Our dedication lies not just in treating symptoms but in addressing the root causes, offering a holistic approach that integrates the best of therapeutic practices with the warmth of community support.
Does CareFirst Cover Addiction Treatment?
Yes. Encore Outpatient Services is in-network with CareFirst for outpatient addiction treatment. Your specific coverage and costs will depend on your CareFirst plan.
CareFirst Coverage for Addiction Treatment in Arlington, VA
Encore is in-network with CareFirst for all levels of care we offer, including our Intensive Outpatient Program (IOP) and General Outpatient Program (GOP). Your specific coverage depends on the benefits and requirements of your individual plan.
Encore accepts CareFirst PPO and HMO plans, CareFirst BlueChoice, and Anthem FEP. Many CareFirst plans use coinsurance rather than a fixed copay, although this varies by plan. We verify your benefits before treatment so you can understand how your coverage applies and what costs you may be responsible for.
How We Help You Understand Your CareFirst Benefits
Before you begin treatment, we review your CareFirst benefits and explain how your plan applies to care at Encore. This includes your expected costs, coverage limitations, and any authorization requirements.
Benefit Verification
We verify your CareFirst benefits using your member ID number and date of birth. We also need a copy of your insurance card before or on the date of admission.
Understanding Your Costs
Admissions explains your remaining deductible, copay or coinsurance, out-of-pocket responsibility, and any coverage limitations.
Authorization Support
CareFirst usually does not require prior authorization. When it does, our verification team handles the authorization process and any needed reviews or appeals.
Your Treatment Plan Can Change as Your Needs Change
Your treatment plan is based on more than your insurance coverage. Our clinical team considers your substance use, mental and physical health, treatment history, current circumstances, and the level of support you need during outpatient care.
You may begin with the structure of our Intensive Outpatient Program or receive care through our General Outpatient Program. Encore is in-network with CareFirst for both levels of care.
Treatment does not remain fixed once you begin. Our clinical team monitors your needs and progress and can adjust your treatment plan when a different amount of support is appropriate. Your CareFirst benefits determine how covered care is paid for, not which level of care our team clinically recommends.
When your needs fall outside the services we provide, we can coordinate with other providers and community resources. If a higher level of care is appropriate, we can help connect you with a provider that offers that treatment.
Using CareFirst Benefits for VASAP Services
If you participate in the Virginia Alcohol Safety Action Program (VASAP), your CareFirst benefits may apply to outpatient services you receive at Encore. We check your individual plan to determine how your coverage applies.
Our team can help you understand:
- Whether Encore accepts your CareFirst plan
- Whether your outpatient services have coverage
- How your individual benefits apply
- Whether you may have costs for covered services
Depending on your CareFirst plan, some or all outpatient services may be covered. We review your benefits before treatment so you can understand how your insurance applies to your care.
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Frequently Asked Questions About CareFirst
Yes. Encore is in-network with CareFirst for both IOP and GOP services. Our clinical team determines the appropriate level of care based on your individual needs, while your CareFirst benefits determine how that treatment is covered.
Encore accepts CareFirst PPO and HMO plans, CareFirst BlueChoice, and Anthem FEP. We verify your specific plan before treatment because having an accepted CareFirst plan does not mean every member has the same benefits or costs.
It depends on your individual plan. Many CareFirst plans use coinsurance rather than a fixed copay, so we review your benefits to determine how your plan applies to the cost of your care.
Usually not. Some CareFirst plans do require authorization, and when they do, our Verification and Billing team handles the process rather than leaving you to manage it on your own.
Yes, if your individual CareFirst benefits cover the applicable outpatient services. We first confirm that Encore accepts your CareFirst plan, then check how your outpatient benefits apply to the services you receive as part of VASAP.
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