22 Health Coverage for Drug & Alcohol Rehab Treatment

22 Health (Community Care) may cover drug and alcohol rehab, detox, outpatient care, and mental health treatment — but your exact benefits depend on your plan, network status, and medical-necessity review.

Seeking addiction treatment is hard enough without insurance uncertainty. This guide explains how 22 Health (Community Care) rehab coverage typically works, what services may be covered, what affects your out-of-pocket cost, and how to verify benefits quickly. If you’d like help right away, our admissions team can verify your 22 Health benefits and explain your options for care at The Recovery Village at Baptist Health.

Quick takeaways (read this first)

• Coverage varies by plan: 22 Health plans may be offered through Community Care–style networks and can differ by plan design.
• Network matters: Coverage is typically limited to contracted providers; out-of-network care may not be covered except emergencies.
• Medical necessity matters: Clinical review is commonly used to determine the appropriate level of care.
• Prior authorization is common: Detox, inpatient/residential, PHP, and IOP often require approval before treatment begins.
• You can verify benefits without committing: Verification is informational and helps clarify coverage and costs.

22 Health (Community Care) overview

22 Health is a health insurance option associated with Community Care–style plan models that emphasize coordinated, in-network care. These plans may be offered through employer groups or community-based arrangements and often include structured authorization and network requirements that affect behavioral health and substance use disorder treatment.

Does 22 Health cover drug and alcohol rehab?

In many cases, yes — 22 Health plans may include benefits for substance use disorder (SUD) treatment and mental health services when care is deemed medically necessary. Coverage and out-of-pocket costs depend on your specific plan, provider network status, and clinical review. Some services may be covered under medical benefits, while others may fall under behavioral health benefits. Medications used in treatment are typically covered under pharmacy benefits.

Important: Coverage does not always mean “no cost.” Plans may include copays, coinsurance, deductibles, authorization requirements, or service limits. Benefit verification is the most reliable way to understand your coverage.

Levels of care 22 Health may cover

Addiction treatment is not one-size-fits-all. 22 Health may cover different levels of care depending on clinical needs, safety considerations, and treatment history. Common levels include:

• Medical detox: Medically supervised withdrawal management when withdrawal may be unsafe or severe.
• Inpatient / residential rehab: 24-hour structured treatment for stabilization and intensive therapy.
• Partial Hospitalization Program (PHP): High-intensity day treatment while living at home or in supportive housing.
• Intensive Outpatient Program (IOP): Multi-day per week therapy that allows patients to maintain daily responsibilities.
• Standard outpatient: Ongoing counseling, therapy, and medication management.
• Aftercare: Continued recovery support following higher levels of treatment.

How 22 Health determines coverage: medical necessity & authorization

Coverage decisions are generally based on medical necessity. 22 Health reviews clinical information to confirm that the requested level of care is appropriate. Like many insurers, plans may reference nationally recognized guidelines such as The ASAM Criteria when evaluating treatment placement and duration.

During benefit verification or authorization, you may be asked about:

• Substance use history and frequency
• Withdrawal risk and prior complications
• Medical and mental health conditions
• Previous treatment attempts and relapse history
• Home environment and available supports
• Safety risks or functional impairment

If a higher level of care is not approved initially, options may include step-down recommendations, peer-to-peer review, or appeal depending on plan rules.

What affects your out-of-pocket cost with 22 Health

Your total cost depends on several plan-specific factors, including:

• Plan design: Employer or community-based plans may have different cost-sharing structures.
• Deductible: What you pay before the plan begins sharing costs.
• Copays and coinsurance: Your portion of covered services.
• Network requirements: In-network care is typically required for coverage.

Tip: If you are close to meeting your deductible or out-of-pocket maximum, treatment costs may be lower than expected.

Does 22 Health cover dual-diagnosis treatment?

Many 22 Health plans include benefits for co-occurring mental health and substance use treatment. This may include therapy, psychiatric services, and medication management for conditions such as depression, anxiety, PTSD, or bipolar disorder when clinically appropriate.

Does 22 Health cover medication-assisted treatment (MAT)?

Medication-assisted treatment (MAT) may be covered when medically appropriate. Coverage depends on both medical and pharmacy benefits, and some medications may require prior authorization.

• Buprenorphine/naloxone
• Methadone (often delivered through specific programs)
• Naltrexone (including long-acting injectable forms)
• Alcohol use disorder medications when indicated

How to check your 22 Health rehab benefits

To get accurate information, have your 22 Health member ID card available.

Option 1: Verify benefits with our admissions team (recommended)

We can confirm network status, authorization requirements, and estimated costs by contacting 22 Health directly or using eligibility tools when available. Verify your insurance online.

Option 2: Call the number on your member ID card

Ask about “behavioral health and substance use disorder benefits,” required authorizations, and cost-sharing.

Rehab accepting 22 Health (Community Care) in Florida

If you’re seeking addiction treatment in Florida and have 22 Health (Community Care) coverage, The Recovery Village at Baptist Health can help you understand your benefits and available treatment options before you begin care.

Disclaimer: This page is for informational purposes only and does not guarantee coverage or payment. Benefits vary by plan and are subject to authorization and medical-necessity review.