Using Evernorth insurance for rehab Infographic

Find Top Rehabs That Accept Evernorth Insurance Now

An Overview of Evernorth for Rehab

Recognizing that you require professional assistance to deal with an addiction or substance abuse disorder is a significant setup forward, but we understand it is fraught with anxiety, to help provide reassurance, we’ve written a comprehensive guide to addiction rehabs that accept Evernorth insurance. You may be unfamiliar with detox and rehab, and the unknown can be frightening. Furthermore, you may be concerned about how you will pay for alcohol or drug addiction treatment.

The mission of Find Addiction Rehabs stems from helping answer all addiction-related questions so that you (or your loved one) can feel confident in your decision to seek help. Individuals who have an Evernorth healthcare policy can learn more about Evernorth rehabilitation options by reading on.

Up To 100% Of Treatment Covered With Evernorth

What Is Evernorth Insurance & How Does It Work?

Evernorth offers health insurance to businesses, employers, and individuals worldwide. Evernorth provides health insurance to hundreds of millions of patients. Many people, however, are unsure about what their insurance plan covers in terms of substance abuse and mental health services.

So, does Evernorth pay for addiction recovery treatment? The short answer is that it will cover at least some of the cost, but the purpose of this page is to help you figure out what your Evernorth Healthcare does and does not cover.

Being a global health services company that assists people in improving their overall health and well-being and serving more than 95 million people worldwide, Evernorth covers a variety of treatments that aid in the recovery of people suffering from substance use disorders. Evernorth also covers mental health services for conditions such as anxiety and depression.

In addition to its mission of providing affordable healthcare for basic needs, the organization assists its members with addiction treatment.

Although coverage varies according to your specific plan, recovery services may include:

  • Drug rehabilitation
  • Detoxification
  • Alcohol rehabilitation
  • Counseling for addiction treatment

How Does Evernorth Rehab Coverage Work?

Using Evernorth insurance for rehab Infographic

Evernorth’s level of coverage for substance abuse treatment will vary depending on your plan and the state you live in.

Preauthorization is usually required for substance abuse treatment. When your health insurer determines a therapy, treatment, medication, or device is medically necessary for your condition, the process gets referred to as preauthorization. It is also referred to as prior authorization or prior approval. It is important to note that policyholders who require preauthorization for substance use disorder services, including treatment at an inpatient facility but do not receive prior authorization may be liable for the full cost of treatment.

If the services you receive are not fully covered, you may be required to meet a deductible and pay a copayment or coinsurance. A co-payment is a fixed amount you pay for services, whereas coinsurance is a percentage of the costs you pay. A deductible is an amount you must pay before Evernorth will pay for services.

Receiving drug rehab treatment from an in-network provider may allow you to avoid paying the full treatment cost. In-network providers negotiate fixed prices for a catalog of services with the healthcare coverage network, at a rate usually lower than the cost for someone with no insurance coverage or when treatment is sought and the provider is out-of-network. Out-of-network providers have not agreed to set prices, so you will most likely be charged more to use them.

Exploring Evernorth Addiction Treatment Options

Evernorth established a Behavioral Health division to better support those suffering from drug or alcohol addiction. The newly founded division includes programs such as an education series in addition to articles, tools, podcasts, and social media outreach for individuals and families.

Evernorth’s free education series teaches about the physical, mental, and emotional symptoms of addiction. Each lesson contains advice for those in recovery as well as their loved ones.

While these seminars provide information on addiction and substance abuse, they are not meant to replace medical care. Always consult with a medical professional about the best treatment for your specific condition.

Evernorth Policy Coverage for Substance Abuse

Your benefits and coverage will vary depending on your Evernorth plan. For example, Evernorth’s most basic plan, bronze, have lower premiums but higher deductibles and out-of-pocket expenses. Those with gold or platinum plans, on the other hand, receive more comprehensive coverage with lower deductibles.

In terms of substance abuse treatment, the services covered by insurance and the costs you will be responsible for vary greatly depending on the type of plan and the state you live in. Contact your health insurance provider to review your policy and determine which types of treatment services are covered under your policy.

Evernorth Employee Assistance Program for Drug and Alcohol Abuse

Evernorth Employee Assistance Program for Drug and Alcohol Abuse

Evernorth provides an employee assistance program (EAP) through which you can speak with licensed clinicians about your drug and alcohol use. The EAP is available with employer-provided health care plans. This program enables you to meet with a licensed counselor in person, speak with a consultant over the phone, or chat with a consultant via live chat.

Do Treatment Centers Need to Be In-Network to Accept Evernorth Insurance?

