Carelon Behavioral Health (Formerly Beacon) Coverage for Alcohol & Drug Rehab

If you’re struggling with drug or alcohol misuse and have Carelon Behavioral Health (formerly Beacon Health Options) insurance, you may be wondering about your coverage for alcohol and drug rehab.

This article will help you understand how to use Carelon (Beacon) medical insurance for drug or alcohol rehab and how to find an in-network addiction treatment center near you.

What Is Carelon Behavioral Health (Formerly Beacon Health Options)?

Carelon Behavioral Health, formerly known as Beacon Health Options, is a behavioral healthcare company that manages customized specialty care services to meet individual needs for a variety of conditions, including substance use and co-occurring disorders.¹

Although Beacon Health Options changed its name to Carelon Behavioral Health, member health plans, benefits, and services remain unchanged.²

People can get Carelon coverage from different sources, including their employers and government agencies like the military.^1,3 They offer a whole-person approach to behavioral health coverage that covers 47 million members across all 50 states in the U.S.⁴

In addition to traditional commercial healthcare plans, Carelon also coordinates care for those who qualify for Medicare and Medicaid.⁵

Does Carelon Insurance Cover Addiction Treatment?

Yes—Carelon insurance should cover addiction treatment in some capacity, although your coverage can vary depending on the specific plan you have.⁴

It’s important to know that the Affordable Care Act (ACA) states that addiction treatment is an essential benefit, and Marketplace insurance plans (like Carelon) must cover behavioral health treatment, such as:⁶

• Psychotherapy and counseling.
• Mental and behavioral health inpatient services.
• Substance use disorder (addiction) treatment.

However, as specific benefits can vary, you should verify your insurance coverage for rehab with your plan administrator to see exactly what’s covered.

River Oaks, a drug rehab near Tampa, FL, is an in-network provider with Carelon (formerly Beacon Health Options).

What Types of Addiction Treatment Does Carelon (Beacon) Cover?

There are a variety of treatment types and levels of addiction treatment that may be covered by Carelon (formerly Beacon). The type of treatment that’s best for you can depend on your individual needs and can also vary depending on the addiction treatment center you choose.¹ Types of addiction treatment may include:

• Medical detox. For many people, this may be the first step in the recovery process. Medical detox is designed to help you safely withdraw from alcohol or drugs and become medically stable so you can enter ongoing treatment at a rehab center.⁷
• Inpatient rehab. This means you live onsite for the duration of treatment and receive round-the-clock care, support, and monitoring. You’ll participate in a combination of therapies and you may receive medication if appropriate for your needs.⁷
• Partial hospitalization addiction treatment. Partial hospitalization programs, or PHPs, are intense and highly structured outpatient programs where you live at home but travel to a treatment center on a regular basis. They generally involve 20 hours or more of weekly treatment.⁸
• Intensive outpatient rehab. Intensive outpatient programs, or IOPs, are structured and supportive outpatient programs that are less intense than PHPs but still require between 9-19 hours of weekly treatment.⁸
• Outpatient rehab. Outpatient rehab can vary widely, with some programs requiring 1-3 days per week of treatment while others offer minimal intensity services such as monitoring and drug education. Outpatient rehab is often used as step-down from more intensive programs, such as inpatient rehab, PHPs, or IOPs.⁸

Carelon also understands the importance of continuing care after you complete a more intense substance use treatment program. After all, recovery is a lifelong process that requires dedication and support to optimize your chances of success.¹

When transitioning from an inpatient program to an outpatient program as well as before you leave a recovery center, you’ll work with a peer support specialist who is either state or nationally certified and may also be trained in Trauma Informed Care and Intentional Peer Support.⁹

When leaving treatment, you’ll receive assistance with creating an aftercare plan, which can include less intense forms of care or participation in peer support groups led by peer support specialists.⁹

How Much Does Rehab Cost With Carelon (Beacon)?

You may wonder about handling the cost of rehab and what your specific costs might be when using Carelon (Beacon) at an addiction treatment center. The cost of rehab can vary widely depending on different factors, such as the:

• Specific substance use program you choose.
• Type of treatment offered.
• Specific Carelon Behavioral Health plan you have.

To inquire about any potential costs you may be responsible for, you can contact Carelon (Beacon) insurance, or your specific carrier in Florida. In many cases, people are responsible for:¹⁰

• A copay, which is the small amount you pay upfront when you visit a provider.
• And/or deductibles, which is the specific yearly amount you’ll need to pay before your plan covers costs.

These amounts can vary widely depending on the plan you have.¹⁰ It’s a good idea to verify any additional costs, such as deductibles and copays outlined on your plan, with your provider so you know what to expect.

How to Use Carelon to Pay for Rehab at River Oaks

You’ll need to follow a few simple steps to get started using Carelon (Beacon) at a rehab center like River Oaks. The first step would be to call the number on your insurance card. When you call your provider, you will be connected with a Carelon case manager or peer support specialist, who will listen to your concerns and needs and work with you to help you decide on an effective treatment plan.¹

To learn more about how to use Carelon (Beacon) medical insurance, you can call your insurance provider to verify your coverage, or you can contact a caring River Oaks admissions navigator at to help you start the admissions process.

You can also instantly verify your benefits using our online form below. Starting treatment can be a life-changing experience, and we’re here to support you all the way.