understand Multiplan coverage
Therapy for substance use covered by Multiplan can be a turning point in your recovery journey. When you balance treatment with work or family, knowing your insurance benefits helps you focus on healing instead of worrying about costs. Multiplan operates as one of the largest preferred provider organization networks in the United States, connecting insurance carriers with over 1.4 million contracted providers, including accredited addiction treatment centers [1]. Although Multiplan itself does not administer benefits or pay claims, it negotiates discounted rates with providers and ensures you can access high-quality care within your insurer’s network.
how Multiplan networks operate
Multiplan partners with major insurers—such as Aetna, UnitedHealthcare, and Cigna—to expand your access to in-network rehab and mental health services. As a result, if your plan uses a Multiplan network (including PHCS, Beech Street, or HealthEOS), you can receive care at contracted facilities at reduced rates. Because Multiplan is a PPO network, you typically:
- Have access to a broad directory of hospitals, therapists, and specialists
- Can seek care without referrals or primary care physician authorizations
- May receive partial coverage for out-of-network providers, subject to higher cost-sharing
To confirm your benefits, review your plan documents or call your insurer’s customer service. This step ensures you know your copayments, deductibles, and any prior authorization requirements before starting treatment.
services covered under Multiplan
Most plans utilizing Multiplan networks cover a full continuum of substance use disorder treatment, as mandated under the Affordable Care Act’s essential health benefits. Coverage often includes:
- Medical detoxification
- Inpatient or residential rehabilitation
- Partial hospitalization programs (PHP)
- Intensive outpatient programs (IOP)
- Standard outpatient therapy
- Medication-assisted treatment (MAT)
- Aftercare and alumni support
(Source: Drug Rehab USA)
In addition, federal parity laws and California state regulations (where applicable) require that mental health and substance use services receive equal treatment to other medical benefits [2]. This means your plan cannot impose stricter limits on rehab days or therapy sessions than it does for other medical conditions.
determining medical necessity
Multiplan-affiliated plans rely on clinical guidelines, most commonly the American Society of Addiction Medicine (ASAM) Criteria, to assess medical necessity. Your provider documents your symptoms, risk factors, and progress, and the insurer uses ASAM standards to:
- Verify appropriate level of care (for example, PHP vs IOP)
- Approve treatment duration based on clinical need
- Authorize extensions if you face setbacks or new co-occurring conditions
As a result, ongoing communication between you, your clinician, and your insurance case manager helps ensure uninterrupted coverage while you move through each stage of recovery.
explore levels of care
Matching the right treatment intensity to your needs is crucial for lasting recovery. Multiplan-covered options at The Hope House range from structured day programs to flexible outpatient therapy, allowing you to balance treatment with daily responsibilities.
| level of care | intensity | weekly commitment | ideal for |
|---|---|---|---|
| partial hospitalization (PHP) | high (6+ hours/day, 5 days) | 30+ hours | those needing daily therapeutic support without overnight stay |
| intensive outpatient (IOP) | moderate (3–5 hours/day, 3 days) | 9–15 hours | individuals progressing from PHP or seeking structured care |
| standard outpatient therapy | low (1–2 hours/session) | flexible | those maintaining stability and integrating skills at home |
partial hospitalization program
In a PHP, you attend therapy, skills groups, and medical check-ins for at least five days per week. This level of care offers:
- Comprehensive daily structure
- Individual and group therapy sessions
- Psychiatric evaluations and medication management
- Family education workshops
PHP serves as an effective alternative to inpatient rehab when you require intensive support but wish to return home each night. Your Multiplan plan typically covers PHP as part of your behavioral health benefits.
intensive outpatient program
Transitioning to an IOP allows you to apply coping skills in real-world settings while maintaining a structured treatment schedule. Key features include:
- Three to five weekly sessions combining group therapy, individual counseling, and skill-building workshops
- Focus on relapse prevention, emotional regulation, and healthy lifestyle development
- Coordination with your work or school schedule
IOP often follows PHP or serves as a primary entry point for those with moderate severity. Coverage for IOP through Multiplan networks is generally consistent with behavioral health benefits, subject to your plan’s medical necessity approval.
standard outpatient care
Outpatient therapy provides the greatest flexibility, enabling you to attend individual or group sessions at times that fit your commitments. Outpatient care includes:
- One-on-one counseling
- Weekly group therapy
- Ongoing psychiatric support for medication management
- Referral to community resources and peer support
This level of care works well for maintenance and relapse prevention once you have built foundational skills in higher-intensity programs.
access outpatient therapy services
Engaging in therapy is an essential component of sustained recovery. With coverage through Multiplan networks, you can choose from various evidence-based modalities that address both substance use and any co-occurring mental health conditions.
individual therapy sessions
Individual therapy offers a confidential space to explore personal triggers, develop coping strategies, and work through trauma or underlying issues. Common approaches include:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Trauma-focused therapies (EMDR, CPT)
Your clinician tailors each session to your goals and progress. Most Multiplan-linked plans cover weekly or biweekly appointments, subject to your plan’s visit limits and medical necessity criteria.
