ValueOptions-related behavioral-health benefits may cover residential addiction treatment when the member’s specific plan includes that level of care and applicable medical-necessity requirements are met. Trinity Behavioral Health accepts ValueOptions benefits, but coverage is plan-specific. ValueOptions became Beacon Health Options, which is now Carelon Behavioral Health.
Before admission, verify the specific residential treatment benefits.
Can ValueOptions benefits cover residential rehab?
Potentially. Coverage can depend on the underlying health plan, current behavioral-health administrator, active eligibility, network status, authorization requirements, medical necessity, and continued-stay review.
Can prior authorization be required?
Yes. Current Carelon materials describe clinical review for authorization and medical-necessity determinations. Exact rules depend on the member’s plan and requested level of care.
Can the approved length of stay change?
It can. Initial authorization and continued-stay review may be separate, and updated clinical information may be requested before additional residential days are approved.
What should I verify?
- Active eligibility
- Underlying payer and current behavioral-health administrator
- Residential treatment benefits
- Network status
- Prior authorization
- Deductible, copay, or coinsurance
- Continued-stay requirements
For the carrier overview, see ValueOptions rehab benefits at Trinity Behavioral Health. You can also review Trinity’s residential rehab program.
Verify Your ValueOptions-Related Residential Benefits
Authoritative resources
- Carelon Behavioral Health — Member Benefits and Resources
- Carelon Behavioral Health — Provider Resources
- Carelon Behavioral Health — Prior Authorization Information
- SAMHSA — Know What Your Insurance Covers
Exact benefits vary by plan and should be verified directly.