Carelon Substance Addiction and Mental Health Coverage

Carelon Insurance Coverage for Intensive Outpatient Programs in California

Carelon Intensive Outpatient Programs Coverage

Harmony Place operates rehabilitation centers across California that accept Carelon Health coverage for addiction recovery. Our facilities provide a tranquil and structured environment if you’re trying to attain sobriety. Structured programs are meticulously designed to support you through every phase of your recovery, integrating evidence-based care with individualized assistance.

Does Carelon Insurance cover Intensive Outpatient Programs (IOPs)? At Harmony Place, we accept Carelon Insurance coverage our treatment programs, as well as dual diagnosis treatment if you’re dealing with addiction and mental health disorders simultaneously. If you are grappling with Substance Use Disorder (SUD), our dedicated team of licensed professionals utilizes a variety of intervention strategies to help you overcome your addiction, empowering you to create a lasting path to sobriety.

Check Your Insurance Call: (855) 652-9048

What Are Intensive Outpatient Programs (IOPs) For?

Intensive Outpatient Programs (IOPs) are a great option if you require structured mental health or substance abuse treatment without the need for 24-hour supervision. These programs provide therapy, counseling, and support multiple days a week, enabling you to live at home while balancing work, school, or family obligations.

IOPs are particularly beneficial if you’re transitioning from inpatient care or if you require more support than what traditional outpatient therapy offers. IOP therapy options often encompass:

Individual counseling
Flexible IOP scheduling
Group therapy
Medication management
Education on coping skills in IOP and relapse prevention
Aftercare support post-IOP

IOPs combine flexibility with comprehensive, evidence-based care, ensuring that your recovery is personalized and effective.

About Carelon Insurance

Carelon Insurance, the health-focused branch of Elevance Health, is committed to providing comprehensive care through integrated services that encompass insurance, clinical care, and behavioral health. Originally founded as CareMore in 1992 by Dr. Sheldon Zinberg and John Edelston, the company rebranded as Carelon in 2024. With over 150 years of combined experience in care, Carelon delivers whole-person care.

In terms of industry standards and practices, Carelon’s operations are firmly grounded in industry-standard practices, including:

Underwriting
Claims processing
Assessments performed by an actuary

Additionally, they manage reinsurance to minimize exposure to catastrophic loss, while protecting you, the insured, through indemnity agreements and explicit endorsements. Insurance adjusters are utilized to assess risks, estimate losses, and establish fair settlements.

In situations involving shared liability, Carelon employs subrogation to recover costs from responsible third parties. They also offer umbrella policies to provide enhanced liability protection beyond standard coverage, explicitly outlining exclusions to clarify which risks are not included. As a modern health insurer, Carelon combines medical innovation with financial stability to meet the diverse health needs of its members.

What to Know About Carelon Health Insurance

Carelon Insurance, the health-oriented division of Elevance Health, is dedicated to delivering comprehensive care through integrated services that encompass insurance, clinical care, and behavioral health. Established in 1992 as CareMore by Dr. Sheldon Zinberg and John Edelston, the company was rebranded as Carelon in 2024. With a collective experience of over 150 years in care, Carelon provides holistic treatment.

Carelon’s operations are firmly rooted in industry-standard practices, which include:

Underwriting
Claims processing
Assessments conducted by an actuary

Additionally, they manage reinsurance to reduce exposure to catastrophic loss while safeguarding you, the insured, through indemnity agreements and explicit endorsements. Insurance adjusters are employed to evaluate risks, estimate losses, and determine fair settlements. In cases of shared liability, Carelon utilizes subrogation to recover costs from accountable third parties. They also provide umbrella policies for enhanced liability protection beyond standard coverage, clearly outlining exclusions to specify which risks are not included. As a contemporary health insurer, Carelon blends medical innovation with financial stability to address the diverse health needs of its members.

Carelon’s Benefits and Policies Explained

Carelon Insurance offers customized benefits and well-structured policies that prioritize holistic care and affordable, coordinated healthcare. Numerous rehabilitation centers offer Intensive Outpatient Programs (IOPs) that take Carelon Health. Below are some of the benefits included in your Carelon policy:

Medicare Advantage & Medicaid Plans
Offering extensive coverage that includes hospital, outpatient, and prescription drug benefits, often supplemented with chronic care programs and disease management.
Chronic Care Management
Supporting care coordination for conditions such as COPD, CHF, ESRD, and diabetes through community care centers, aimed at minimizing hospital admissions and enhancing patient outcomes.
Behavioral Health Services
Carelon Behavioral Health provides mental and behavioral health support through employer-based programs, government collaborations, and access for over 40 million individuals, including substance abuse coverage.
Utilization Management & Prior Authorization
Carelon Medical Benefits Management conducts prior authorizations and clinical reviews for advanced imaging, home health, and outpatient services, ensuring evidence-based and cost-effective care.
Healthcare Research & Analytics
Through Carelon Research, we provide data-driven insights aimed at improving health outcomes and fostering advancements in evidence-based care.

