Carelon Massachusetts Drug and Alcohol Rehab Treatment Coverage

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Serenity at Summit is a leading provider in the field of drug and alcohol addiction rehabilitation and mental health treatment services with a Massachusetts-based facility. Our centers offer a nurturing and tranquil atmosphere, fostering addiction recovery and enhancing mental well-being. We are committed to ensuring accessibility to quality treatment by accepting various health insurance plans.

If you are covered by Carelon Behavioral Health, we may also be able to accommodate your plan. Call (844) 326-4514 to verify your insurance coverage levels and better understand the available treatment options for yourself or a loved one. Our devoted professionals are readily available to offer guidance and support as you embark on the path toward a brighter, healthier future.

Exploring Massachusetts and its Cities

In the northeastern part of the United States, Massachusetts is renowned for its abundant history, scenic landscapes, and diverse urban centers. The Bay State¹ shares borders with New Hampshire, Vermont, Connecticut, Rhode Island, and the Atlantic Ocean. Massachusetts’ topography showcases a broad spectrum of natural beauty, ranging from the undulating hills of Haverhill to the coastal enchantment of Quincy.

The state’s capital and largest city, Boston, stands out as a dynamic center of culture and education, while nearby Cambridge is home to esteemed institutions such as Harvard and MIT. Moving westward, Worcester thrives with artistic expression and cultural diversity, and Springfield is recognized for its industrial legacy and as the birthplace of basketball.² Heading north, Lowell pays homage to its industrial heritage, with each city contributing to Massachusetts’ captivating appeal for residents and visitors alike.

Who is Carelon Behavioral Health?

Carelon Behavioral Health, previously known as Beacon Health Options, is a behavioral healthcare provider that offers services to various entities such as health plans, employers, governments, and labor organizations. Established by a leading healthcare organization in the United States, Carelon Behavioral Health serves over 47 million clients, including Fortune 500 companies.³

Carelon aims to remove health barriers with expertise, data, and technology, providing affordable, accessible, and personalized healthcare solutions that address the mind, body, and spirit.4 This network of behavioral health specialists offers personalized support, focusing on making sure that the quality of mental health care is superior, using evidence-based methods, measuring results, and actively supporting mental health causes. They also provide educational resources to clients and communities.5

Some Carelon Brands, Products, and Services in Massachusetts

Carelon Behavioral Health provides various services such as pharmacy, behavioral health, complex care delivery, medical benefits management, payment integrity, palliative care, advocacy, research, digital platforms, and operations and technology services. With this diverse range of brands, products, and services, you can easily find all the offerings you need: 

Carelon Brands

  • Formerly known as Ingenio Rx, CarelonRx is a pharmacy benefit manager that manages a network of over 60,000 pharmacies and provides prescription drug benefits to health plans and employers. The company is responsible for dispensing over 1 billion prescriptions annually.6
  • Carelon Behavioral Health (formerly Beacon Health Options) provides comprehensive behavioral health services, including individual, group, and family therapy and medication management.
  • Formerly known as myNEXUS, Carelon Post Acute Solutions is a home healthcare provider that offers nursing care, physical therapy, occupational therapy, and speech therapy. They serve over 200,000 patients annually through a network of more than 10,000 providers.7

Carelon Products and Services

  • Carelon provides access to behavioral health services through an extensive network of licensed clinicians.
  • Employee Assistance Programs (EAPs) provide employees with counseling, digital tools, and educational resources to help them achieve a better work-life balance and improve their well-being.
  • Medical benefits management services provide health plans and employers with claims processing, network management, and utilization review.8
  • Carelon provides compassionate palliative care to patients and their families with chronic or life-limiting illnesses.9
  • Carelon provides advocacy services to help patients and families navigate healthcare and access necessary care.10
  • Healthcare providers and the insured benefit from digital tools and insights based on data, promoting transparency, connection, and affordability.11

What is Carelon Rehab Coverage?

Carelon primarily focuses on managing and coordinating behavioral health services, specifically mental health and substance abuse treatment, rather than providing traditional insurance coverage for rehabilitation services. Despite this distinction, Carelon rehab coverage in Massachusetts encompasses a broad range of services and programs related to the treatment of substance use and mental health conditions.

Rehabilitation services may include, but are not limited to, outpatient care, counseling, and medication-assisted treatment (MAT). To gain a comprehensive understanding of Carelon rehab coverage in Massachusetts, please review your policy documents or contact us. Our team is committed to helping you clarify the extent of your coverage, ensuring you have access to the necessary resources tailored to your specific treatment needs.

