GEHA Rehab Coverage GEHA Drug & Alcohol Rehab Coverage Accepted

GEHA Insurance Coverage

GEHA (Government Employee Health Association) is a not-for-profit insurance program which provides medical and dental insurance plans for federal employees, retirees, and their families. GEHA started in Missouri in 1937 and has since evolved to provide insurance to about 1.8 million people worldwide


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Does GEHA cover inpatient rehab?

GEHA’s Standard and High health plans both cover some or all of substance abuse treatment. You can expect to see common forms of treatment covered, including:

  • Detox
  • Inpatient Treatment
  • Outpatient Treatment
  • Prescription Medications
  • Behavioral Health Therapy

One of GEHA’s largest requirements is around accreditations. They require clients to receive treatment from programs that are nationally certified through organizations like CARF or The Joint Commission, and be licensed by the state they work in. These requirements are meant to ensure you receive substance abuse treatment through a qualified program.

Criteria for Rehab Covered by GEHA

In order to qualify for GEHA’s rehab coverage you will need to meet a specific criteria to ensure treatment is medically necessary. When considering treatment, an addiction specialist or your primary care physician will likely ask:

  • How many years have you been abusing the substance?
  • How often are you drinking or using drugs?
  • When was the last time you used?
  • What treatments have you taken part in before?

Will GEHA cover multiple rehab stays?

Yes. GEHA may cover treatments that are deemed medically necessary. Typically the medical staff involved in your treatment program or your general practitioner will be able to work with your insurance company to determine your unique needs.

Mental Health Coverage Under GEHA

Addiction and mental health diagnoses often go hand-in-hand, this is typically referred to as a dual diagnosis. GEHA offers a variety of behavioral health coverage options that can be used inside or outside of rehab. When searching for treatment, be sure to inquire about mental health programs offered alongside addiction treatment to truly heal your mind and body.

Medication-assisted treatment (MAT) is an option for those seeking to battle their addiction with a combination of medications and therapy. Typically, MAT is used with opioid-specific medications and alcohol-specific medications. They are FDA-approved and proven to help people battle opioid or alcohol addictions.

GEHA covers a wide range of prescription medications and may cover some or all of your MAT medications if your personalized program includes MAT. Medications are typically covered separately from rehab, but the medical teams on staff should be able to determine coverage before prescribing and ensure you’re receiving a solution within your budget.

GEHA, as with all insurance companies, are federally required to cover essential services. While the exact coverage will vary, substance abuse treatment and behavioral health services are considered an essential service and you may qualify for assistance from your insurance provider.

Typically, the standard option has higher out-of-pocket costs with a lesser monthly premium, while the high option offers extended coverage at a higher monthly rate.

For any out-of-pocket costs or deductible minimums, federal employees and those under GEHA may have established a Health Care Flexible Savings Account (HCFSA). This account has unique tax benefits and can make treatment more cost effective.

What length of treatment does GEHA cover?

You can expect length of treatment coverage to vary per plan and per client. GEHA covers treatment deemed medically necessary, which typically equates to 1-6 weeks of inpatient rehab and roughly 4-12 weeks of intensive outpatient rehab. This number will vary widely per client.

Covering Out-of-Pocket Expenses

While rehab is deemed essential, your particular plan will dictate how much is covered and how much you will have to pay out-of-pocket. Most likely you will have a deductible requirement before your GEHA insurance kicks in. If you’ve yet to meet your deductible for the year, you have a variety of options to pay for rehab until insurance kicks in:

  1. Personal Loan
  2. Credit Card
  3. Payment Plan

Will my GEHA insurance premium go up after rehab?

No. It is illegal for insurance providers to raise premiums after using your policy to cover substance abuse treatment.

Learn more about your GEHA rehab coverage, today.

The Hope House is an Arizona-based luxury rehab program with two beautiful locations in the desert mountains of Scottsdale. Both of our addiction treatment centers are partnered with GEHA to help alleviate the financial worries associated with treatment. Both facilities offer extensive addiction treatment options, a robust mental health program, relaxing luxury amenities, and executive treatment options for business professionals.

Our team will work closely with your insurance to fully understand your unique benefits plan and ensure maximum coverage to make your stay as easy as possible.

Does GEHA cover local or out-of-state rehab?

Both. GEHA is offered to federal employees around the country and is likely to cover treatment in all 50 states and not just your home state.  Your exact benefits will need to be confirmed before you begin treatment in- or out-of-state.

Get Treated at The Hope House A GEHA-Approved Rehab