Key Takeaways
- Florida Blue typically covers PHP when it is determined to be medically necessary.
- The Recovery Village Palm Beach at Baptist Health is in-network with Florida Blue, reducing out-of-pocket costs for members.
- Coverage specifics — copays, coinsurance, deductible — depend on your individual plan.
- Pre-authorization may be required for PHP; our admissions team handles this.
- Free, confidential benefits verification available 24/7.
Florida Blue Coverage for PHP
Under the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, Florida Blue is required to provide coverage for substance use disorder treatment at levels comparable to medical and surgical care. PHP is a recognized, evidence-based component of addiction treatment, and most Florida Blue plans include benefits for this level of care when clinically indicated.
Coverage is tied to medical necessity. This means Florida Blue evaluates clinical information to confirm that PHP is the appropriate level of care for your specific situation. Factors considered include substance use history, severity of addiction, previous treatment attempts, co-occurring mental health conditions, and current medical status.
The Recovery Village Palm Beach at Baptist Health is in-network with Florida Blue. This means Florida Blue members who receive PHP at our facility benefit from lower copays, lower coinsurance rates, and costs that apply toward their in-network deductible and out-of-pocket maximum.
What PHP Involves
Partial hospitalization (PHP) is a structured day treatment program — typically 5-6 hours daily, 5-6 days per week — designed for patients stepping down from inpatient care. PHP provides intensive therapeutic programming while giving patients increasing autonomy in the evenings. It bridges the gap between residential treatment and outpatient care.
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How Florida Blue Coverage Works for PHP
Pre-Authorization
Many Florida Blue plans require pre-authorization before PHP begins. This involves submitting clinical information to Florida Blue to demonstrate medical necessity. Our admissions team handles this process directly — you do not need to navigate it yourself.
Cost Factors
Your out-of-pocket cost for PHP with Florida Blue depends on your specific plan’s deductible (amount paid before coverage begins), copay (fixed amount per service), coinsurance (your percentage share after deductible), and out-of-pocket maximum (annual cap on your total costs).
In-Network Advantage
Because The Recovery Village Palm Beach at Baptist Health is in-network with Florida Blue, your costs for PHP will be significantly lower than they would be at an out-of-network facility. In-network rates are pre-negotiated, and your spending counts toward your in-network deductible and out-of-pocket maximum.
Verify Your Florida Blue Benefits for PHP
Contact our admissions team for free, confidential verification. You will learn whether your plan covers PHP, estimated out-of-pocket costs, pre-authorization requirements, and coverage duration expectations.
Frequently Asked Questions
Does Florida Blue cover PHP?
Yes, in most cases, when medically necessary. Specific coverage depends on your plan.
How much will PHP cost with Florida Blue?
Depends on your plan’s deductible, copay, and coinsurance. Verify for free through our admissions team.
Does Florida Blue require pre-authorization for PHP?
Many plans do. Our team handles this on your behalf.
How long will Florida Blue cover PHP?
Coverage duration is based on ongoing medical necessity, not a fixed number of days.
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More: Florida Blue Coverage Overview · All Insurance Providers · Treatment Programs