Check Your Insurance by Phone

Call Now: (844) 326-4514

Does Carelon Cover Rehab for Drugs and Alcohol in Massachusetts?

Carelon is committed to offering comprehensive behavioral health services, including drug and alcohol rehabilitation, in Massachusetts. Their inclusive services may cover detoxification, inpatient care, outpatient rehabilitation, medication-assisted treatment (MAT), counseling, and a range of additional support for substance abuse treatment and relapse prevention.

To better understand the details of your coverage and any co-pays, deductibles, limitations, or exclusions associated with it, please review your particular plan carefully. For tailored information about Carelon alcohol rehab or Carelon drug rehab services, call (844) 326-4514.

Does Carelon Cover Medical Detoxification Treatment in Massachusetts?

Carelon typically includes medical detox treatment as part of its range of behavioral health services. This treatment ensures the safe withdrawal from addictive substances under the supervision of medical professionals. It’s important to note that the specifics of coverage for medical detox may vary among plans.

You can also check your insurance coverage by filling out our confidential online form. Our dedicated team is prepared to promptly provide detailed information regarding your medical detox coverage and address any questions you may have. We’ll ensure you receive the necessary insights to better understand your Carelon rehab coverage in Massachusetts.

Does Carelon Cover Residential Treatment in Massachusetts?

Carelon typically offers coverage for residential treatment in Massachusetts, specifically crafted for individuals struggling with substance abuse, mental health challenges, or dual diagnosis. Residential programs provide a structured, supportive environment, ensuring you or your loved one can access intensive 24/7 care. The extent of coverage for residential treatment may differ based on your specific plan and other factors.

For a comprehensive understanding of your residential treatment coverage in Massachusetts, we recommend reviewing your policy details. Your path to recovery is our top priority, and we are committed to providing the necessary support.

Does Carelon Cover Mental Health Therapy Treatment in Massachusetts?

Carelon Behavioral Health frequently encompasses mental health therapy treatment coverage within its broad range of behavioral health services. These services include diverse therapeutic approaches such as counseling, cognitive-behavioral therapy (CBT), motivational interviewing, and others tailored to address various mental health challenges.

However, the specifics of your coverage depend on your individual policy and other contributing factors. We are dedicated to supporting your journey toward improved mental health while prioritizing your overall well-being. For a clearer understanding of your Carelon rehab coverage in Massachusetts, call (844) 326-4514.

Check Your Insurance Coverage

Does Carelon Cover EMDR Therapy in Massachusetts?

Carelon Behavioral Health commonly provides coverage for Eye Movement Desensitization and Reprocessing (EMDR) therapy, an evidence-based therapeutic approach designed to alleviate symptoms associated with trauma-related conditions. EMDR involves guided lateral eye movements as part of the therapeutic process. This innovative method is recognized for its effectiveness in addressing various psychological challenges stemming from traumatic experiences.

The specific coverage for EMDR therapy is contingent on your plan and other influencing factors. If you have questions or need a comprehensive understanding of the extent of your coverage for EMDR therapy, please don’t hesitate to call (844) 326-4514. This step is essential for making informed decisions about mental health care, whether for yourself or a loved one.

Other Rehab Treatment Programs in Massachusetts Covered by Carelon

In addition to the treatment programs mentioned earlier, Carelon extends its coverage to various other rehabilitation programs in Massachusetts. This comprehensive approach ensures a thorough focus on mental health and substance abuse care. These additional programs are designed to cater to diverse needs, offering tailored solutions for individuals seeking effective and specialized treatment.

Coverage for Partial Hospitalization Programs

Partial Hospitalization Programs (PHPs) are an intensive and structured treatment option for mental health and substance use challenges, offering a middle ground between outpatient care and round-the-clock inpatient treatment. These programs specifically address various conditions, such as depression and anxiety, through a combination of individual and group therapy, medical monitoring, and educational components.

Carelon typically extends its coverage to include PHPs, recognizing their effectiveness in providing comprehensive care. This coverage ensures ongoing support, allowing individuals to maintain their daily routines while receiving essential treatment. This approach acknowledges the importance of integrating therapy into everyday life, promoting a sustainable, holistic approach to recovery for you or your loved one.

Coverage for Intensive Outpatient Programs

Carelon typically provides coverage for Intensive Outpatient Programs (IOPs), which serve as a transitional level of care designed for individuals in need of ongoing support in mental health and substance abuse treatment. IOPs encompass regular therapy sessions, group therapy, and counseling, allowing individuals to maintain their daily routines while still receiving the necessary treatment.

Intensive outpatient programs acknowledge the importance of flexibility and continuity in the treatment process, providing a balanced and supportive framework for you or your loved one.

