Find Alcohol & Drug Rehabs that Accept HealthNet Insurance

In many cases, yes. Health Net may provide coverage for substance use disorder (SUD) treatment when the services are considered medically necessary. 

Coverage varies by plan type, state of residence, network status, and the level of care you need. Because individual plan details differ, it’s important to verify your specific benefits before starting treatment.

When medically necessary, Health Net plans may include coverage for many of the following services:

• Medically supervised detox (inpatient or outpatient)
• Inpatient or residential rehab, including 24-hour structured care
• Partial Hospitalization Programs (PHP)
• Intensive Outpatient Programs (IOP)
• Standard outpatient counseling, including individual, family, or group therapy
• Medication-Assisted Treatment (MAT) using FDA-approved medications for opioid or alcohol dependence
• Dual-diagnosis treatment for co-occurring mental health and substance use conditions

Coverage availability varies by plan and state, so verifying benefits is essential.

Health Net evaluates SUD treatment through its behavioral health benefit guidelines, which may include:

• Medical necessity criteria
• Provider network status
• State-specific plan requirements
• Clinical documentation from your provider

Some services may require prior authorization before treatment begins.

Health Net Plan Types That May Cover Addiction Treatment

• Health Net HMO: Requires use of in-network providers and often a PCP referral; covers behavioral health and SUD services within the network.
• Health Net PPO: Offers more flexibility to use both in- and out-of-network addiction treatment providers, though out-of-network costs are higher.
• Health Net EPO: In-network only (no out-of-network coverage), but generally doesn’t require a PCP referral; covers SUD treatment if the provider is in the network.
• Ambetter (Health Net’s Marketplace Partner): Marketplace plans include addiction treatment as an essential health benefit, with coverage varying by state, tier, and network.
• Health Net Medi-Cal (California): Covers some behavioral health SUD services, but full rehab services may fall under the state’s Drug Medi-Cal (D/MC) program, so network verification is crucial.

Health Net encourages using in-network providers, which can help lower costs because those facilities have agreed-upon rates with the insurer.

• In-network providers: Typically lower copays, coinsurance, and fewer billing complications.
• Out-of-network providers: May still be covered under certain Health Net PPO-style plans, but costs can be higher, and members may have additional paperwork or upfront payments.

Costs vary widely depending on your specific Health Net plan, but you may expect:

• An annual deductible before coverage begins
• Copays or coinsurance for covered services
• Lower costs for in-network addiction treatment
• Variations in cost-sharing depending on your state, plan tier, and benefits

Better Addiction Care can help estimate your expected out-of-pocket costs under your Health Net plan.

Before certain levels of treatment are approved, Health Net may require:

• A clinical assessment diagnosing a substance use disorder
• Supporting documentation confirming medical necessity
• Referral or recommendation from a healthcare provider
• Treatment at a licensed, approved facility
• Prior authorization for higher levels of care (such as inpatient or residential treatment)

These steps ensure treatment aligns with Health Net’s clinical and network standards.

Health Net may have certain steps before approving addiction treatment, depending on the level of care:

• Basic outpatient – coverage may be approved within 1–2 business days in many cases.
• Detox or inpatient programs – these typically require a clinical review, which can take a few days.
• Emergencies – approval may be expedited to ensure immediate care.

Verifying your benefits beforehand may help you understand:

• Whether the facility you’re considering is in-network
• What your deductible, copay, and coinsurance look like
• Whether prior authorization is required
• Which services (detox, MAT, IOP, etc.) may be included in your specific plan

Better Addiction Care completes these verifications for you so you can focus on healing instead of paperwork.

You can verify your benefits by:

• Calling the number on your Health Net ID card to ask about behavioral health and SUD coverage
• Logging into your Health Net online member portal
• Allowing Better Addiction Care to contact Health Net directly to confirm coverage, network facilities, and any authorization requirements

Health Net typically evaluates eligibility for rehab or other substance use disorder services using medically recognized, non-restrictive criteria. Common factors include:

• Severity of symptoms – how intense or disruptive the substance use is to daily life.
• Safety risks – any immediate health dangers to the individual or others.
• Previous attempts at quitting – history of unsuccessful efforts to stop or reduce use.
• Co-occurring conditions – presence of mental health or other medical conditions that may affect treatment needs.

While Health Net plans cover medically necessary addiction treatment, some services may not be included:

• Luxury amenities – private rooms, spa services, or massage therapy are generally considered optional extras.
• Non-evidence-based programs – treatments that are purely holistic or not supported by clinical research may not be covered.
• Out-of-network rehab – unless you have PPO coverage, using facilities outside the network may result in higher costs or no coverage.
• Long-term sober living – extended residential stays are typically covered only when there is a documented medical or clinical need.

If coverage is limited or partial, options may include:

• Switching to or choosing an in-network facility
• Discussing outpatient alternatives when clinically appropriate
• Asking about sliding-scale options from treatment centers
• Reviewing state-sponsored or community-based supports
• Exploring payment arrangements offered by individual facilities

Better Addiction Care helps you navigate all available options.

If your request for addiction treatment is denied, there are several steps you can take to address the situation:

• Request a reconsideration – ask Health Net to review the denial, providing any clarifying information.
• Submit additional clinical documentation – share updated medical records or provider notes to support the need for treatment.
• Choose an in-network alternative – selecting a covered facility may resolve coverage issues quickly.
• Discuss step-down care – consider outpatient or partial hospitalization programs if full inpatient care was initially denied.

With Health Net, Better Addiction Care can help you:

• Confirm behavioral health coverage and SUD benefits
• Handle pre-authorizations and required documentation
• Match you with accredited treatment centers that accept Health Net
• Explain expected costs so you’re financially prepared before admission

Our team simplifies the insurance process so you can prioritize your recovery.

Getting help is simple.
Call Better Addiction Care today or complete our secure online form to check your Health Net benefits and explore treatment options tailored to your needs and coverage.