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Medicaid Managed Care — New York

Healthfirst Addiction Treatment Coverage on Long Island

Healthfirst is New York's largest non-profit health insurer and one of the most widely accepted Medicaid plans for addiction treatment on Long Island. Most services are covered with $0 out-of-pocket cost.

$0

Out-of-Pocket Cost

For Medicaid members

No Prior Auth

For Outpatient

IOP & PHP services

100%

MAT Coverage

Suboxone, Vivitrol, Sublocade

Same-Day

Intake Available

At participating facilities

Published: November 25, 2025
Last Edited: March 15, 2026
12 min read
BZ

Written by

Benjamin Zohar, NCACIP

Nationally Certified Advanced Addiction Intervention Professional

EZ

Edited by

Ezra Zohar, M.S. Ed.

Editorial Director

BM

Medically Reviewed by

Brandon McNally, RN

Medical Reviewer, ICU Critical Care Nurse

Published: November 25, 2025
Last edited: March 15, 2026
12 min read

What Healthfirst Covers for Addiction Treatment

Healthfirst Medicaid managed care provides comprehensive coverage for substance use disorder treatment at OASAS-certified facilities throughout Nassau and Suffolk counties. Under the Mental Health Parity and Addiction Equity Act and New York State law, addiction treatment must be covered at the same level as medical and surgical benefits.

Medical Detoxification (Inpatient & Outpatient)
Inpatient Residential Rehabilitation (28–90+ days)
Intensive Outpatient Programs (IOP)
Partial Hospitalization Programs (PHP)
Medication-Assisted Treatment (MAT)
Individual & Group Counseling
Dual Diagnosis / Co-Occurring Disorders
Peer Support & Recovery Services
Family Therapy & Psychoeducation
Aftercare & Relapse Prevention Planning
Case Management Services
Crisis Intervention Services

Covered MAT Medications

Medication-assisted treatment (MAT) is considered the gold standard for opioid and alcohol use disorders. Healthfirst covers all FDA-approved MAT medications:

Suboxone

Buprenorphine/Naloxone

Use: Opioid dependence

Form: Film / Tablet

Sublocade

Extended-release buprenorphine

Use: Opioid dependence

Form: Monthly injection

Vivitrol

Extended-release naltrexone

Use: Opioid & alcohol

Form: Monthly injection

Brixadi

Buprenorphine ER injection

Use: Opioid dependence

Form: Weekly/Monthly injection

Healthfirst Plans Accepted for Rehab

Healthfirst Medicaid Managed Care

Full addiction treatment coverage with $0 copay. Most commonly used plan for substance abuse treatment. Accepted at all OASAS-certified facilities on Long Island.

Most Common

Healthfirst Essential Plan

Low-cost coverage for New Yorkers who don't qualify for Medicaid. Addiction treatment covered with minimal copays ($0–$20 depending on plan level).

Healthfirst Child Health Plus

Coverage for children and adolescents under 19. Includes substance abuse counseling and behavioral health services.

Healthfirst Medicare Advantage

For adults 65+ or those with disabilities. Covers medically necessary addiction treatment including detox, rehab, and MAT.

How to Verify Your Healthfirst Benefits

1

Locate your Healthfirst member ID

Find your member ID number on your Healthfirst insurance card. You'll need this when calling to verify benefits.

2

Call Healthfirst Member Services

Call 1-866-463-6743 to verify your behavioral health and substance abuse benefits. Ask about covered services, prior authorization requirements, and in-network providers on Long Island.

3

Or call us for free verification

Our team can verify your Healthfirst benefits for free and help you find an appropriate treatment center. We check your specific plan details, coverage levels, and available facilities.

4

Begin treatment

Once benefits are verified, you can begin treatment — often the same day. OASAS-certified facilities handle the intake and authorization process on your behalf.

Where Healthfirst Is Accepted on Long Island

Healthfirst is accepted at OASAS-certified addiction treatment facilities throughout Long Island:

Nassau County

  • • Detox & residential programs
  • • Outpatient clinics (IOP/PHP)
  • • MAT providers & clinics
  • • Community health centers
Nassau County treatment options

Suffolk County

  • • Hospital-based detox units
  • • Residential rehabilitation
  • • Outpatient treatment programs
  • • Sober living residences
Suffolk County treatment options

Your Parity Rights Under New York Law

Under the Mental Health Parity and Addiction Equity Act (MHPAEA) and Timothy's Law (New York State), Healthfirst cannot impose more restrictive limitations on substance use disorder treatment than on medical/surgical benefits. This means:

  • No separate, lower annual or lifetime dollar limits for addiction treatment
  • Co-pays and deductibles cannot be higher than comparable medical benefits
  • Prior authorization requirements must be no more restrictive than for medical care
  • Day and visit limits must be comparable to medical/surgical limits

If you believe Healthfirst has improperly denied addiction treatment coverage, you can file a complaint with the New York Department of Financial Services at 1-800-342-3736.

Healthfirst vs. Other Medicaid Plans for Rehab

FeatureHealthfirstFidelis CareUHC Community
Copay for Rehab$0$0$0
Detox Coverage✓ Full✓ Full✓ Full
Inpatient Rehab✓ Full✓ Full✓ Full
IOP/PHP✓ No prior auth✓ No prior auth✓ No prior auth
MAT (Suboxone/Vivitrol)✓ Full✓ Full✓ Full
LI Network SizeLargeLargeModerate
NYC/LI CombinedLargestLargeLarge

All three plans provide equivalent coverage for core addiction treatment. The primary differences are network size and member services. Compare Fidelis Care → | Compare UHC Community Plan →

Frequently Asked Questions About Healthfirst Rehab Coverage

Related Insurance Guides

Verify Your Healthfirst Benefits — Free & Confidential

Our team can verify your Healthfirst coverage and connect you with an appropriate treatment center on Long Island. The call is free, confidential, and takes about 5 minutes.

Call 631-762-3763

Available 24/7 — No obligation

Medical Disclaimer: This page is for informational purposes only and does not constitute medical advice. Coverage details may vary by specific Healthfirst plan. Always verify your individual benefits with Healthfirst Member Services (1-866-463-6743) before beginning treatment. Information is current as of March 2026.

Recovery Support Network

Long Island Rehab Helpline & Crisis Intervention connects families with trusted clinical resources across New York.

Our network includes: Intervention NY, Every1 Center, HVATC, and Long Island Addiction Treatment Resources