In-network providers have a contract with the insurance company to provide rehab services at a predetermined cost. This means that your out-of-pocket costs (self-pay) will be reduced in comparison to an out-of-network provider. If you choose an out-of-network facility, you may even be responsible for the entire cost of addiction treatment.

Choose a rehab facility that is in-network with Evernorth whenever possible. If you are unable to locate an in-network provider or prefer an out-of-network facility, you may be able to negotiate a payment plan with the rehab facility so that you can pay back the cost of treatment over time.

While not all Evernorth plans require that your treatment center be in-network, it is important to note that using an out-of-network provider typically increases your out-of-pocket expenses.

There are some plans that don’t cover any services that aren’t in the network. This means that you’ll have to pay for everything yourself. Other plans, on the other hand, will cover specific portions after a deductible or coinsurance has been met.

Pre-certification is required for many out-of-network treatment options. Evernorth will do this by comparing the request to nationally recognized guidelines.

In cases where pre-certification is required, Evernorth will determine which services are covered based on your plan. To find out what treatment options are available to you, consult your policy or call the number on the back of your insurance card.

The Heavy Financial Burden of Addiction

Financial Burden of Addiction

The alarming rate of addiction in the American population has had a significant economic impact. According to the National Institute on Drug Abuse, the annual cost of healthcare, law enforcement, and crime, as well as the cost of lost productivity at work due to substance abuse, totals more than $700 billion.

With alcohol and drug rehab now being covered by group health insurance plans, such as Evernorth rehab coverage, not only does it help to remove the stigma that is often associated with addiction, but it also means that many more people will be able to receive the treatment they require, easing the financial strain on the economy.

Evernorth Addiction Resources

Evernorth established a Behavioral Health division to better support those suffering from drug or alcohol addiction. The newly formed division now includes an education series in addition to articles, tools, and podcasts for individuals and families, along with more services.

Evernorth’s free education series teaches about the physical, mental, and emotional symptoms of addiction. Each lesson contains advice for those in recovery as well as their loved ones.

While these seminars provide information on addiction and substance abuse, they are not meant to replace medical care. Always consult with a medical professional about the best treatment for your specific condition.

Luxury Rehabs Are Covered By Insurance Too!

Different Types of Evernorth Substance Abuse Treatment

The following addiction treatment services may be covered by your Evernorth health insurance plan:

Detox Services

In some cases, you may require assistance when detoxing from drugs and alcohol, which can be uncomfortable, painful, or even fatal. Medical detox allows you to safely withdraw from drugs and alcohol because you will be under medical supervision 24 hours a day, seven days a week. Medication may also be given to you to help with withdrawal symptoms.

Inpatient or Residential Care

Inpatient/residential live-in treatment centers offer drug and alcohol rehabilitation while you live on-site. Most inpatient programs last between 15 and 90 days, depending on the program and your specific needs.

Partial Hospitalization Program (PHP)

As part of a partial hospitalization program, you can live at home while getting treatment during the day.

Intensive Outpatient Program (IOP)

Intensive outpatient rehabilitation and therapy entail attending treatment programs a few evenings per week. You can live at home and even work during the day in an intensive outpatient program.

Outpatient Treatment

Individuals who have completed inpatient treatment frequently attend outpatient treatment to continue their sobriety journey. You live at home and go to a rehab facility for therapy and support 10–12 hours per week.

The total out-of-pocket costs for addiction treatment are determined by the Evernorth plan you have. Monthly premiums, copays, deductibles, and other potential costs vary by plan. However, with Evernorth health insurance, at least a portion of your costs should be covered.

Evernorth Health Insurance Benefits

Is Evernorth going to cover any other addiction services?

Apart from detoxification, and residential and outpatient programs, a selection of other addiction treatment services can be provided individually or alongside inpatient or outpatient treatment.

The following are some of the most commonly used addiction treatment services that you should be aware of before enrolling in a treatment program:

Medication-assisted treatment (MAT):

When a person has been prescribed a medication to help ease withdrawal symptoms and reduce cravings for certain substances, this is referred to as MAT. The most common application of MAT is in the treatment of alcohol and opioid addiction. Acamprosate, Disulfiram, methadone, Vivitrol, buprenorphine, and Suboxone are some of the most commonly used medications for these addictions. Many Evernorth plans will pay for some or all of these prescriptions.


To treat substance use disorders, a variety of therapies may be used. Individual, group, and family counseling are examples of behavioral therapies such as cognitive-behavioral therapy. The majority of Evernorth plans cover some form of therapy.

