EmblemHealth Provider Information

Explanations of a deductible, co-payment, and coinsurance include:

  1. A deductible is the responsibility of the member to pay upfront for covered services prior to the health insurer covering costs. For example, members with a $500 deductible plan must pay upfront the first $500 of coverage costs.
  2. A co-payment is a set fee that members finance for treatment. It is usually required before, but sometimes after a member has paid their deductible.
  3. Coinsurance is a percentage of the entire cost for a covered treatment a member is liable for after their deductible has already been satisfied. Health plans with more expensive monthly premiums will usually have lower co-payments and coinsurance rates than those with lower monthly premiums.
Patient receiving mental health care using insurance coverage from EmblemHealth
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Suppose you or a loved one is covered under EmblemHealth insurance and requires a medical facility to assist with detox before seeking rehab. In that case, these treatments are normally covered under the plan. EmblemHealth is a non-profit health insurance company that covers more than 3 million residents of Connecticut, New Jersey, New York State, and the tri-state New York City area. EmblemHealth will usually cover substance abuse treatment and mental health disorders, depending on the specific plan. Even if the plan provides coverage, members could still be responsible for deductible costs, copayments, and coinsurance to cover addiction treatment.

Mental Health Treatment Offerings at Behavioral Health Centers

Behavioral Health Centers has had a long relationship with EmblemHealth. Your insurance plan can cover inpatient treatment at our facility or allow you to receive services through our partial hospitalization program (PHP). Both inpatient and PHP treatment give you access to various intensive therapies, including cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).

We Accept Most Insurance

Behavioral Health Centers does not accept Medicare or Medicaid.

How to Cover What EmblemHealth Insurance Won’t

For those with an EmblemHealth plan who don’t have upfront money for addiction treatment that your plan doesn’t cover, you may want to check with providers that can offer payment plans. Overall, patients usually have several different choices to cover substance addiction treatment, which include:

  • Borrowing from friends or family
  • Payment plans
  • Personal loans
Insurance coverage and health insurance plans from Emblem health reduced out of pocket costs for mental health services and addiction treatment
mental health services and addiction treatment covered by EmblemHealth health insurance plans

Verifying Coverage and Finding the Best Treatment

In regards to verifying coverage plans, EmblemHealth makes the process quite simple. Members can seek treatment at an approved outpatient treatment facility within its network. This means members can show up at any network provider and receive substance addiction treatment that is needed almost immediately. While some members might be skeptical in choosing outpatient treatment, according to statistics on substance addiction rehabs, residential and outpatient treatment centers’ success rates are almost the same.

It would be best to locate the appropriate treatment center and rehab facility to tailor an addiction treatment program to fit your specific addiction treatment needs. For those who need help finding a rehab center, it is advised to call EmblemHealth to learn more about your plan.

The best way to verify your EmblemHealth insurance benefits for drug and alcohol rehab is by reaching out to our admissions specialists to discuss your addiction treatment options. Everything is confidential to speak freely about your mental health or substance abuse disorder, so call us today at 772-774-3872 to learn more about what mental health treatment and substance abuse treatment is covered by EmblemHealth insurance.