Explore the Best Local Attractions in the California Area

California is a treasure trove of local attractions that showcase its vibrant culture, stunning natural landscapes, and a wide range of entertainment options. In Southern California, you can delve into the iconic allure of the Hollywood Walk of Fame and the Griffith Observatory in Los Angeles. The picturesque beaches of Santa Monica and Malibu offer a perfect seaside escape.

Families are particularly drawn to the magical world of Disneyland in Anaheim. At the same time, San Diego captivates with its renowned San Diego Zoo, as well as the museums and gardens of Balboa Park. Heading north, San Francisco will entice you with its celebrated landmarks, including the Golden Gate Bridge, Alcatraz Island, and Fisherman’s Wharf. Wine enthusiasts will find Napa Valley and Sonoma irresistible, thanks to the many exceptional wine-tasting experiences. Lake Tahoe, nestled near the Sierra Nevada mountains, offers exhilarating skiing in winter and scenic hiking in summer. Cities like Sacramento and Santa Barbara blend rich history, striking architecture, and breathtaking coastlines, making California an ideal destination.

Does Carelon Health Cover IOP for Substance Abuse in California?

Carelon Behavioral Health offers coverage for Intensive Outpatient Programs (IOPs) related to substance abuse in California, provided that your treatment is deemed medically necessary and the provider is in-network. Specific coverage details can vary depending on your policy, including factors such as benefits, deductibles, copays, and the requirement for prior authorization.

It is advisable to confirm these details to ensure that you’re not putting yourself at peril and to have clarity and proper coverage. Typically, Carelon plans include a wide array of substance abuse treatments, such as medical detox, residential or inpatient care, Partial Hospitalization Programs (PHPs), and IOP therapy options. Contact us at Harmony Place to verify your coverage benefits and gain an understanding of substance abuse treatment pricing. Our compassionate team will explain out-of-pocket expenses for your care.

Is PHP Treatment for Drug and Alcohol Abuse Covered by Carelon Health in California?

Partial Hospitalization Program (PHP) treatment for drug and alcohol addiction is often covered by Carelon Behavioral Health plans in California, provided that the program is considered medically necessary. Carelon includes PHP as part of its comprehensive addiction services, which also encompasses inpatient, outpatient, detox, and dual-diagnosis treatment.

Coverage details, such as copay amounts, deductibles, premiums, the provider’s in-network status, and prior authorization requirements, vary based on your specific plan. To verify your benefits for drug and alcohol rehab in California, consult your plan documents or contact us at Harmony Place.

Indoor sitting area at Harmony Place addiction rehab center in Los Angeles

Comparing Partial Hospitalization and Intensive Outpatient Programs in California

Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs) in California are crafted to deliver organized assistance if you’re struggling with addiction and mental health challenges. Primarily, these programs differ in their intensity levels. PHPs are noted for providing more extensive support by conducting full-day sessions. This rigorous method provides comprehensive medical oversight, counseling, and skill-building exercises.

Conversely, IOPs require fewer hours weekly, enabling you to juggle your therapy with everyday tasks such as work or education. PHPs typically run four to six days a week and necessitate several hours of participation each day. This schedule is advantageous if you require more robust support. Meanwhile, IOP duration and frequency demand less time, consisting of three to five weekly sessions. This makes them suitable if you’re moving from inpatient care or handling less critical issues. Both PHPs and IOPs are prevalent throughout California, offering adaptable solutions.

Does Carelon Health Insurance Cover Medical Detox Services in Southern California?

Carelon Health, which offers coverage through various plans in Southern California, includes medically supervised detox services as part of its substance use treatment options. However, the specifics of your coverage, such as the use of in-network providers, prior authorization requirements, and out-of-pocket expenses, vary based on your policy details.

Several treatment centers, like Harmony Place, offer medical detox programs that take Carelon Health. To determine your actual benefits and costs, contact our admissions counselors. Let us take the stress out of the equation.

Does Carelon Health Cover Dual Diagnosis Treatment in California?

