Carelon Behavioral Health Coverage for Drug & Alcohol Rehab

Carelon Behavioral Health may cover some or all addiction treatment costs and is in-network with The Recovery Village Atlanta.

When someone needs help for addiction, it’s not a luxury — it’s medically necessary care. Because substance use disorders and mental health conditions are recognized as essential health needs, many plans must provide benefits for rehab and behavioral health treatment. If your coverage is managed through Carelon Behavioral Health, you may have benefits that help reduce the cost of detox, inpatient/residential rehab, outpatient services and mental health treatment. This guide explains what to know about Carelon Behavioral Health rehab coverage for addiction treatment and how to verify your benefits at The Recovery Village Atlanta, which serves the Atlanta area across two locations.

Carelon Behavioral Health Provider Overview

Carelon Behavioral Health is a behavioral health services organization that supports health plans, employers, providers and government agencies with behavioral health benefits, care navigation and access to treatment. Carelon Behavioral Health is formerly Beacon Health Options and rebranded under the broader Carelon family of services associated with Elevance Health. If you’ve heard the name Beacon before, you may still see it referenced on some plan documents or member materials, but Carelon Behavioral Health is the current brand used for behavioral health coverage administration and network management.

It’s helpful to know that Carelon Behavioral Health is often not the “insurance company” printed on your member ID card. Instead, your medical plan (or employer plan) may partner with Carelon Behavioral Health to administer behavioral health benefits — meaning Carelon may manage authorizations, provider networks, and benefit determinations for mental health and substance use services. In practical terms, that can affect which facilities are in-network, what services require prior authorization, and how your benefits apply when you enter treatment.

For many members, the most important question is simple: “Will my plan help pay for rehab?” In many cases, yes. The specifics depend on your plan design, but Carelon Behavioral Health commonly supports coverage for evidence-based addiction treatment and co-occurring mental health care.

Carelon Plans and Coverage Levels

Because Carelon Behavioral Health is a benefits administrator and network manager, coverage levels can vary widely based on your employer, your primary insurance carrier, and your specific plan option. However, most members will see benefits structured in familiar ways, such as:

• PPO (Preferred Provider Organization): PPO-style plans typically allow more flexibility in choosing providers and may offer out-of-network benefits. You may not need referrals for specialty care, but deductibles and coinsurance can apply.
• HMO (Health Maintenance Organization): HMO-style plans often have lower premiums and more predictable copays, but usually require you to use in-network providers and may require referrals or additional steps for specialty behavioral health care.
• EAP + Behavioral Health Coverage: Some employers include an Employee Assistance Program (EAP) that provides short-term counseling and care navigation. For higher levels of care (like detox or residential), members transition into the behavioral health benefit administered through Carelon.

Your out-of-pocket costs for rehab typically depend on your deductible, coinsurance, and annual out-of-pocket maximum. Some plans have separate deductibles for in-network vs. out-of-network care. Others bundle behavioral health into the same deductible as medical services. If your plan is employer-sponsored, details can also differ based on whether the employer is fully insured or self-funded.

The fastest way to understand your costs is to verify benefits directly. A Recovery Advocate can confirm whether The Recovery Village Atlanta is in-network for your plan, explain what your plan covers, and estimate expected out-of-pocket responsibilities before you arrive.

Does Carelon Behavioral Health Cover Drug and Alcohol Rehab?

Carelon Behavioral Health commonly supports coverage for substance use disorder treatment, including drug and alcohol rehab. Coverage may include multiple levels of care, especially when treatment is considered medically necessary. Depending on your plan, covered services may include:

• Medical detox (withdrawal management with clinical monitoring)
• Residential or inpatient rehab (structured, 24/7 therapeutic care)
• Partial hospitalization program (PHP) (high-intensity day treatment)
• Intensive outpatient program (IOP) (structured treatment with the ability to live at home or in supportive housing)
• Outpatient therapy (individual, group, or family therapy sessions)
• Aftercare planning and recovery support services

Many plans require prior authorization before starting certain levels of care, particularly residential treatment or PHP. Authorization is a standard process used to confirm that the recommended treatment level matches your clinical needs. Clinical criteria are often used to determine medical necessity and the appropriate level of care. If authorization is required, our admissions team can help coordinate this process and communicate what documentation may be needed.

