Suffolk County Insurance Coverage

UnitedHealthcare is the largest health insurer in the United States and one of the most commonly accepted plans at OASAS-certified addiction treatment facilities on Long Island. UHC covers the full continuum of substance use disorder treatment — medical detox, inpatient residential rehab, PHP, IOP, standard outpatient, and all FDA-approved MAT medications including Suboxone, Sublocade, Vivitrol, and Brixadi. UHC's behavioral health division, Optum, manages substance use disorder benefits and utilization review. Prior authorization is required for inpatient and residential care; IOP and outpatient often proceed without prior auth. UHC employer-sponsored PPO plans typically offer both in-network and out-of-network access. Under MHPAEA federal parity law, UHC cannot apply more restrictive criteria to addiction treatment than to comparable medical benefits. Call 631-762-3763 for a same-day UnitedHealthcare benefits verification.

Empire BlueCross BlueShield is New York's largest commercial health insurer and one of the most widely accepted plans at OASAS-certified addiction treatment facilities on Long Island. Empire BCBS covers the full treatment continuum — medical detox, inpatient rehabilitation, PHP, IOP, outpatient counseling, and all FDA-approved MAT medications including Suboxone, Sublocade, Vivitrol, and Brixadi. Under New York's Timothy's Law and federal MHPAEA parity requirements, Empire BCBS is prohibited from applying more restrictive criteria to addiction treatment than to comparable medical benefits. Prior authorization is typically required for inpatient and residential levels of care; IOP and outpatient often do not require prior auth. Empire PPO members have both in-network and out-of-network access. Call 631-762-3763 for a same-day Empire BCBS benefits verification and in-network provider match on Long Island.

Aetna is one of the nation's largest commercial health insurers, covering addiction treatment at the full continuum of care for Long Island members. Aetna's behavioral health division manages substance use disorder benefits, and prior authorization is typically required for inpatient and residential levels of care. Aetna covers all FDA-approved MAT medications including buprenorphine (Suboxone, Sublocade), naltrexone (Vivitrol), and Brixadi injectable. Under MHPAEA federal parity law, Aetna cannot apply more restrictive prior auth or utilization review criteria to addiction treatment than to comparable medical benefits. Aetna HMO, PPO, and EPO members on Long Island should verify in-network OASAS-certified providers before admission. Call 631-762-3763 for a free same-day Aetna benefits check.

Cigna, operating its behavioral health division through Evernorth, provides comprehensive addiction treatment coverage for Long Island members. Cigna covers the full continuum of care — detox, inpatient rehabilitation, PHP, IOP, outpatient counseling, and all FDA-approved MAT medications. Cigna's Collaborative Care Model integrates behavioral health with medical management, often allowing streamlined prior authorization for step-down levels of care (PHP and IOP) when inpatient admission is clinically justified. Cigna also offers EAP-connected pathways for employer-sponsored members, which can facilitate confidential referrals and a limited number of free counseling sessions before insurance benefits are activated. Prior authorization is required for residential levels of care. Long Island members should verify in-network OASAS providers before admission — call 631-762-3763 for a free Cigna benefits check.

Fidelis Care is one of New York's largest Medicaid managed care plans, serving over 1.7 million members statewide. Their Medicaid Managed Care and HealthierLife (HARP) plans provide comprehensive addiction treatment coverage at OASAS-certified facilities across Long Island with $0 copay and $0 deductible for qualifying members. Coverage includes medical detox, inpatient residential rehabilitation, intensive outpatient programs (IOP), partial hospitalization (PHP), and all FDA-approved MAT medications including Suboxone, Sublocade, Vivitrol, and Brixadi. Most outpatient services do not require prior authorization. Fidelis also offers the Essential Plan for low-income adults above the Medicaid threshold, and Ambetter from Fidelis Care through the NY State of Health Marketplace.

Blue Cross Blue Shield plans are accepted at most OASAS-certified addiction treatment facilities on Long Island. The national BlueCard network means that members from any BCBS affiliate — including Empire BCBS (NY), Horizon (NJ), Excellus (Upstate NY), Highmark (WNY), Anthem, and others — can typically access Long Island providers under host-plan rules. Coverage includes the full continuum of addiction treatment: detox, inpatient rehab, PHP, IOP, outpatient counseling, and MAT. Prior authorization requirements and cost-sharing vary by affiliate and plan type. New York members with Empire BCBS plans have the broadest in-network access across Long Island. Call 631-762-3763 with your BCBS member ID to verify your specific plan's coverage, prior auth requirements, and in-network Long Island providers.

Healthfirst is New York's largest non-profit health insurer, serving over 1.8 million members. Their Medicaid managed care plan provides comprehensive addiction treatment coverage at OASAS-certified facilities across Long Island with $0 copay. Coverage includes medical detox, inpatient rehabilitation, intensive outpatient programs, medication-assisted treatment (Suboxone, Sublocade, Vivitrol, Brixadi), and ongoing recovery support. Healthfirst also offers Essential Plan and Medicare Advantage options with addiction treatment benefits.

