Health Smart Insurance Coverage for Drug & Alcohol Rehab

Does HealthSmart Cover Drug and Alcohol Rehab?

While HealthSmart doesn’t directly provide insurance coverage, it empowers your employer to choose a plan that best suits the needs of their employees.² HealthSmart administers your employer’s self-funded plan, so it does not choose coverage options, although it can help employers optimize their health plans and decide what to include.^2,3

Before selecting a treatment center, we encourage you to connect with your employer to find out about the benefits offered by your personalized insurance plan. This step ensures you’re well informed about the range of covered treatment options, including any specific centers or programs that may be included. By understanding your coverage, you can confidently choose a program that aligns with your needs and maximizes your benefits.

How to Check Your HealthSmart Benefits

HealthSmart provides an online member portal that allows its members to check coverage, view claims, get a digital ID card, view plan details, and more. If you need access to your member portal information, check with your benefits administrator or human resource department.

What Addiction Treatment Does HealthSmart Cover?

HealthSmart administers a variety of insurance plans that offer flexibility in coverage options.² While some plans may include essential health benefits like mental health and addiction treatment, others may provide alternative coverage options to cater to diverse healthcare needs.²

If your employer covers addiction treatment, you might wonder what types of treatment are covered. Individual plans vary, but some common types of treatment that could be covered include:⁴

• Detox — Drug and alcohol detox is the process of safely and effectively removing drugs or alcohol from the body. It is often the first step in addiction treatment, as it allows the body to adjust to functioning without substances.
• Inpatient rehab — Inpatient rehab, also known as residential treatment, is a type of addiction treatment where individuals reside at a center for a specific period, typically ranging from a few weeks to several months. It provides a structured and supportive environment for people to focus on their recovery from substance use disorders.
• Partial hospitalization programming (PHP) — PHP is a structured addiction treatment program that provides intensive outpatient care. Individuals attend treatment for several hours per day, usually 5 or more days a week, and return home in the evening. It’s designed for individuals who need more support than traditional outpatient treatment but don’t require a more intensive program.
• Intensive outpatient programming (IOP) — An IOP offers higher levels of care than standard outpatient therapy but less than an inpatient or partial hospitalization program. IOPs typically involve several hours of treatment each week, spread across multiple days. IOPs can serve as a step-down from more intensive programs, like inpatient treatment, or a step-up from less intensive outpatient treatment.
• Outpatient treatment—Outpatient treatment is a less intensive, more flexible option in which individuals attend therapy, group sessions, or other forms of treatment, typically once or twice a week. This enables individuals with home, work, or school obligations to maintain their commitment while receiving supportive, evidence-based care.

Is Mental Health and Co-Occurring Disorder Treatment Covered Under HealthSmart?

Because employer-funded health plans vary greatly in the types and levels of treatment they cover, it’s a good idea to check with your benefits administrator for your specific coverage levels.^2,3 However, many plans that cover addiction treatment also cover mental health disorder care because they frequently co-occur, and integrated treatment is recommended for better outcomes.⁴

What to Do if My Policy Does Not Cover an Inpatient Drug Rehab Program

Even if your insurance plan doesn’t cover inpatient addiction treatment, you still have plenty of options for getting the care you need! Scholarships, payment plans, and support from loved ones can make treatment accessible.

Additionally, you may wish to consider other forms of care; effective treatment only sometimes requires inpatient care. Outpatient programs offer flexible, high-quality support while allowing you to maintain your daily life.

Explore your options and take the first step towards a healthier future. American Addiction Centers is here to help you explore your options and support you as you take the first steps toward a healthier future. Reach out to us today at , and let’s explore the possibilities together.

Our Treatment Centers

1. HealthSmart. (2024). How we help.
2. HealthSmart. (2024). We we serve: Employers
3. Center for Medicare and Medicaid Services. (2011). Frequently asked questions on essential health benefits bulletin.
4. Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131