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Insurance for Substance Abuse

WellFirst Health Insurance 

Sana Lake Recovery is an In-Network Provider for WellFirst Health

Sana Lake Recovery is proud to be an in-network provider for WellFirst Health Insurance. Our partnership ensures that individuals seeking treatment for substance abuse and mental health disorders can access high-quality care without the overwhelming financial burden. WellFirst Health Insurance covers a variety of addiction and mental health services, making recovery more accessible for residents throughout Illinois and Missouri. 

WellFirst Insurance for Drug and Alcohol Rehab

WellFirst Health Insurance serves people throughout Illinois and Missouri with comprehensive health insurance plans. These plans cover a variety of addiction and mental health services, ensuring that individuals receive the care they need at different stages of recovery.

The initial phase of addiction treatment, where individuals undergo supervised withdrawal to cleanse their bodies of harmful substances. 

Residential programs providing intensive, 24/7 care and support in a structured environment. 

Flexible programs allowing individuals to receive treatment while continuing with their daily lives.

The use of medications like Suboxone, in combination with counseling and behavioral therapies, to treat substance use disorders. 

Does WellFirst Cover Inpatient Treatment?

Inpatient Detox for Drugs and Alcohol

Inpatient detox is the first crucial step in addiction treatment, involving the medical supervision of withdrawal symptoms as individuals stop using drugs or alcohol. This process can be challenging and potentially dangerous without professional support.

WellFirst Health Insurance may cover all or some of the costs associated with inpatient detox, depending on your specific plan. Coverage typically includes medical supervision, medications to manage withdrawal symptoms, and therapeutic support. 

Residential Treatment

Residential treatment provides a structured and supportive environment for individuals recovering from addiction. This level of care includes 24/7 medical and therapeutic support, helping patients focus entirely on their recovery.

Many WellFirst Health Insurance plans cover inpatient treatment, which may include various therapeutic modalities, group therapy sessions, and individualized treatment plans. Coverage details will vary based on the specific terms of your policy. 

Will WellFirst Cover Outpatient Treatment?

Partial Hospitalization Program (PHP)

PHP offers a high level of care while allowing patients to return home in the evenings. This program is suitable for individuals who need intensive treatment but have a stable living environment.

WellFirst Health Insurance plans may cover PHP services, which include several hours of therapy and support each day. 

Intensive Outpatient Program (IOP)

IOP is a step down from PHP, providing substantial support and therapy while offering more flexibility for patients to manage their daily responsibilities.

WellFirst Health Insurance may cover IOP, which typically involves multiple therapy sessions per week, focusing on both addiction recovery and mental health. 

General Outpatient Program (OP)

General outpatient offers the most flexible treatment option, suitable for individuals with less severe addiction issues or those transitioning from higher levels of care. This program allows patients to attend therapy sessions while maintaining their daily routines.

WellFirst Health Insurance plans may cover outpatient services, including individual and group therapy sessions. 

Will WellFirst Health Insurance Cover Suboxone?

What is Medication Assisted Treatment?

Medication Assisted Treatment (MAT) combines the use of FDA-approved medications like Suboxone with counseling and behavioral therapies to treat substance use disorders. MAT is particularly effective for opioid addiction, helping to reduce cravings and withdrawal symptoms, and supporting long-term recovery. 

MAT Coverage

WellFirst Health Insurance plans may cover MAT, including medications such as Suboxone, methadone, and naltrexone. Coverage specifics will depend on your individual plan, but generally, MAT is recognized as an essential component of comprehensive addiction treatment. 

What Other Treatment Does WellFirst Cover?

WellFirst Health Insurance offers coverage for a variety of therapeutic services that support addiction recovery and mental health. These therapies are integral to a holistic treatment approach, addressing the psychological and emotional aspects of recovery: 

Family therapy involves the participation of family members in the treatment process. It aims to improve communication, resolve conflicts, and strengthen the family unit. Family therapy is crucial for creating a supportive home environment conducive to recovery. WellFirst may cover family therapy sessions as part of a comprehensive treatment plan. 

ACT is a type of psychotherapy that encourages individuals to accept their thoughts and feelings rather than fighting or feeling guilty for them. It emphasizes commitment to personal values and taking action that aligns with those values. WellFirst Health Insurance may cover ACT sessions, which can be particularly beneficial for individuals struggling with addiction and co-occurring mental health disorders. 

CBT is a widely used therapeutic approach that helps individuals identify and change negative thought patterns and behaviors. It is effective in treating a variety of issues, including addiction, depression, and anxiety. WellFirst Health Insurance plans may cover CBT as part of both inpatient and outpatient treatment programs. 

DBT is a form of cognitive-behavioral therapy that focuses on teaching skills to manage emotions, cope with stress, and improve relationships. It is especially effective for individuals with borderline personality disorder and other conditions involving emotional dysregulation. WellFirst Health Insurance may cover DBT sessions, which are typically conducted in both individual and group settings. 

Ways to check insurance coverage for addiction treatment

How Do I Check My Coverage?

Ways to Check Your Plan Through WellFirst

To determine the specifics of your coverage, you can: 

Review Your Policy Documents: Check your health insurance policy documents for detailed information about covered services and benefits. 

Contact Customer Service: Call the customer service number on your WellFirst insurance card to speak with a representative who can provide detailed information about your plan. 

Verify Insurance Through Sana Lake's Insurance Verification Portal

At Sana Lake Recovery, we offer an insurance verification portal where you can quickly and easily verify your coverage. Our team is also available to assist you in understanding your benefits and ensuring that you can access the necessary treatment without unnecessary delays. 

General Information About Health Insurance

Health Insurance Terminology

A fixed amount you pay for a covered health care service, usually at the time of service. 

The amount you must pay out of pocket for covered services before your insurance plan starts to pay.

The monthly amount you pay for your health insurance plan. 

The most you will have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits. 

Health care providers that have a contract with your insurance company to provide services at a negotiated rate. 

Providers that do not have a contract with your insurance company, often resulting in higher out-of-pocket costs for you. 

How Does Insurance Work?

Health insurance works by helping to cover the costs of medical care. You pay a premium to maintain your coverage, and when you need medical services, your insurance plan helps pay for the costs.

Depending on your plan, you may also have to pay deductibles, copays, and coinsurance. It’s essential to understand the details of your plan, including what services are covered, any network restrictions, and your out-of-pocket responsibilities. 

Receive Treatment at Sana Lake Recovery

Our admissions team will work with both you and your insurance provider to make sure you get the help you need that won’t break the bank. We believe that 100% of your focus and attention should be on getting the help that you need to live a happy, healthy, and sober life. You focus on that, and we will handle the rest.

WellFirst: Understanding How Insurance Works. Medica. (n.d.). 

Results from the 2020 national survey on drug use and … NIDA. (n.d.). 

American Society of Addiction Medicine. (2020). The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions. 

Picture of Ashley Murry LCSW
Ashley Murry LCSW
Ashley Murry, LCSW, is the Chief Clinical Officer at Sana Lake Recovery. She oversees clinical operations, ensuring effective treatment strategies and compliance. Before this, she was Program Director at Gateway Foundation, managing care programs and collaborating with state departments. Ashley has also served as Director of Clinical Services at Treatment Management Company, improving staff retention and clinical standards. She holds a Master's in Social Work from the University of South Florida and a Bachelor's in Social Work from Saint Leo University. She is licensed in Florida, Arizona and Missouri.
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