Coverage for Acute Treatment Programs

Carelon typically extends its coverage to acute treatment programs to address urgent and severe mental health issues. These programs serve as a crucial lifeline during crises, providing intensive, short-term care that ensures swift, appropriate intervention. This level of care plays a pivotal role in stabilizing conditions and preventing mental health deterioration, emphasizing the importance of timely support during critical moments.

Coverage for Inpatient Rehab

Inpatient rehabilitation is a comprehensive treatment program designed to offer continuous care for individuals dealing with severe mental health, substance abuse, or dual diagnosis challenges. This initiative involves residing in a specialized facility and receiving ongoing monitoring, therapy, and medical support within a highly structured environment.

Carelon typically provides coverage for inpatient rehab, ensuring individuals have access to intensive care, support groups, and aftercare assistance that is crucial for maintaining their recovery and sobriety. For more information on the above treatment programs, please call (844) 326-4514.

Rehab Centers in Massachusetts That Take Carelon

We are devoted to guiding you through the process from detoxification to outpatient care, empowering you to achieve overall well-being. Within our modern facility, you’ll find a serene environment to begin your recovery journey, addressing substance addiction and other mental health concerns. Our comprehensive approach incorporates advanced clinical practices and evidence-based methods, ensuring thorough and effective treatment.

If you are in search of an accredited treatment center that accepts insurance, including many Carelon Behavioral Health plans, visit our Massachusetts location at the address below:

Check Your Insurance by Phone

Call Now: (844) 326-4514

How Much is Rehab with Carelon Insurance?

The cost of rehabilitation depends on various factors, with your specific insurance policy being a significant consideration. For those without insurance, psychotherapy sessions generally range from $100 to $200 an hour,12 while the average cost of residential rehabilitation treatment in Massachusetts is $56,725.13 Individual circumstances and the duration of treatment, among other considerations, can present significant variations in actual costs.

Check your insurance coverage now or by reviewing your policy documents. We can assist you in navigating the essential steps for treatment and offer more precise estimates for rehabilitation expenses in Massachusetts.

How To Check Carelon Coverage Levels for Rehab Treatment

Understanding health insurance can be overwhelming, but at Serenity at Summit, we’re here to make it easier for you. Our goal is to assist you in checking your insurance coverage. Our dedicated team is committed to protecting your rights, ensuring you get the best care, and offering guidance and support every step of the way.

Simply call us at (844) 326-4514, and rest assured that any information you provide will be confidential. Contacting us allows our team to verify your rehab insurance, freeing you to focus on your journey to recovery. We recognize the significance of this step in your healing process and strive to make the insurance verification process as smooth and stress-free as possible.

Check Your Insurance Coverage

How To Get Carelon to Pay for Rehab Treatment in Massachusetts

To ensure Carelon covers the costs of rehab treatment in Massachusetts, taking a few key steps is essential. Firstly, thoroughly review the insurance policy documents. This will give you a clear understanding of their coverage for rehabilitation services. Pay attention to the specifics, such as types of treatment covered, in-network facilities, and any limitations or requirements.

Give us a call, or contact your insurance department to discuss your situation and inquire about the coverage details for rehab treatment in Massachusetts. Provide any necessary information needed to assess your case accurately. By actively engaging with Carelon, you can ensure clarity on your coverage, making the process smoother when seeking rehabilitation. The specific details and steps may vary based on individual policies and circumstances, so contact Carelon directly for personalized assistance, and remember that being proactive in understanding your coverage is crucial for a successful, stress-free reimbursement process.

How Many Times Will Carelon Pay for Rehab in Massachusetts?

In Massachusetts, the frequency and extent of rehab coverage by Carelon Behavioral Health are contingent on several factors, chiefly your healthcare plan and the medical necessity determined by healthcare professionals. In general, insurance plans in Massachusetts typically cover the expenses of rehab treatment if it is deemed medically necessary and appropriate by a healthcare professional.

Considerations include the nature of the condition being treated, the duration of the treatment, and more. For example, limitations or exclusions may exist on the number of days or sessions covered within a specific time frame.