Carelon Health offers coverage in California for dual diagnosis treatment, which addresses both mental health and Substance Use Disorders (SUDs) simultaneously. Coverage typically includes residential care, dual diagnosis IOPs, PHPs, individual and group therapy, and Medication-Assisted Treatment (MAT). However, specific details such as covered services, session limits, prior authorization requirements, and in-network provider options depend on your plan.

It is crucial to understand the extent of your coverage, as you risk financial loss otherwise. Contact us at Harmony Place to fully grasp your monetary responsibilities for residential treatment before beginning your care.

Please Complete the Form Below

We Will Check Your Carelon Coverage

Carelon Health Insurance Coverage for Various Treatment Options in California

Carelon Health provides comprehensive coverage for mental health and substance abuse treatments in California. Their benefits comply with the Affordable Care Act, ensuring access to essential mental health and addiction services, often featuring cost efficiencies for in-network providers, such as Harmony Place, and pre-authorization assistance. Here’s a detailed overview of the coverage available across various care settings:

Outdoor backyard view of Harmony Place, a substance addiction rehab center

Carelon Health Partial Hospitalization Programs

Carelon provides coverage for Partial Hospitalization Programs (PHP), which offer structured daytime treatment—four to six days per week—without the need for overnight stays. PHP is particularly beneficial if you’re transitioning from inpatient care or seeking intensive support while managing your daily life. These programs typically encompass psychiatric evaluations, group therapy, skill-building sessions, and case management.

Carelon Health Inpatient Programs

Coverage for inpatient or residential treatment is provided when it is considered medically necessary. This encompasses medical detoxification, which may last several days, and extended residential rehabilitation with round-the-clock clinical support. Carelon members have access to inpatient psychiatric units for acute crises, dual diagnosis treatment, residential care, and medically supervised detoxification.

Carelon Health Outpatient Programs

Carelon offers different levels of outpatient care to meet diverse needs. IOPs involve multiple weekly sessions that blend group and individual therapy, perfect if you require substantial support without the need for hospitalization. Standard outpatient care includes regular counseling and medication management appointments, with the possibility of group therapy sessions.

Coverage is provided when the services are medically necessary and in-network providers are utilized. Most treatment centers offer financial assistance for IOP and other outpatient care options by providing IOP payment plans. Additionally, some offer sliding scale fees for IOP.

Carelon Health Stabilization and Crisis Programs

According to the Affordable Care Act, stabilization and crisis intervention services are vital benefits. Carelon offers insurance for emergency psychiatric care and crisis stabilization, available in both inpatient and outpatient environments. This encompasses mobile crisis teams and urgent counseling assistance, providing prompt support during severe mental health emergencies.

Carelon Health Sober Living

While sober living in independent environments may not always be billed separately to insurance, Carelon frequently covers clinically supervised elements, such as case management, peer support, and transitional PHP or IOP, if you are residing in sober living facilities. Additionally, you can access peer support specialists and community-based recovery services through Carelon’s social drivers of health and peer specialist programs.

Does Carelon Health Support IOP Services for Addiction Recovery in California?

Carelon provides coverage for IOP for addiction recovery in California. IOPs are ideal if you’re dealing with milder substance abuse challenges and have a supportive home environment. The degree of your coverage will vary depending on your policy, so it is crucial to confirm your benefits and eligibility.

You may be responsible for premiums, deductibles, coinsurance, and copays. If you want to learn more about addiction recovery programs costs, contact us at Harmony Place. Our knowledgeable team can help determine your total costs with or without Carelone health coverage.

What Are the Benefits of Intensive Outpatient Programs in California?

Intensive Outpatient Programs (IOPs) in California offer a low-cost outpatient treatment alternative if you’re seeking structured assistance for addiction or mental health challenges without requiring full-time residential care. IOPs adeptly merge flexibility with effectiveness, making them ideal if you need to balance daily obligations, such as work or school, while attending therapy sessions.

With several sessions each week, IOPs offer personalized counseling, group therapy, and workshops that focus on skill development, allowing you to pursue personal growth and recovery in a supportive environment. Although IOPs offer numerous advantages, such as affordability, the ability to stay connected to daily life, and tailored support, they might not be suitable for you. If you’re battling severe addiction or living in an unstable home environment, you may need more intensive help. Therefore, it is vital to carefully consider IOP benefits and drawbacks when you’re choosing the most suitable level of care, ensuring that you receive the support you truly need.

