recovery Center.
Understanding your insurance coverage can be overwhelming, especially during this high-stress time. Our admissions team handles the benefits verification and prior authorization at no cost to you. In most cases, we can get you admitted to rehab on the same day.
What Beacon Health/Carelon Covers for Residential Rehab
Beacon Health covers residential stays as long as they have met the criteria for medical necessity. Residential rehab is a structured substance use disorder treatment program where participants live at the facility for the duration of their care.
According to the National Association of Insurance Commissioners, “medical necessity” is a standard that insurance companies use to determine if services, treatments, or medication is covered under the benefit plan. To receive a decision of medical necessity, the care must be considered reasonable, necessary, and clinically appropriate for the diagnosis, or the treatment for an illness or injury must be based on accepted medical standards.
Most policies cover 30-, 60-, and 90-day stays. Covered services include individual and group therapy, dual diagnosis treatment, medication management, and family counseling.
How Long Will They Pay For?
At Evolve Recovery Center, we believe that treatment should be tailored to your specific needs, not on a set schedule. Therefore, the length of your residential treatment will depend on your medical needs. Our team of highly qualified addiction professionals works closely with you to develop an individualized treatment plan that focuses on your needs.
Our clinical team works with Beacon Health/ Carelon to make sure you get the time you need in residential treatment to regulate your nervous system, prepare for the next step in treatment and focus on long-term recovery.
Prior Authorization: What It Is and Who Handles It
A prior authorization is an approval from your insurance company that must be obtained before certain services are provided. This approval confirms that your insurance provider has deemed your substance use disorder treatment as medically necessary and eligible for coverage under your specific plan.
Our admissions team will contact Beacon Health/Carelon for you, submit any required clinical documentation, and can typically obtain any prior authorizations within 24-72 hours.
Protecting Your Job While in Rehab (FMLA)
Under the Family and Medical Leave Act (FMLA), most adults are guaranteed up to 12 weeks of unpaid, job-protected leave per year for qualifying reasons, such as personal health, caring for family members, and the birth or adoption of a child.
Our admissions team will help you complete the required paperwork, provide proof of medical necessity to your employer, and answer any questions you may have to ensure the process is as easy as possible for you.
What Rehab at Evolve Looks Like
Your Carelon managed behavioral health rehab should feel like a home away from home. We provide the care you need at any of our accredited inpatient programs in Georgia, Massachusetts, New Jersey, and Florida.
Our staff of highly trained addiction specialists utilizes a mix of evidence-based behavioral therapies, such as cognitive behavioral therapy, dialectical behavioral therapy, and others, to help you overcome your substance use disorder as well as any co-occurring disorders.
Evolve Recovery Center’s integrated approach to care recognizes that many individuals facing addiction may also be struggling with other mental health conditions, including anxiety, depression, post-traumatic stress disorder, bipolar disorder, and attention-deficit hyperactivity disorder (ADHD). We work closely with you to develop an individualized treatment plan that focuses on your unique needs and never takes a one-size-fits-all approach to your care.
How to Use Your Beacon Health/Carelon Insurance at Evolve (3 Steps)
Our admissions team is here to help you navigate the process and make it less stressful for you. Call us at 888-369-7727 and speak with a member of our team. We will verify your rehab benefits and complete any prior Beacon Health residential treatment authorization that may be needed. In most cases, you can get admitted to our program on the same day.
Frequently Asked Questions
Yes. Beacon Health/Carelon authorizes and manages residential substance use disorder treatment benefits on behalf of the insurance companies it works with.
Our admissions team works closely with Beacon Health/Carelon to coordinate your care and make sure that you understand your benefits and coverage, so there are no unexpected costs for you to worry about while you are completing your treatment.
A utilization review is a process where your insurance provider evaluates the medical necessity and appropriateness of the services you are obtaining. These reviews act as a cost-saving measure that prevents any unnecessary inpatient stays, surgeries, or procedures.
Periodically during your stay at Evolve Recovery Center, Carelon will review your clinical status and confirm the need for your continued treatment. Our clinical staff works closely with them to ensure they have the proper documentation they need to prevent any interruptions to your Carelon behavioral health rehab coverage.
Yes. Many Anthem plans use Carelon for behavioral health. At Evolve Recovery Center, our team has experience navigating the benefits verification and prior authorization process with them to ensure you get the care you need. This may include advocating for extended stays when it is clinically necessary.
Let us know when you’re ready to take that first step. You can call us now at 888-369-7727 to verify your Beacon Health/Carelon benefits and get started today. All calls are free and confidential with no obligation.