EmblemHealth — operating through its HIP and GHI plan brands — is one of New York's largest non-profit health insurers and is widely accepted at OASAS-certified addiction treatment facilities on Long Island. EmblemHealth covers the full continuum of addiction treatment: medical detox, inpatient residential rehab, PHP, IOP, outpatient counseling, and all FDA-approved MAT medications including Suboxone, Sublocade, Vivitrol, and Brixadi. GHI (commercial) and HIP (HMO) members have different network rules — GHI PPO members typically have broader provider access including out-of-network benefits. Prior authorization is required for inpatient and residential care. Timothy's Law and MHPAEA parity protections apply to all EmblemHealth commercial plans in New York. Call 631-762-3763 for a same-day EmblemHealth benefits verification and in-network Long Island facility referral.

Humana is a major national health insurer with a significant Medicare Advantage presence on Long Island. Humana commercial and Medicare Advantage plans cover addiction treatment including detox, inpatient rehab, PHP, IOP, outpatient counseling, and MAT. Humana's behavioral health benefits are subject to medical necessity review and prior authorization for inpatient care. Humana Medicare Advantage plans on Long Island often include enhanced behavioral health benefits beyond Original Medicare, including lower cost-sharing for MAT and outpatient substance use counseling. Long Island residents with Humana employer coverage should verify network participation at specific OASAS-certified facilities. Call 631-762-3763 for a same-day Humana benefits verification and facility referral.

MVP Health Care is a regional non-profit health insurer primarily serving the Capital Region, Hudson Valley, and Upstate New York. Long Island residents with MVP coverage — typically through an Upstate employer or family plan — can access addiction treatment at select Long Island providers, with out-of-area care processed under MVP's behavioral health policies. MVP covers medically necessary addiction treatment including detox, inpatient rehab, PHP, IOP, outpatient counseling, and MAT. New York Timothy's Law and MHPAEA federal parity protections apply. Prior authorization is required for inpatient levels of care. Call 631-762-3763 to confirm which Long Island OASAS-certified facilities are in-network for MVP Health Care and verify your specific plan benefits.

MetroPlusHealth is New York City's largest municipally sponsored health plan, serving Medicaid, Essential Plan, and Qualified Health Plan members across New York. MetroPlus members on Long Island — including those who have moved from NYC to Nassau or Suffolk County — retain full addiction treatment benefits at OASAS-certified Long Island facilities. Coverage includes $0 copay for Medicaid members accessing medical detox, inpatient rehab, PHP, IOP, outpatient counseling, peer support, and all FDA-approved MAT medications including Suboxone, Sublocade, Vivitrol, and Brixadi. HARP-enrolled members have access to enhanced behavioral health and recovery services. Most outpatient addiction treatment services do not require prior authorization. Call 631-762-3763 to verify MetroPlus coverage and find in-network Long Island providers.

NYSHIP Empire Plan covers NYSHIP drug rehab and all levels of addiction treatment for NY State employees, retirees, and dependents on Long Island. Our independent navigation team helps you understand every option — from sober coaching and peer mentorship to detox, IOP, and inpatient — and connects you with the right fit. Call 631-762-3763 or visit interventionny.com. Free, confidential, 24/7.

WellCare of New York is a Medicaid managed care plan serving New York State Medicaid-eligible members across Long Island and throughout the state. WellCare covers the full OASAS addiction treatment continuum — medical detox, inpatient residential rehabilitation, PHP, IOP, outpatient counseling, peer support, and all FDA-approved MAT medications including Suboxone, Sublocade, Vivitrol, and Brixadi — with $0 copay for qualifying Medicaid members. WellCare is a subsidiary of Centene Corporation, one of the nation's largest Medicaid managed care organizations. HARP-enrolled members have access to enhanced behavioral health services including peer support specialists and community-based recovery coordination. Most outpatient and MAT services do not require prior authorization. Call 631-762-3763 to verify WellCare Medicaid benefits and identify in-network OASAS-certified Long Island providers.

UnitedHealthcare Community Plan is UHC's Medicaid managed care product serving New York State Medicaid-eligible members on Long Island and throughout the state. UHC Community Plan covers the full OASAS addiction treatment continuum with $0 copay for qualifying Medicaid members — including medical detox, inpatient rehabilitation, residential, PHP, IOP, outpatient counseling, peer support, and all FDA-approved MAT medications. Behavioral health benefits are administered through Optum, UHC's behavioral health division. HARP (Health and Recovery Plan) enrolled members have access to enhanced community-based services including peer specialists and community psychiatric support. Most outpatient and MAT services do not require prior authorization under the Community Plan. Call 631-762-3763 to verify UHC Community Plan coverage and identify in-network OASAS-certified Long Island facilities.