6th Degree Health plans may cover drug and alcohol rehab, detox, outpatient care, and mental health treatment — but your exact benefits depend on your employer plan, network status, and medical-necessity review.

Trying to get help for addiction is hard enough without insurance confusion. If your coverage is connected to 6th Degree Health, you may be wondering what’s covered, what approvals are required and what you might pay out of pocket. This guide explains how 6th Degree Health rehab coverage typically works, what factors influence approval and cost, and how to verify benefits for care at The Recovery Village Palm Beach at Baptist Health.

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

Quick takeaways (read this first)

  • 6th Degree Health is usually tied to employer coverage: It often supports access and care coordination through employer-sponsored plans.
  • Coverage varies by plan: Two people with “6th Degree Health” on their card may have different benefits depending on employer and plan design.
  • Network rules matter: In-network coverage is typically stronger; out-of-network services may be limited or not covered outside emergencies.
  • Medical necessity drives approval: Clinical review helps determine the appropriate level of care and length of stay.
  • Prior authorization is common: Detox, inpatient/residential, PHP and IOP often require pre-approval.
  • You can verify benefits without committing: Verification is informational and helps clarify your options and expected costs.

What is 6th Degree Health?

6th Degree Health is typically associated with employer-sponsored healthcare arrangements that may include network access, care coordination and benefit administration. It may work alongside other organizations (such as a medical plan administrator or a behavioral health manager) depending on how your employer structures benefits.

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That means your coverage details are usually determined by your specific employer plan, including:

  • Your plan’s network and contracted providers
  • Whether behavioral health benefits are managed separately
  • Whether addiction treatment is covered under medical benefits, behavioral health benefits, or both
  • Your plan’s prior authorization rules
  • Your deductible, copays, coinsurance, and out-of-pocket maximum

If you’re not sure who manages what, don’t worry — benefit verification can identify the right contacts and clarify which benefits apply.

Does 6th Degree Health cover drug and alcohol rehab?

In many cases, yes — employer-sponsored plans connected to 6th Degree Health may include coverage for substance use disorder (SUD) treatment and mental health services when care is considered medically necessary. However, what’s covered and what you pay depends on your plan’s benefits, network status and authorization requirements.

It’s also common for coverage to be split across benefit types:

  • Medical benefits: May cover detox services, physician services, labs, and some inpatient/residential components depending on how the plan is structured.
  • Behavioral health benefits: May cover therapy, counseling, group programming, psychiatric care, PHP/IOP, and certain residential services.
  • Pharmacy benefits: Often cover medications used in treatment, though some drugs may require prior authorization or have preferred formulary rules.

Bottom line: The most accurate way to understand your coverage is to verify your benefits using your member ID information.

Levels of care 6th Degree Health plans may cover

Addiction treatment isn’t one-size-fits-all. Many plans cover a range of services depending on clinical needs, safety risks, treatment history and medical necessity. Common levels of care include:

  • Medical detox: Medically supervised withdrawal management when withdrawal may be unsafe or severe.
  • Inpatient / residential rehab: 24/7 structured treatment with intensive therapy and clinical oversight.
  • 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 allowing patients to maintain work, school or family responsibilities.
  • Standard outpatient: Ongoing counseling, therapy, and medication management.
  • Aftercare: Continued recovery support following discharge from higher levels of care.

Some plans also cover additional services such as family therapy, case management, relapse prevention planning and recovery support resources. Availability depends on the plan and the approved level of care.

How coverage decisions are made: medical necessity & authorization

Most employer-sponsored plans require treatment to be medically necessary to be covered. “Medical necessity” generally means the level of care is clinically appropriate based on your symptoms, risks and treatment needs. Plans commonly use clinical guidelines and structured reviews to determine the appropriate level of care and length of stay.

Prior authorization is common for detox, inpatient/residential, PHP and IOP. During authorization, the plan (or a behavioral health manager) reviews clinical information to confirm that the recommended level of care is appropriate.

You may be asked about:

  • Substance use history, frequency and duration
  • Withdrawal symptoms and any past withdrawal complications
  • Medical conditions and medications
  • Mental health symptoms (anxiety, depression, PTSD, etc.)
  • Previous treatment attempts and relapse history
  • Home environment and available support
  • Safety risks (self-harm, overdose risk, unstable housing, etc.)

If a higher level of care isn’t approved initially, options may include an alternative recommended level of care (step-down), a peer-to-peer review with the treating clinician, or an appeal depending on plan rules.

What affects your out-of-pocket cost with 6th Degree Health

Your total cost depends on plan-specific factors. Even if a service is covered, you may still have cost-sharing. Common factors include:

  • Deductible: The amount you pay before the plan begins sharing costs.
  • Coinsurance: A percentage of costs you may pay after meeting the deductible.
  • Copays: Fixed fees for certain services.
  • Out-of-pocket maximum: A yearly cap on covered cost-sharing (after which the plan may pay more).
  • Network status: In-network care is usually less expensive; out-of-network may be higher or not covered.
  • Authorization: Lack of prior authorization can reduce coverage or lead to denial depending on plan rules.

Tip: If you’ve already met (or are close to meeting) your deductible or out-of-pocket maximum, your share of treatment costs may be lower than expected. Verification can help estimate what your plan may cover.

Does 6th Degree Health cover dual-diagnosis treatment?

Many employer plans include coverage for co-occurring (dual-diagnosis) treatment, meaning treatment for substance use and mental health conditions together. This may include therapy, psychiatric services, and medication management for conditions such as depression, anxiety, PTSD, or bipolar disorder when clinically appropriate.

Because dual-diagnosis care is common in addiction treatment, plans often evaluate the whole clinical picture during authorization and continuing care reviews.

Does 6th Degree Health cover medication-assisted treatment (MAT)?

Medication-assisted treatment (MAT) may be covered when medically appropriate. Coverage depends on medical and pharmacy benefits, formulary rules and any prior authorization requirements. MAT may be used for opioid use disorder, alcohol use disorder and other clinical needs.

Examples of medications that may be covered include:

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

If a medication isn’t covered as expected, options may include prior authorization, an alternative medication, or a formulary exception depending on the plan.

How to verify your 6th Degree Health rehab benefits

To verify benefits accurately, it helps to have your member ID card available. Key details include the member ID, group number, and any behavioral health contact information listed on the back of the card.

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

We can help confirm eligibility, network status, authorization requirements, and estimated costs by contacting the appropriate benefit administrator or using eligibility tools when available. Verify your insurance online.

Option 2: Call the number on your member ID card

Ask specifically about “behavioral health and substance use disorder benefits,” prior authorization requirements for detox/residential/PHP/IOP, and your cost-sharing amounts (deductible, coinsurance, copays, and out-of-pocket max).

Rehab accepting 6th Degree Health in Florida

If you’re seeking addiction treatment in Florida and have coverage connected to 6th Degree Health, The Recovery Village Palm Beach 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, eligibility, network rules, and medical-necessity review.