Even if you’re unsure whether your coverage includes residential treatment, it’s still worth verifying. Many members assume they must “fail” outpatient first, but in reality, the appropriate level of care is based on safety and clinical need — such as withdrawal risk, relapse risk, co-occurring mental health symptoms, and the stability of the home environment.

Does Carelon Cover Mental Health Services?

Yes. Behavioral health benefits administered through Carelon often include mental health treatment services. Because mental health and addiction frequently occur together, addressing both conditions is a key part of long-term recovery. When someone has both a substance use disorder and a mental health disorder (like depression, anxiety, PTSD, or bipolar disorder), treatment is typically most effective when it’s integrated — meaning both issues are treated at the same time.

Depending on your plan, Carelon-administered benefits may cover:

• Psychiatric evaluation and ongoing medication management
• Evidence-based therapies such as CBT (cognitive behavioral therapy) and DBT (dialectical behavior therapy)
• Trauma-informed therapy and structured support for PTSD-related symptoms
• Group therapy and psychoeducation groups
• Family therapy or family programming as clinically appropriate
• Dual diagnosis treatment for co-occurring disorders

At The Recovery Village Atlanta, treatment is individualized. That means care plans are built around the patient’s history, symptoms, substance use patterns, and mental health needs — not a one-size-fits-all program. When dual diagnosis is present, our team treats mental health symptoms alongside addiction with coordinated therapy and clinical support.

Carelon and Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) can be a critical component of recovery for many people, especially those with opioid use disorder or alcohol use disorder. MAT uses FDA-approved medications alongside counseling and behavioral therapies to reduce cravings, ease withdrawal symptoms, and support stabilization.

Coverage for MAT through Carelon Behavioral Health may depend on how your plan structures medical vs. pharmacy benefits. In many cases, the medication component is covered through your pharmacy plan, while counseling and program participation are covered through the behavioral health benefit. Common MAT medications may include buprenorphine-based medications, naltrexone, or other clinically appropriate options.

The Recovery Village Atlanta offers medication-assisted treatment (MAT) when clinically appropriate and integrates medication support into a full recovery plan that includes therapy, relapse prevention, and mental health services when needed.

Carelon Treatment Duration and Level-of-Care Reviews

How long Carelon-administered benefits will cover treatment depends on your plan, your clinical needs, and the level of care recommended by the treatment team. Some people may benefit from a shorter residential stay with robust outpatient follow-up. Others may require a longer step-down process through multiple levels of care.

At The Recovery Village Atlanta, the total stay commonly ranges around 40–72 days and may include:

• Medical detox
• Residential rehab
• Partial hospitalization program (PHP)
• Intensive outpatient program (IOP)

During treatment, many plans conduct periodic reviews to confirm that the current level of care remains appropriate. These reviews are normal and are designed to ensure that patients receive the right intensity of treatment at each stage of recovery. If a step-down is recommended, it often reflects progress and stabilization — not a denial of care.

If your plan requires reviews or authorizations, our team can help coordinate communication and ensure the right documentation is provided in a timely manner.

Georgia Rehab That Accepts Carelon Behavioral Health

The Recovery Village Atlanta provides comprehensive addiction and mental health treatment for adults in the Atlanta area. With two locations serving Atlanta, we offer a continuum of care designed to meet people where they are — whether they need medically supervised detox, residential support, or flexible outpatient programming.

Our treatment approach is evidence-based and individualized, with services that may include medical care, therapy, psychiatric support, relapse prevention planning, and aftercare coordination. If you have Carelon Behavioral Health benefits, our admissions team can confirm whether we are in-network for your specific plan and provide a clear explanation of how your coverage applies.

How to Verify Your Carelon Behavioral Health Coverage

Benefits can be confusing, especially when a behavioral health administrator is involved. The simplest way to get clarity is to verify coverage directly. Our Recovery Advocates can help you:

• Confirm network status for your specific Carelon-administered plan
• Check deductibles, copays, coinsurance and out-of-pocket maximums
• Identify authorization requirements for detox, residential, PHP, or IOP
• Estimate out-of-pocket costs before admission whenever possible
• Coordinate next steps so you can enter care without unnecessary delays

If you’re ready to take the next step, contact our team to speak with a Recovery Advocate. You can also use our insurance verification process to quickly check benefits and understand your options.

Looking for another insurance provider? We are also in-network with Cigna, BCBS and Aetna.