Carelon Health Coverage for Intensive Outpatient Programs in California

Map of areas around Harmony Place addiction rehab near LA

Harmony Place is one of the many addiction rehabilitation centers located in California that accept Carelon Health coverage. If you are struggling with addiction, our holistic inpatient programs and diverse intervention strategies are tailored to help you achieve sobriety. Call (855) 652-9048 today to discover how you can become one of our inspiring success stories.

Harmony Place Rehab in California

At Harmony Place, we offer affordable residential treatment in California. Our Woodland Hills facilities are experts in addiction intervention strategies and place a strong emphasis on detoxification and preventing relapse. If you are combating substance abuse and mental health disorders, our dual diagnosis programs can be highly advantageous for you.

Harmony Place
23041 Hatteras St.
Woodland Hills, CA 91367

Harmony Place East
22913 Burbank Blvd.
Woodland Hills, CA 91367

Check Your Insurance Call: (855) 652-9048

What Are the Costs of IOP in California With Carelon Health Insurance?

With Carelon Health insurance in California, an Intensive Outpatient Program (IOP) is typically covered when it is medically necessary. You can expect to pay a copay or coinsurance, similar to standard outpatient mental health services, which usually range from $0 to $75 per session, in addition to your deductible, depending on your specific plan.

In the absence of insurance, the costs for IOP in California typically range from $250 to $350 per day, which can accumulate to approximately $3,000 to $10,000 per month, depending on the location, services provided, and the duration of the program. Trying to figure out the costs of your care can be aggravating and overwhelming. Contact us at Harmony Place for help determining your insurance benefits or to learn more about our residential inpatient treatment programs.

Why Consider an IOP for Addiction Support?

Selecting an Intensive Outpatient Program (IOP) for addiction recovery provides you with a structured yet flexible pathway to sobriety. IOPs provide comprehensive support while you juggle your daily responsibilities, making it an excellent option if you don’t require round-the-clock supervision but still need a high level of care.

Here are the key benefits of enrolling in a structured outpatient care pogram:

1. Customized Treatment Plans

A customized IOP meets your unique needs, addressing co-occurring disorders, substance abuse history, and personal aspirations. This tailored approach contributes to more robust outcomes and fosters a deeper recovery.

2. Flexible Scheduling for Everyday Life

A flexible IOP accommodates work, school, or family obligations. With both day and evening sessions available, you can continue residing at home while receiving structured therapy and support multiple times a week.

A woman using her smartphone to check insurance for drug and alcohol addiction rehab

3. Access to Skilled and Compassionate Staff

You will gain from the expertise of a dedicated team comprising experienced therapists, addiction counselors, and medical professionals specializing in evidence-based care. The team collaborates closely with you to develop coping skills in IOP, prevent relapse, and promote sustainable recovery.

4. Peer Support and Group Therapy

Group sessions foster sharing and connection, helping you combat isolation and form a supportive network of peers in recovery. A supportive team cultivates a safe environment where you can grow together through shared experiences.

5. Seamless Transition from Higher Levels of Care

If you’re transitioning from inpatient or PHP programs, an IOP serves as an essential bridge. It ensures continuity of care, helping you apply what you’ve learned in more intensive settings to real-life situations with post-IOP aftercare support.

6. Holistic and Integrative Therapies

In addition to traditional therapy, a comprehensive program incorporates mindfulness, yoga, trauma-informed care, and other holistic practices. These components enhance emotional regulation, promote overall wellness, and support your healing process.

Statistics on Intensive Outpatient Programs in California

The California Health Care Foundation reported a 68% increase in the number of Southern California facilities providing substance use treatment, including structured outpatient care, from 2017 to 2019. During this same period, the number of hospital inpatient care facilities doubled.
According to the Los Angeles County Department of Public Health, there were 6,521 treatment admissions (involving 5,863 patients) to Intensive Outpatient Programs (IOPs), which represented 0% of total admissions. The average length of stay for these programs was 80 days.
The 2020 National Survey of Substance Abuse Treatment Services, conducted by the Substance Abuse and Mental Health Services Administration, revealed that in 2019, California had 621 facilities offering IOP therapy options, serving a total of 5,883 patients.
In 2011, 6,089 facilities in the United States reported offering holistic IOP programs, which accounted for 44% of the total 13,720 addiction treatment facilities. These IOPs catered to 141,964 individuals, representing 12% of the 2 million people receiving treatment.
In 2022, approximately 1,482,612 people in Los Angeles County required treatment for substance abuse, including IOP for addiction recovery.