Addiction Statistics in Massachusetts

  • Between February 1-13, 2023, 30.8% of Massachusetts adults reported symptoms of anxiety and/or depression. The percentage for the United States was 32.3%.14
  • Outpatient services in Massachusetts account for $106 million, which is 4.59% of total U.S. public spending.15
  • According to recent findings, Massachusetts is ranked 27th in terms of the cost of residential drug rehabilitation treatment, from cheapest to most expensive state.
  • More than half of the admissions to drug rehabilitation centers in Massachusetts are due to heroin addiction.
  • A recent study published in the American Journal of Public Health highlighted that counties with primarily rural populations have some of the highest rates of opioid use disorder. The counties with the highest prevalence rates are Berkshire (6.06%), Bristol (5.81%), Hampden (5.34%), Barnstable (5.03%), and Worcester (4.38%). However, Suffolk County, which includes the city of Boston, has a lower prevalence rate of 3.36%.16
  • A serious mental illness affects approximately 260,000 adults in Massachusetts.17
  • There are 17,975 homeless individuals in Massachusetts, and one in five of them have a serious mental illness.
  • Amidst the pandemic, it has been reported that nearly 38% of adults residing in Massachusetts increased their alcohol consumption.18
  • 18% of Massachusetts adults report binge drinking on one occasion in the past thirty days.19
  • The estimated prevalence of Opioid Use Disorder (OUD) in Massachusetts among individuals aged 11 or older increased from 2.72% in 2011-2012 to 4.60% in 2015.20

Sources

  1. “The Bay State.” State Symbols USA, 2 June 2017, statesymbolsusa.org/symbol-official-item/massachusetts/state-nickname/bay-state.
  2. “Where Basketball Was Invented: The History of Basketball.” Springfield College, springfield.edu/where-basketball-was-invented-the-birthplace-of-basketball. Accessed 13 Nov. 2023.
  3. “About Us.” Carelon Behavioral Health, www.carelonbehavioralhealth.com/about-us. Accessed 13 Nov. 2023.
  4. “Carelon Health | Whole-Person Care.” www.carelonhealth.com, www.carelonhealth.com.
  5. “1.3 Carelon Beh Care.” www.carelonbehavioralhealth.com, www.carelonbehavioralhealth.com/solutions/carelon-behavioral-care.
  6. “CarelonRx | PBM and Home Delivery Pharmacy (IngenioRx).” www.carelonrx.com, www.carelonrx.com. Accessed 8 Nov. 2023.
  7. “Post Acute Care.” Careloninsights.com, www.careloninsights.com/medical-benefits-management/post-acute-care. Accessed 8 Nov. 2023.
  8. “Medical Benefits Management.” Carelon.com, www.carelon.com/capabilities/medical-benefits-management. Accessed 8 Nov. 2023.
  9. “Palliative Care.” Carelon.com, www.carelon.com/capabilities/palliative-care. Accessed 8 Nov. 2023.
  10. “Advocacy.” Carelon.com, www.carelon.com/capabilities/advocacy. Accessed 8 Nov. 2023.
  11. “Carelon Digital Platforms.” Carelon.com, www.carelondigitalplatforms.com. Accessed 8 Nov. 2023.
  12. Lauretta, Ashley. “How Much Does Therapy Cost in 2023?” Forbes Health, 14 Apr. 2023, www.forbes.com/health/mind/how-much-does-therapy-cost.
  13. Stilkind, Joseph. “Average Cost of Drug Rehab [2023]: By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab.
  14. “Mental Health in Massachusetts.” KFF, 20 Mar. 2023, www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/massachusetts.
  15. Stilkind, Joseph. “Average Cost of Drug Rehab [2023]: By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab.
  16. Barocas, Joshua A. MD, et al. “Estimated Prevalence of Opioid Use Disorder in Massachusetts, 2011–2015: A Capture–Recapture Analysis.” American Journal of Public Health, vol. 108, no. 12, American Public Health Association, Dec. 2018, pp. 1675–81. https://doi.org/10.2105/ajph.2018.304673.
  17. “Mental Health in Massachusetts.” National Alliance on Mental Illness (NAMI), Feb. 2021, www.nami.org/NAMI/media/NAMI-Media/StateFactSheets/MassachusettsStateFactSheet.pdf.
  18. Jernigan, David H., Ph. D., and Xixi Zhou B. I. D. “Alcohol Causes 1 in 20 Deaths in Massachusetts.” © 2023 Boston University, 2022, www.bu.edu/sph/files/2022/12/BU_SPH_Alcohol-221205-FINAL.pdf.
  19. “Explore Excessive Drinking in Massachusetts | AHR.” America’s Health Rankings, www.americashealthrankings.org/explore/measures/ExcessDrink/MA. Accessed 7 Nov. 2023.
  20. Barocas, Joshua A., et al. “Estimated Prevalence of Opioid Use Disorder in Massachusetts, 2011–2015: A Capture–Recapture Analysis.” American Journal of Public Health, vol. 108, no. 12, American Public Health Association, Dec. 2018, pp. 1675–81. https://doi.org/10.2105/ajph.2018.304673.

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