group therapy sessions
Group therapy fosters connection and mutual support among peers facing similar challenges. In these sessions, you will:
- Share experiences and encourage accountability
- Practice interpersonal skills and relapse prevention techniques
- Build a sense of camaraderie in a supportive environment
Studies show that group participation can significantly reduce relapse rates by reinforcing healthy behaviors and offering diverse perspectives.
family therapy programs
Addiction affects not only you but also your loved ones. Family therapy:
- Helps rebuild trust and communication
- Educates relatives on boundary-setting and relapse signs
- Provides a forum for healing and mutual support
Many Multiplan-affiliated plans include family sessions under behavioral health benefits, ensuring your support network has the tools needed for lasting recovery.
integrate medication-assisted treatment
Medication-assisted treatment (MAT) combines FDA-approved medications with counseling to address substance use disorders, particularly opioid addiction. Integrating MAT into your care plan can:
- Reduce cravings and withdrawal symptoms
- Lower the risk of overdose and relapse by at least 25 percent [3]
- Support long-term recovery when paired with therapy
suboxone outpatient program
Suboxone (buprenorphine/naloxone) is a commonly covered medication under Multiplan networks. In an outpatient setting, you will:
- Receive regular medication dosing with on-site clinical support
- Attend individual and group counseling to reinforce behavioral change
- Undergo periodic drug testing and medical monitoring
Multiplan plans in most states cover Suboxone programs as part of your behavioral health benefits, subject to prior authorization.
combining MAT with therapy
For optimal results, MAT is most effective when integrated with psychosocial interventions. By attending therapy alongside your medication regimen, you:
- Learn coping strategies to manage cravings
- Address underlying emotional or psychological triggers
- Build resilience and relapse prevention skills
This comprehensive care model reflects best practices endorsed by the American Society of Addiction Medicine.
coverage considerations
Before starting MAT, verify with your insurer:
- Prior authorization requirements
- Dosage and duration limits
- Any copayment or coinsurance obligations
Your provider’s care coordinator at The Hope House can assist in navigating these details, ensuring seamless enrollment in your MAT program.
involve your support network
Recovery thrives in a community of understanding and encouragement. Involving family, friends, and peers strengthens your motivation and accountability throughout each phase of care.
family involvement
Engaging your loved ones in education and therapy:
- Enhances communication and trust
- Helps family members set healthy boundaries
- Provides tools for long-term support
Our family workshops and therapy sessions are often covered under your Multiplan-affiliated benefits, making it easier for relatives to participate.
peer support groups
Peer groups offer shared experiences, empathy, and practical guidance. Common formats include:
- 12-step fellowships
- SMART Recovery meetings
- Alumni-led support circles
Accessing these groups alongside formal treatment fosters solidarity and reduces isolation.
alumni services
After completing a program at The Hope House, you remain part of our alumni community. Services include:
- Monthly check-ins and booster sessions
- Social events and recovery outings
- Continued case management for transitions
Alumni involvement helps you sustain progress and gives you a chance to mentor others.
plan your step-down pathway
A structured step-down approach ensures you maintain momentum as you transition between levels of care. Each stage builds on the last, reinforcing skills and reducing relapse risk.
transitioning from PHP to IOP
As you progress, your clinical team evaluates readiness based on:
- Symptom stability and coping skills
- Attendance and participation in PHP
- Personal and occupational commitments
When moving to IOP, you retain regular therapy while gaining flexibility for work or family responsibilities.
moving to outpatient care
Stepping down to standard outpatient services involves:
- Scheduling weekly individual and group sessions
- Maintaining medication management appointments
- Engaging in community support groups
This transition empowers you to integrate recovery into everyday life, reinforcing independence and self-efficacy.
aftercare planning
Aftercare is essential for sustaining gains. A personalized plan may include:
- Scheduled follow-up therapy sessions
- Ongoing MAT or psychiatric support
- Referral to community resources and sober living homes
Working with your care coordinator ensures a smooth shift into aftercare, with coverage verification for continued services.
choose The Hope House
At The Hope House, we understand how vital accessible, in-network treatment is for your recovery. Our programs combine evidence-based therapies, family involvement, and flexible scheduling to support your unique needs.
comprehensive care approach
Our individualized plans include:
- PHP, IOP, and outpatient therapy
- MAT options such as Suboxone
- Family workshops and peer support
- Alumni services for long-term success
We adhere to ASAM criteria and maintain rigorous clinical oversight to ensure high-quality, personalized care.
flexible scheduling options
You deserve treatment that adapts to your life. We offer:
- Morning, afternoon, and evening sessions
- Weekend group therapy
- Telehealth therapy for greater convenience
This flexibility helps you stay consistent with your recovery while fulfilling work or family obligations.
insurance verification assistance
Our dedicated insurance team works with you to:
- Confirm your Multiplan network benefits
- Obtain prior authorizations promptly
- Estimate out-of-pocket costs
By handling logistics, we free you to focus on healing and growth.
Ready to take the next step? Reach out today to discuss how we can support your recovery with therapy for substance use covered by Multiplan. Our compassionate team is here to guide you on every step of your journey.
