FHE Health is in-network with Carelon Behavioral Health, formerly known as Beacon Health Options and ValueOptions. To find out what your Carelon plan covers, just give us a call at (833) 596-3502. We’ll provide a confidential and free verification of your behavioral health benefits.
Beacon Health Options Is Now Carelon Behavioral Health
If your insurance card or plan documents say Beacon Health Options or ValueOptions, your behavioral health benefits are now managed under the Carelon Behavioral Health name. ValueOptions became part of Beacon Health Options, and in March 2023 Beacon Health Options was renamed Carelon Behavioral Health. Carelon is part of Elevance Health, the company formerly known as Anthem.
Carelon manages behavioral health benefits for employers, health plans and government programs. That means your coverage for mental health and substance use treatment may be managed by Carelon even if your medical insurance card shows a different company name.
What Carelon Coverage Means for Addiction and Mental Health Treatment
Under federal healthcare laws, most health plans offered through the Marketplace or by employers must provide some kind of chemical dependency treatment coverage. This includes plans with behavioral health benefits managed by Carelon.
In fact, under the Affordable Care Act, plans sold on the Marketplace and many employer-sponsored plans must cover behavioral health treatment and addiction treatment. What this means is that you are likely to have some type of benefit for drug and alcohol rehab if you need these services.
Another important point is that parity laws prevent plans from making behavioral health benefits more restrictive than medical benefits. Co-pays and deductibles for behavioral health benefits managed by Carelon must be in line with the co-pays and deductibles the plan has for other medical treatment.
Keep in mind that while the specifics of each insurance policy vary, as a member whose behavioral health benefits are managed by Carelon, you have the right to some form of mental health, substance use and addiction treatment services that your insurance covers.
With the reassurance that your Carelon benefits cover some of your care, you may be curious about the types of drug and alcohol treatment or mental health disorder treatment available to you. Here’s a look at some of the services most commonly needed.
Drug and Alcohol Detox Coverage from Carelon
Most drug and alcohol rehab facilities require detoxification (detox) as a first step in advancing to a formal treatment program. Helping the individual undergoing detox entails ensuring a safe, comfortable and effective cleansing of the substances from the body through medically monitored, professional services. When drugs and alcohol are discontinued, the body goes through withdrawal symptoms, ranging from mild to severe, sometimes life-threatening. The goal of professional drug and alcohol detox is to make the individual as comfortable as possible while minimizing the risks of complications and maximizing detox process effectiveness. Carelon addiction treatment coverage likely includes drug and alcohol detox.
Medical Integration Coverage from Carelon
For those struggling with addiction, the disease itself is often accompanied and complicated by underlying medical and/or mental health conditions. To successfully treat substance use disorder requires comprehensive medical integration of care. Being able to treat the whole person means addressing physical changes that may have occurred due to substance use, depression, anxiety or other mental health conditions. In the detox process and addiction withdrawal, there can be high-risk complications, which may include delirium tremens from alcohol withdrawal, seizures, cardiac arrest, pulmonary, liver and kidney damage, and a number of other serious conditions. Medical integration, typically included in insurance coverage for addiction and mental health treatment, including coverage managed by Carelon, ensures prompt treatment of any symptoms that occur, helping make the transition from detox to treatment safer, more comfortable and effective.
On-Site Psychological Services Covered by Carelon
Many individuals who are in treatment or require treatment for co-occurring substance use disorder and mental health issues, or who experience diagnosed depression or another mental health disorder, may need a variety of on-site psychiatric services, including behavioral health counseling and other psychiatric treatments. This may include medication, medication management and different types of therapies prescribed during on-site psychiatric consultations. Many of these services may be covered through Carelon behavioral health benefits.
Residential Treatment Coverage from Carelon
Carelon addiction treatment coverage may include residential treatment at facilities that specialize in drug and alcohol rehab. Alcohol and drug treatment often includes a residential stay, which can range from one week to 30 to 90 days or longer depending on the patient’s needs. That’s why finding an in-network rehab center that works with Carelon matters. A residential stay at FHE Health’s alcohol and drug rehab in Deerfield Beach is often covered by insurance, including plans managed by Carelon. Be advised, though, that prior authorization may be required for Carelon to cover rehabilitation services.
Outpatient Treatment Coverage from Carelon
Once residential treatment is completed, it’s important to have a follow-up that may entail getting continuing care on an outpatient treatment basis. Such outpatient rehabilitation helps support long-term recovery and reduce the risk of relapse. Plans managed by Carelon recognize the value of providing outpatient treatment coverage as a further benefit in the ongoing goal of maintaining sobriety.
Getting Help When You Have Carelon (Beacon) Insurance
Insurance can be a complicated matter to navigate, but you don’t have to face it on your own. Our team at FHE Health is ready to help you sort through the complexities and give you the reassurance you need with a full verification of your Carelon Behavioral Health coverage. Once you call us, we handle the verification in a confidential manner. We will make all the necessary inquiries, and this will not affect either your insurance plan or your employment.
If you have Carelon Behavioral Health coverage through your employer, EAP or health plan, call our dedicated, compassionate team of administrators so we can answer your questions and verify your Carelon addiction treatment coverage right away. Day or night, our team is always available when you call to provide immediate assistance for drug and alcohol rehab.