Sober aftercare:

After completing an inpatient treatment program, sober aftercare, also known as sober living, is sometimes recommended. Sober aftercare is not covered by all Evernorth plans. On a case-by-case basis, other plans may provide coverage for sober living.

Additional services include: Evernorth may also cover drug testing, interventions, experiential therapies, and other medications, such as those for co-occurring mental health disorders.

What Is Dual Diagnosis?

What is Dual Diagnosis Treatment

Substance abuse is frequently accompanied by the diagnosis of a mental disorder such as depression, anxiety, or a personality disorder. It is not uncommon for the mental disorder to be the direct cause of the addiction. As a result, treating the addiction without addressing the mental health issue is unlikely to result in a long-term positive outcome.

Dual diagnosis treatment, which involves treating both the addiction and the mental illness at the same time, can be difficult. However, it is not advisable to try to deal with one issue at a time in order to avoid becoming overwhelmed by it, as this increases the risk of relapsing.

Clients with dual diagnoses receive treatment that is tailored to their specific needs and requirements. Among the therapies and protocols that can be used are:

How Long Does Evernorth Insurance Cover Inpatient Drug Rehab Centers?

The length of your Evernorth insurance coverage is determined by the type of care you require. Coverage varies based on the plan, the length of rehabilitation needed, the relative severity of your substance use disorder and or mental health issues, among other factors. Evernorth offers several policy options, so review yours to learn more about your specific coverage.

According to the National Institute on Drug Abuse, a person’s treatment must be long enough and include sufficient resources to be effective. 6, second complete paragraph For many people, this means a 6-month or longer rehab treatment. That is not to say that shorter treatment times cannot be effective. Many people benefit from three or fewer months of rehabilitation. Some people with more severe substance use disorders, on the other hand, require longer treatment.

Detox is not a cure for drug addiction. Detox, therapy, counseling, community resources, and other services are frequently included in a full course of rehab treatment. It is about providing a support system as much as it is about preventing drug use. We need enough time to build that system for treatment to succeed, which shorter treatment courses do not always allow for. This can lead to people resuming their drug use.

Fast & Free Insurance Verification

Recovery is a lifelong process, and we at Find Addiction Rehabs want you to have a strong foundation when you begin to heal. If you are unsure how long your Evernorth insurance benefits will cover treatment, contact Find Addiction Rehabs. We’ll look up your coverage and assist you in finding a rehab center that meets your requirements.

Another factor to consider is that you may need to travel to another state for the addiction treatment that is best suited to your needs. Although Evernorth Health Insurance plans may cover the cost of treatment, keep in mind that travel costs are not covered, and treatment facilities are not allowed to pay for your travel. So, if you’re thinking about going to a rehab program out of state, consider the cost of travel for yourself and any loved ones who might want to visit you while you’re in treatment.

Evernorth Coverage For Outpatient Treatment

Evernorth Coverage For Outpatient Treatment

Outpatient rehab services covered by your Evernorth plan typically include:

  • Substance and Drug Detoxification Medication Management
  • Individual, Group and Family Therapy
  • Intensive Outpatient Treatment
  • Anti-Craving Medication Management

How Can I Reduce Costs Not Covered Through my Evernorth Plan?

Making the decision to enter a drug or alcohol rehab program takes a lot of guts. Many people struggle with this decision because it is difficult for them to admit that they may require professional help to deal with their substance abuse problems. As a result, it can be extremely disheartening to discover that rehab is simply out of reach for anyone who does not have the financial means to seek treatment.

It is critical that you do not let the cost of treatment prevent you from receiving the care you require. There are a variety of alternatives to help with addiction treatment costs that are not covered by your insurance.

How to Check Your Evernorth Rehab Coverage and Insurance Benefits

Before deciding on which rehab center is best for your needs, it is critical to review your insurance benefits to determine which costs are covered by your insurance provider and which are your responsibility. Knowing exactly what your Evernorth plan covers can provide you with peace of mind while you or a loved one is in drug or alcohol recovery. You can do the work of becoming and remaining sober without having to worry about unexpected costs or financial difficulties.

What Are the Coverage Levels and Plans for Evernorth?

Evernorth health plans are classified into several categories, and the features of those plans may differ depending on your:

  • Your home state.
  • Job (if you obtained insurance through your employer).
  • Eligibility for state/federal government-funded healthcare. Government-funded healthcare typically includes:
  • Medicaid, which is typically available to low-income individuals.
  • Medicare, which is primarily for seniors or those with certain medical conditions.
  • You are choosing a plan through the Affordable Care Act (ACA) marketplace (rather than your employer).


