Does Fidelis Cover Addiction Treatment in New Jersey?

Yes, Fidelis Covers Addiction Treatment in New Jersey. Fidelis Care provides coverage for substance use disorder through several plan types available in New Jersey, including the NJ FamilyCare plan and the Managed Long-Term Services & Supports (MLTSS) options.

Addiction Treatment Programs Covered by Fidelis in New Jersey are outpatient counseling, intensive outpatient programs, partial hospitalization, and dual-diagnosis care.

Other insurance providers for addiction treatment in New Jersey include Premera, Blue Cross Blue Shield, and Magellan Health.

What Fidelis Care Plans Are Available In New Jersey For Addiction Treatment?

Fidelis Care Plan types for addiction treatment in New Jersey include the NJ FamilyCare plan and the Managed Long-Term Services & Supports (MLTSS) plan. These plans cover a range of addiction treatment services such as outpatient counseling, intensive outpatient programs, partial hospitalization, and dual-diagnosis care, with integrated behavioral health benefits. Coverage is provided through in-network providers, and certain services require prior authorization to ensure medical necessity.

What Types of Addiction Treatment Programs Does Fidelis Cover in New Jersey?

The different types of addiction treatment programs that Fidelis covers in New Jersey include structured daytime and evening therapy sessions, higher frequency clinical support programs, comprehensive day-treatment services, integrated dual-diagnosis care, and personalized post-treatment strategies. These coverage options encompass various levels of care from outpatient support to intensive clinical oversight, allowing individuals to maintain their daily responsibilities while receiving appropriate treatment.

The common types of addiction treatment programs Fidelis covers in New Jersey are explained below:

• Outpatient Treatment Programs – Structured daytime or evening therapy sessions allowing individuals to live at home and maintain work, tailored for those with mild to moderate substance use disorders.

• Intensive Outpatient Programs (IOP) – A higher frequency of sessions than standard outpatient care, intended for those needing more clinical support while preserving daily routines and responsibilities.

• Partial Hospitalization Programs (PHP) – Day-treatment services that provide comprehensive clinical oversight while enabling clients to return home in the evenings, suitable for transitional or stabilization care.

• Co-Occurring Disorder Treatment – Integrated care for individuals diagnosed with both substance use and mental health disorders, ensuring dual-focus interventions within a single treatment plan.

• Relapse Prevention Planning – Post-treatment strategies including personalized plans and access to ongoing recovery coaching, are designed to reduce the likelihood of relapse after program completion.

Does Fidelis Require Pre-approval For Rehab In New Jersey?

Yes, Fidelis requires pre-approval for rehab in New Jersey. Prior authorization is a requirement for addiction treatment services covered under Fidelis health plans. The process involves submitting clinical information to confirm medical necessity before treatment begins.

Does Fidelis Cover Dual Diagnosis and Mental Health Treatment in New Jersey?

Yes, Fidelis covers Dual Diagnosis and Mental Health treatment in New Jersey. Dual diagnosis treatment, clinically referred to as co-occurring disorder care, is included under Fidelis plans. Coverage details depend on the specific plan, required authorizations, and whether care is received from in-network providers.

Are There Out Of Pocket Payments With Fidelis Addiction Treatment Cover In New Jersey?

Yes, there are out-of-pocket payments with Fidelis addiction treatment coverage in New Jersey. The amount depends on factors such as plan type, deductible, copayments, and whether services are received from in-network or out-of-network providers.

What Are Some Other Insurance Providers For Addiction Treatment In New Jersey?

Some other insurance providers for addiction treatment in New Jersey include:

Magellan Health

Magellan Health is a behavioral health plan administrator covering a full continuum of addiction treatment in New Jersey. Coverage of Magellan Health includes medical detox, inpatient and outpatient programs, and dual diagnosis care, with treatment plans guided by ASAM criteria to ensure appropriate, individualized care.

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Premera

Premera, operating within the Blue Cross Blue Shield network, provides insurance plans covering addiction treatment services. Coverage of Premera includes medication-assisted treatment (MAT) and virtual care options to support members seeking treatment for substance use disorders, with benefits varying by the specific policy.

Blue Cross Blue Shield

Blue Cross Blue Shield in New Jersey, primarily Horizon BCBS, offers comprehensive coverage for drug and alcohol addiction treatment. Plans of Blue Cross Blue Shield include medical detox, inpatient residential programs, outpatient therapies, and dual diagnosis care, with the best coverage levels available through in-network providers.