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Emblem Health Coverage for Drug and Alcohol Detox & Addiction Treatment


As one of the nation’s largest nonprofit health plans, Emblem Health operates as a neighborhood health plan that services New York City and the surrounding areas. Emblem Health offers marketplace as well as Medicaid and Medicare-based plans, all of which provide coverage for drug and alcohol detox and addiction treatment.

Affordability shouldn’t be an issue when someone is willing to get help for an addiction problem, but it often is. It helps to know that your Emblem Health plan can pick up a good portion of your treatment costs, so the path to getting needed treatment help is clear.

With an overall understanding of what your plan will and won’t cover, the task of finding a detox program that’s right for you becomes that much easier. is here to help you find a program that offers the level of care you need to get well.

Does Emblem Health Cover Drug & Alcohol Detox?

When left untreated, drug and alcohol problems strip away your ability to control the urge to use over time. Before long, the need for the drug takes precedence over everything else in your life. The only way to regain control is to stop substance abuse altogether. Detox treatment programs provide the types of supports needed to break the cycle of substance abuse.

Emblem Health plan benefits include coverage for drug and alcohol detox treatment. Plan benefits cover a range of treatment program types and services. Benefit coverage varies from plan to plan and policy to policy, so it’s important to know exactly what your policy will and will not cover.

Programs and services that may be covered by your Emblem Health plan include:

  • Medically managed inpatient detox
  • Medically supervised outpatient detox
  • Methadone therapy
  • Medical care to stabilize medical conditions brought on by substance abuse
  • Mental health treatment for psychological conditions brought on by substance abuse

Does Emblem Health Cover Drug & Alcohol Rehab?

Drug and alcohol rehab treatment is the next step in the addiction recovery process. Whereas detox treatment addresses the physical aspects of drug and alcohol withdrawal, rehab treatment addresses the psychological aspects of withdrawal. Unlike the physical effects, psychological withdrawal can persist long after drug or alcohol use stops, so it’s important to choose a program that offers the level of support you need to maintain abstinence for the long-term.

Emblem Health covers rehab treatment services through their Behavioral Health Services Program. At this point, your overall condition will determine what types of programs and services your plan will cover. As long as the program you choose is considered a necessary part of your recovery progress, your Emblem Health plan should cover a good portion of your treatment costs.

Contact to find rehab programs covered by your Emblem Health plan!

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Rehab programs and services typically covered by Emblem Health include:

  • Methadone maintenance treatment, or long-term methadone therapy
  • Outpatient care
  • Ongoing mental health care (when needed)
  • Ongoing medical care (when needed)
  • Residential programs
  • Intensive outpatient care

How Long Will Emblem Health Cover Detox Services?

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Emblem Health will help cover detox costs so you can focus on recovery.

While the standard detox treatment stay typically runs from two to four weeks, it’s not uncommon for people coming off severe addiction problems to require much longer stays. Severe addictions naturally breed serious medical and psychological problems that must be treated in order for any progress  to be made in addiction recovery. For these reasons, your Emblem Health plan will cover detox services for as long as it takes to treat symptoms of physical withdrawal and stabilize any conditions resulting from chronic substance abuse.

It helps to keep in mind that inpatient hospitalization and residential programs cost considerably more than outpatient treatment, so coverage durations will vary widely between these program types. For example, some Emblem Health plans limit the length of outpatient treatment to 60 visits per year and typically pay 100 percent of treatment costs. Coverage terms for inpatient and residential-based detox programs will likely be much shorter and pay considerably less than outpatient benefit coverages.

Does Emblem Health Provide Coverage for Luxury Detox & Other Non-Essential Benefits?

Luxury-based programs place a heavy emphasis on comfort and emotional well-being during the course of detox recovery. These types of programs are more likely to use holistic practices, so alternative therapies and plush accommodations make up a big part of their treatment approach.

Services commonly offered by luxury detox programs include:

  • Personal fitness trainer
  • Private rooms
  • Equine or horseback riding therapy
  • Vacation-like locales, such as in the mountains or beachfront
  • Fine dining

Unfortunately, Emblem Health plans won’t cover any treatments or services unless they’re a necessary part of the detox treatment process. This means, much of the cost for these programs must be paid out-of-pocket. As some of these programs do accept partial payment from insurance, it is possible to have at least a small portion of your treatment costs covered should you so choose to go with a luxury program.

How Can I Cover the Excess Costs of Detox That Are NOT Covered by Insurance?

As good as Emblem Health coverage may be, it’s likely you’ll have to pay a portion of your overall treatment costs, which may end up being pricey depending on your coverage and the program you choose. In some instances, these costs can become a real barrier to getting needed treatment care.

Thankfully, most detox (and rehab) programs offer ways to help you better manage these out-of-pocket costs. Payment assistance options (which can vary from program to program) make it possible to cover any out-of-pocket costs without straining your financial resources.

Assistance options typically take the form of:

  • Paying on a month-to-month basis
  • Medical credit cards
  • Coordinating a bank loan
  • Cost-adjusted payments based on your income earnings

Free Insurance Benefits Check-Your Detox May Be Fully Covered

Considering the toll substance abuse takes on the body and mind, it can be tempting to just go with any program that takes Emblem Health coverage. While it is best to get into treatment as soon as possible, it’s just as important to ensure the program you choose can actually help you get and stay clean and sober. Also, your health plan coverage can go a lot further with programs that work with Emblem Health on a regular basis. can help you check your benefit coverage and match your plan with programs that work with your plan provider. can also help you choose a program that’s able to offer the types of treatment supports you need to succeed in recovery.

Call us here at 800-996-6135(Who Answers?) to speak with one of our program advisers about finding a program that’s right for you.  

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