Most insurance plans will cover either all or a portion of the treatment.
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Navigation:
- Overview
- Scalable, Customized Treatment Coverage and Support
- What Treatment Services Does Sentara Health Plans Offer?
- Additional Support Resources
- How Do I Find a Substance Use Treatment Provider Covered by Sentara Health Plans?
Overview
Sentara Health Plans offers a comprehensive and robust range of substance abuse treatment coverage options for members struggling with alcohol or drug addiction. Their Addiction and Recovery Treatment Services (ARTS) resources offer a path to treatment services designed to accommodate members at each stage of their treatment journey, whether they need inpatient, virtual, or outpatient care. If you or someone you care about is covered by a Sentara plan and needs help with an alcohol or drug use disorder, your Sentara plan may help pay for at least a portion of treatment, making care more accessible.
Scalable, Customized Treatment Coverage and Support
Sentara Health Plans claims to offer specialized behavioral health and substance use services to assist members on their path to healing and recovery. The organization prides itself on being able to meet patients where they are regarding their clinical and lifestyle needs, including offering coverage for in-home and community-based care options to make treatment plans easier to start and maintain.
They also offer access to experienced and qualified individuals and organizations that provide person-centered, trauma-informed support and services to members as they work toward healing and lasting recovery.
In-house resources and support for members include:
- A dedicated line for their Behavioral Health Services program: 1-888-946-1168 (TTY: 711) or 757-552-7174.
- A 24-hour Behavioral Health Crisis Line staffed by professionals who can help those in crisis and assist them in finding a provider: 1-833-686-1595.
For patients facing transportation-related barriers that impede their access to treatment and support services, Sentara Health Plans offers a dedicated line where patients can arrange rides to and from their programs. Members can call 1-877-892-3986 (TTY: 711), Monday through Friday, from 6 a.m. to 6 p.m., to set up a ride. Trips need to be scheduled at least five business days in advance. Weekends and holidays do not count toward these days.
What Treatment Services Does Sentara Health Plans Offer?
Each member’s access to treatment resources will vary based on their plan type, scope of coverage, ongoing care needs, and other criteria.
However, Sentara Health Plans covers, at least in part, a broad array of clinical treatment models through its ARTS resources, including:
- Inpatient medical detox
- Partial hospitalization programs
- Group home and sober living services
- Residential and inpatient rehab
- Intensive outpatient (IOP) treatment
- Regular outpatient (individual, family, and group) substance use treatment
- Opioid treatment services
- Peer support services
Rehab generally consists of group therapy, individualized counseling, and supplemental therapies that are administered according to members’ care needs and facility resources.
Sentara Health Plans may also cover medication-assisted treatment (MAT) for prescription or non-prescription drug addiction. This may include the use of select FDA-approved medications to reduce cravings and withdrawal symptoms. MAT must be administered by a credentialed medical professional as part of an approved opioid treatment program (OTP).
Additional Support Resources
In addition to covering many clinical treatment services, Sentara Health Plans provides access to a host of support resources, including but not limited to:
- Mental health case management
- Therapeutic Day Treatment Services for Children (TDT)
- Mental Health Partial Hospitalization Program (MH-PHP)
- Mobile crisis response
- Community stabilization services
- Residential crisis stabilization
- Assertive Community Treatment (ACT)
- Mental Health Intensive Outpatient Services (MH-IOP)
- Mental Health Partial Hospitalization Program (MH-PHP)
- Mental Health Skill-Building Services (MHSS)
- Intensive In-Home Services
- Psychosocial Rehabilitation Services
- Mental Health Peer Support Services
- Multi-Systemic Therapy (MST)
- Functional Family Therapy (FFT)
- Applied Behavior Analysis (ABA)
It’s important to note that prior authorization is required for many clinical and support services, including but not limited to inpatient and outpatient rehab, medical detox, and partial hospitalization programs. Your ARTS admissions representative will be able to guide you through program specifics, eligibility requirements, and the prior authorization process.
How Do I Find a Substance Use Treatment Provider Covered by Sentara Health Plans?
The fastest and most direct way to access a provider covered by your Sentara plan is to either talk to your primary care provider (PCP) or call your Sentara Health Plans care coordinator to discuss the best options for you. You can also browse our nationwide directory for rehab that accept Sentara plans.
To find an ARTS provider, members can either:
- Look in the Provider Directory at sentarahealthplans.com/findadoc
- Call their Sentara Health Plans care coordinator
- Call Member Services at 1-800-881-2166 (TTY: 711).
Sentara Health Plans encourages members and their loved ones to contact them for more information about their ARTS programs. Members can obtain information about program and coverage specifics for themselves or their covered family members, providing peace of mind and accurate information as they begin treatment.
If your family member is covered by your Sentara Health Plans policy, they may be able to access similar treatment benefits, depending on the specific plan and eligibility requirements. If a child in your family requires residential care, psychiatric services, or other select care resources, their treatment may be covered under the Behavioral Health Services Administrator (BHSA).
