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NYSHIP Rehab Coverage

Insurance Coverage for Drug Rehab

NYSHIP Rehab Center

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What options do I have to pay for rehab is an all too common question for someone who has acknowledged a problematic relationship with drugs and alcohol and knows that a comprehensive addiction treatment program is the best place to start. However, it is common knowledge that rehab can be costly. A key reason many people who could benefit from detox and therapy at an Orange County treatment program like Laguna View Detox choose not to seek help is that they are unsure how the economic cost of rehab will impact their families.

Fortunately, the way insurance companies address mental health and addiction treatment needs have dramatically changed in recent years. The Affordable Care Act, passed in 2010, dramatically changed how insurance benefits covered addiction and mental health treatment. Before the Affordable Care Act, many insurance providers dramatically limited or entirely restricted levels of care for addiction and mental health treatment. 

Additionally, post-relapse follow-up treatment for future mental health or addiction treatment needs could be considered a pre-existing disorder. This means that future or subsequent treatments did not have to be covered as part of an existing insurance plan. Fortunately, the Affordable Care Act changed how insurance companies, including private and federally funded insurance companies, were required to cover addiction treatment care. Now, all insurance plans are required to provide addiction treatment and mental health care at some level.

Knowing the benefits of healthcare coverage and how you can best utilize the benefits of your insurance when seeking addiction treatment can help dramatically reduce the worry and concern associated with knowing you or a family member needs help to overcome addiction. Due to the different levels of care offered at most rehab facilities that accept NYSHIP, it is important to reach out to your provider directly or to your insurance program administered to verify your coverage before beginning treatment.

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Learn more about your insurance

What is the NYSHIP?

NYSHIP is an abbreviation for the New York State Health Insurance program. Also known as the Empire Plan, NYSHIP was launched in 1957 to provide New York State employees access to affordable, high-level medical care. NYSHIP provides a broad range of treatment coverage to over 1.2 million New York State employees, retirees, and their family members.


Laguna View Detox offers a state-of-the-art drug & alcohol detox program that is safe & effective at our Orange County facility.

Residential Inpatient

The evidence-based approach at Laguna View Detox's luxury residential inpatient program offers world-class methods that work.

Aftercare & Alumni

We offer thorough aftercare planning & alumni programming to keep clients connected to the recovery community.

The LVD Difference

Does the New York State Health Insurance Plan Cover Drug Rehab?

The Empire Plan provides equal coverage for substance abuse treatment and other medical conditions. This means that when you seek help at a rehab program that accepts your benefits, you could expect your insurance plan to reimburse your provider at a rate equal to what they would pay if you sought help at a hospital for another medical condition. Depending on your specific plan, insurance may cover some or all of your addiction treatment needs so long as they are determined to be medically necessary.

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What Types of Treatment are Covered by NYSHIP?

An Orange County detox center, like Laguna View Detox, offers several different levels of care. When researching a treatment program covered by NYSHIP, you may see references to inpatient care, outpatient rehab, medication management, family counseling, and individual counseling, among other treatment services. Again, the level of coverage you have as part of your insurance plan will vary depending on your specific plan benefits, required copays, and annual deductibles.

Contact the admissions team at Laguna View Detox for help if you are unsure what your plan will cover. Our highly skilled admissions team is familiar with NYSHIP plans and will work with you and your insurance administrator to verify your insurance coverage before beginning treatment. 

The Empire Plan and NYSHIP offer extensive coverage for addiction treatment. Depending on your specific policy and your treatment needs, your plan benefits will usually include:

inpatient treatment

aftercare outpatient care

aftercare planning and services

medication management

psychotherapies and other therapeutic interventions

dual diagnosis treatment

detoxification services

All of these treatment services are available for individuals with a wide range of substance abuse and mental health conditions, including addictions to cocaine, prescription opioids, alcohol, amphetamines, and benzodiazepines. Mental health conditions that can be addressed with your NYSHIP insurance plan include post-traumatic stress disorder, depression, bipolar disorder, eating disorders, and others.

Know how to make the most of nyship

How to Verify Benefits and Coverage for NYSHIP

There are a few ways you can verify your benefits and coverage for addiction treatment using your NYSHIP plan.

First, you can examine your insurance program paperwork and the information provided to you when you signed up for your policy. Often, the documents provided by your plan administrator offer detailed descriptions of the services and benefits that are covered as part of your policy and those that are not. Additionally, your insurance policy will provide specific information about in-network and out-of-network coverage options. 

Suppose you do not have access to paper versions of your insurance documents. In that case, many insurance companies provide copies of their policy information online through an account directly linked to your personal details. Online portals are also available to determine whether an addiction treatment and detox program like Laguna View Detox is in-network with a particular treatment provider.

A second wave to verify your benefits and coverage is to contact your insurance administrator directly. On the back of your card, you will likely find a list of contact information and numbers you can call to verify your benefits. Most policies have specific numbers for specific treatment needs, including drug and alcohol addiction treatment services. Reaching out to the provider directly and providing information about the rehab facility where you plan to seek treatment can quickly determine your level of coverage, whether the facility is in-network, and what, if any, out-of-pocket expenses you should expect

Third, you can contact a member of our admissions team at Laguna View Detox, a Southern California rehab center. Contacting insurance companies or reading through policy documents can quickly become confusing and overwhelming. We have many years of experience working with insurance companies, including Empire Plan and NYSHIP. We can work together with you and your insurance policy administrator to help you develop a better understanding of your policy coverage levels for detox and addiction treatment.

NYSHIP Drug and Alcohol Rehab

Laguna View Detox is a NYSHIP Rehab in Southern California

Although NYSHIP is a New York State-based insurance plan, its policies extend coverage throughout the nation to thousands of addiction treatment providers, including Laguna View Detox. You can use your NYSHIP at our Orange County inpatient rehab to take the first steps towards overcoming the challenges of drug and alcohol addiction and achieving lasting sobriety.

Addiction is a complex and complicated disease. But no two people who suffer from addiction symptoms will experience the same challenges while actively using or while trying to get sober. The safest and most effective way to detox and achieve lasting sobriety from most substances, including many drugs and alcohol, is to begin with professional detox services before transitioning to a comprehensive, evidence-based therapy program.

If you are ready to take your first steps towards a lifetime of health and Wellness and freedom from drug and alcohol addiction, don’t wait another day to call. Contact our admissions team today at Laguna View Detox to learn more about our NYSHIP rehab in Southern California. 


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