Insurance Verification & Coverage
We Accept Most Major Insurance Plans
RECO Health works with most major insurance providers to ensure you can access the treatment you need. We're committed to maximizing your benefits and minimizing your out-of-pocket costs.
Aetna
Comprehensive coverage for behavioral health and substance abuse treatment programs.
Blue Cross Blue Shield
Extensive network coverage for addiction treatment and mental health services.
Cigna
Behavioral health benefits for substance use disorder treatment and recovery.
United Healthcare
Comprehensive mental health and substance abuse treatment coverage.
Humana
Behavioral health services and addiction treatment program benefits.
Medicare & Medicaid
Government-sponsored coverage for qualifying addiction treatment services.
Don't See Your Provider?
We work with many additional insurance providers beyond those listed above. Contact our admissions team to verify your specific plan and benefits.
How Insurance Verification Works
Our admissions team handles the entire verification process, working directly with your insurance provider to determine your coverage and benefits.
Provide Your Insurance Information
Share your insurance card details with our admissions team via phone, email, or our secure online form. We need your member ID, group number, and the phone number on the back of your card.
We Contact Your Insurance Provider
Our benefits verification specialists will call your insurance company directly to verify your coverage for addiction treatment services. We'll ask detailed questions about your specific benefits.
Review Your Benefits Breakdown
Within 24 hours, we'll provide you with a detailed breakdown of your coverage including deductibles, copays, out-of-pocket maximums, and what percentage of treatment costs are covered.
Discuss Financial Responsibility
We'll clearly explain any out-of-pocket costs you may be responsible for and discuss payment options, including payment plans if needed. There are never any surprises.
Obtain Pre-Authorization if Required
If your insurance plan requires pre-authorization for treatment, our team will handle all the paperwork and communications with your insurer to secure approval before you arrive.
Ongoing Claims Management
Throughout your treatment, we'll submit all claims to your insurance provider and handle any follow-up required. We'll keep you informed every step of the way.
What Does Insurance Typically Cover?
Most insurance plans provide comprehensive coverage for addiction treatment services. Here's what is typically included in your benefits.
Medical Detoxification
24/7 medical supervision during withdrawal, including medications to manage symptoms and ensure safety.
- ✓ Medical monitoring and vitals
- ✓ Medication management
- ✓ 24/7 nursing care
- ✓ Physician oversight
Residential Treatment
Inpatient care with 24-hour support, therapy, and structured programming in a residential setting.
- ✓ Room and board
- ✓ Individual therapy sessions
- ✓ Group therapy
- ✓ Case management
Outpatient Programs
Partial hospitalization (PHP), intensive outpatient (IOP), and standard outpatient services.
- ✓ PHP (6+ hours/day)
- ✓ IOP (9-12 hours/week)
- ✓ Outpatient counseling
- ✓ Continuing care
Medication-Assisted Treatment
FDA-approved medications that help reduce cravings and support long-term recovery.
- ✓ Medication prescriptions
- ✓ Medical monitoring
- ✓ Psychiatrist visits
- ✓ Medication management
Therapy & Counseling
Evidence-based therapeutic interventions delivered by licensed professionals.
- ✓ Individual counseling
- ✓ Group therapy
- ✓ Family therapy
- ✓ Specialized trauma therapy
Aftercare Planning
Comprehensive discharge planning and ongoing support to maintain long-term sobriety.
- ✓ Discharge planning
- ✓ Alumni support groups
- ✓ Relapse prevention planning
- ✓ Community resources
In-Network vs. Out-of-Network Benefits
Understanding the difference between in-network and out-of-network coverage can help you maximize your insurance benefits.
In-Network Coverage
What It Means
RECO Health has a contract with your insurance company to provide services at pre-negotiated rates. This typically results in lower out-of-pocket costs for you.
Typical Benefits
- Lower deductibles
- Reduced copayments
- Higher coverage percentages (often 80-100%)
- Lower out-of-pocket maximums
- Simplified claims process
Example Costs
After meeting your deductible, you might pay 20% of costs (coinsurance) with the insurance covering 80%. For a $10,000 treatment program, your cost would be $2,000 plus any deductible.
Out-of-Network Coverage
What It Means
RECO Health does not have a contract with your insurance company, but most plans still provide some level of coverage for out-of-network providers.
