Verify Your Insurance Coverage

Yes — under the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA), most major insurance plans are legally required to cover substance use disorder (SUD) and mental health treatment at the same level as medical and surgical care. This means if your plan covers a hospital stay, it must also cover residential addiction treatment.

After Action accepts most major commercial insurance plans, including:

• Blue Cross Blue Shield (BCBS)
• Aetna
• Cigna / Evernorth
• United Healthcare / UBH
• Humana
• Magellan Health
• Optum
• Tricare (for eligible military first responders)

Coverage varies by plan, employer, and state. The fastest way to know what your plan covers is a free verification call — our team handles the paperwork while you focus on the decision ahead.

Source: SAMHSA National Helpline. For a breakdown of your specific benefits, call After Action at (866) 645-5672 for a free insurance verification.

Insurance coverage for addiction treatment is rarely all-or-nothing. Several factors determine your out-of-pocket costs and what gets approved:

• In-network vs. out-of-network: Using an in-network provider typically means lower out-of-pocket costs. After Action works with most major carriers as an in-network or preferred provider — we confirm your network status during the verification call.
• Deductible and out-of-pocket maximum: Most plans require you to meet a deductible before coverage kicks in. Once you hit your annual out-of-pocket maximum, the plan covers 100%.
• Prior authorization: Most residential and PHP programs require the insurance company to pre-approve treatment before it begins. Our admissions team initiates this process the same day we verify your benefits.
• Medical necessity: Insurers require documentation that the level of care requested is clinically necessary. Our clinical team handles all medical necessity documentation.
• Co-occurring diagnoses (PTSD, depression, anxiety): First responders frequently present with PTSD alongside substance use. Dual-diagnosis treatment may qualify for additional mental health coverage under MHPAEA.
• What if my claim is denied? Insurance denials happen — and they can be appealed. According to NIDA, treatment works and is cost-effective. Our team can guide you through the appeals process or explore alternative funding if needed. Contact our admissions team if you have received a denial.

Yes, in most cases. The ACA and MHPAEA require that most health insurance plans — including employer-sponsored plans — cover substance use disorder treatment at parity with medical care. This includes detox, residential, PHP, IOP, and outpatient levels of care. The actual amount covered depends on your specific plan, deductible, and whether the facility is in-network.

Yes. The ACA prohibits insurance companies from denying coverage or charging higher premiums due to a pre-existing condition, which includes a history of substance use disorder. Seeking treatment cannot be used against you when applying for or renewing health insurance coverage.

Yes. Under MHPAEA, mental health treatment — including PTSD treatment — must be covered at the same level as physical health care. At After Action, we specialize in trauma-informed treatment programs designed specifically for first responders, including firefighters, law enforcement, paramedics, and veterans.

If your insurance offers partial or no coverage, After Action offers financing options and self-pay arrangements. We also work with you on appeals if an authorization is denied. No one should be turned away from treatment due to cost — call us at (866) 645-5672 and our financial counselors will walk through every available option with you.