So what plans does Evernorth offer? Evernorth’s health insurance plans fall into several main categories:

  • Health maintenance organization (HMO): An HMO plan is a good choice for people who don’t mind seeing a limited number of providers within the Evernorth network. HMO plans cover services provided by physicians and facilities that have direct contracts with the insurance company.
  • Exclusive provider organization (EPO): An EPO plan gives patients more options when it comes to choosing a doctor or facility for their healthcare needs. However, some services may be unavailable if Evernorth is not in service.
  • Preferred provider organization (PPO): Patients with a PPO plan have access to a broader network of healthcare providers. Nonetheless, seeking care outside of the network frequently results in higher out-of-pocket expenses.


In addition, Evernorth also provides two other options:

  • LocalPlus: This plan provides patients with an affordable way to receive healthcare services from a limited network. Your policy coverage details will typically include only network services or include out-of-network services (for an additional cost).
  • Open access plan (OAP): An OAP plan, like a PPO plan, has a larger network of providers. OAP plans also allow you to pay extra fees to travel outside of the network.


Other Evernorth Health Insurance Benefits

Health Insurance Benefits

Knowing the full extent of your substance abuse/mental health insurance coverage as well as your general coverage is critical in any situation, but especially when looking for an appropriate treatment center or planning your life after rehab. Evernorth insurance plans are well-known for being adaptable and cost-effective in a variety of situations.

For example, did you know that preventative care services such as annual checkups, screenings, and routine immunizations are almost certainly 100 percent covered in-network? Evernorth also has a plethora of personalized online tools and a mobile app that can be used to locate in-network providers, manage account balances, check on insurance claims, and more.

Furthermore, Evernorth service representatives are available 24 hours a day, every day of the week if you have any questions about your health insurance policy’s features, providers, or anything else. In an emergency, this can be extremely helpful in locating the nearest in-network healthcare provider.

Evernorth is available in 20 states and approximately 30 countries outside of the United States, and the company claims to have the best return-to-work results of any insurance provider. This is a particularly good reputation to have in the rehab industry. It reassures recovering addicts that their Employee Assistance Program (EAP) truly works for those who enter an inpatient treatment program.

How To Find A Rehab Program That Accepts Evernorth

Insurance can help to reduce or eliminate the cost of addiction treatment services. This can ease your stress regarding the financial side of attending an alcohol or drug addiction rehab program.

While it may seem confusing at first, using Evernorth insurance to cover treatment programs doesn’t have to be a difficult process. Contact a treatment specialist today to get more information on the coverage your plan offers and the treatment facilities that accept Evernorth insurance.

Before choosing a rehab facility, review your Evernorth policy benefits to see which costs will be covered by your insurance and which will be paid for out of pocket by you. Call the number on your insurance card or log in to your account on Evernorth’s website to find out how much you may need to cover in terms of copays and any deductibles that must be met before coverage for the services you require kicks in.

Find Addiction Rehabs can also help you verify your insurance coverage. Visit our insurance verification page, enter your information, and you’ll be able to see right away if the recovery center you’re thinking about is in-network with Evernorth. Alternatively, reach out to our recovery representatives to have them check your benefits and assist you in understanding what is covered.

Knowing what costs are covered by your Evernorth health insurance plan for drug and alcohol addiction services can help you budget for any additional expenses that may arise while you or a loved one is receiving treatment for substance abuse. Knowing what costs you may be responsible can help with peace of mind, letting you concentrate on what really matters: getting healthy and staying that way.

Call one of our admissions navigators for more information on what your Evernorth insurance plan covers for rehab. We will be able to answer all of your questions and provide you with the information and support you require as you seek treatment.

Find Addiction Treatment Options Nationwide Now

Get a Confidential Insurance Verification Today

Insurance can be a complicated subject, but we make it simple for you to understand what your Evernorth health insurance will cover. Contact us today, either online or by phone, to begin a confidential insurance verification.

During this time, we will contact your insurance company to learn as much as we can about how your Evernorth addiction treatment may be covered. Then we give you that information so you can make an informed decision about seeking treatment.

Please be aware that your insurance verification is completely confidential. It will also have no effect on your ability to obtain insurance or your employment. Your employer is never notified of insurance verifications or charges to your insurance plan. Call us right now to put your mind at ease and learn more about how your plan covers rehab and addiction treatment.


* Disclaimer: Find Addiction Rehabs is not affiliated with or endorsed by Evernorth. Details about Evernorth’s coverage are intended for informational purposes only. The specific details of your plan may vary and the specific treatment services you require may or may not be covered. Please call our representatives today for more definitive details on your plan and options.

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