Typical Benefits
- Higher deductibles
- Higher copayments
- Lower coverage percentages (often 50-70%)
- Higher out-of-pocket maximums
- May require upfront payment
Example Costs
After meeting your higher deductible, you might pay 40% of costs with insurance covering 60%. For a $10,000 treatment program, your cost could be $4,000 plus deductible.
Single Case Agreements
If RECO Health is out-of-network with your insurance, we may be able to negotiate a Single Case Agreement that provides in-network benefits for your treatment. Our admissions team will explore this option during verification.
Mental Health Parity & Addiction Equity Act
Federal law protects your right to addiction treatment coverage that is equal to coverage for physical health conditions.
What Is the Mental Health Parity and Addiction Equity Act?
The Mental Health Parity and Addiction Equity Act (MHPAEA) is a federal law enacted in 2008 that requires health insurance plans to provide mental health and substance use disorder (SUD) benefits that are comparable to—and no more restrictive than—benefits for medical and surgical care.
This means your insurance company cannot impose stricter limitations on addiction treatment than they do for physical health conditions like diabetes or heart disease.
What This Law Requires
Equal Financial Requirements
Deductibles, copays, and coinsurance for addiction treatment cannot be higher than those for medical/surgical benefits.
Equal Treatment Limitations
Insurers cannot impose stricter limits on number of visits, days of coverage, or other treatment restrictions for behavioral health.
Equal Prior Authorization
Prior authorization and utilization review processes for SUD treatment must be comparable to those for medical care.
Equal Out-of-Pocket Costs
Annual and lifetime dollar limits on mental health and SUD benefits must be equal to limits on medical/surgical benefits.
What To Do If Your Insurance Denies Coverage
If your insurance company denies coverage for addiction treatment or imposes restrictions that violate the Mental Health Parity Act, you have the right to appeal. RECO Health can help you:
- File an internal appeal with your insurance company
- Request a detailed explanation of the denial
- Compare your addiction treatment benefits to medical/surgical benefits
- File an external review with your state insurance department
- File a complaint with the U.S. Department of Labor if your plan is subject to ERISA
Insurance & Coverage FAQs
RECO Health accepts most major insurance plans including Aetna, Blue Cross Blue Shield, Cigna, United Healthcare, Humana, and many others. We verify benefits for all plans and can determine your coverage within 24 hours. Even if we're not in-network with your specific plan, we may be able to negotiate a Single Case Agreement to provide in-network benefits, or work with your out-of-network benefits.
Most insurance plans cover detoxification, residential treatment, outpatient programs, therapy sessions, medication-assisted treatment, and aftercare planning. The Mental Health Parity and Addiction Equity Act requires insurers to cover mental health and substance abuse treatment similarly to physical health conditions. Specific coverage varies by plan, which is why we verify your benefits before admission.
Our admissions team can verify your insurance benefits within 24 hours, often much faster. We'll contact your insurance provider directly to determine your coverage, deductible, copay, and out-of-pocket costs. In many cases, we can provide preliminary benefits information within a few hours, especially if you call during business hours.
RECO Health offers flexible payment plans, self-pay options, and financial assistance programs. Our admissions team will work with you to find an affordable solution that doesn't compromise the quality of care. We believe that cost should never be a barrier to recovery, and we'll explore every option to make treatment accessible. Visit our Financial Options page for more details.
The Mental Health Parity and Addiction Equity Act (MHPAEA) is a federal law requiring insurance companies to provide coverage for mental health and substance use disorder treatment that is comparable to coverage for physical health conditions. This means insurers cannot impose stricter limitations on addiction treatment benefits, including higher copays, more restrictive treatment limits, or more burdensome prior authorization requirements. If your insurer denies coverage in violation of this law, we can help you appeal.
Most insurance plans require some form of cost-sharing, which may include deductibles, copayments, or coinsurance. Your exact out-of-pocket costs depend on your specific insurance plan and benefits. During the verification process, we'll provide a detailed breakdown of any costs you'll be responsible for, and discuss payment plan options if needed. We never want financial concerns to delay your path to recovery.
Continue Your Admissions Journey
Financial Options & Payment
Explore payment plans, self-pay options, and financial assistance programs available at RECO Health.
Learn More →What to Bring to Treatment
Complete packing checklist to help you prepare for your arrival at RECO Health.
View Checklist →Family Guide to Admissions
Information for family members about what to expect during the treatment process.
Read Guide →