Carelon Drug and Alcohol Rehab Treatment Coverage in New Jersey

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Summit Helps is a leading provider of drug and alcohol addiction rehab and mental health services with a New Jersey-based treatment center. Dedicated to aiding individuals in overcoming addiction and enhancing mental well-being, our facilities provide a tranquil and encouraging setting for your or your loved one’s recovery.

Recognizing the crucial importance of access to quality treatment, we accept a range of health insurance plans to enhance the accessibility of our services, meaning we may take your Carelon Behavioral Health plan. We invite you to call (888) 995-6311 to discuss your insurance coverage details and explore the available treatment options for you or your loved one. Our committed team is ready to offer the guidance and support needed to embark on the path towards a brighter and healthier future.

Addiction and Mental Health Statistics in New Jersey

A 2021 report indicates that among those 13–17, 14% experience mood disorders, 32% face anxiety disorders, and 19% struggle with behavior disorders. 10.7% of youth in the state faced challenges related to anxiety and depression in 2020, an increase from 2016. The state’s 2023 budget allocates over $50 million from the American Rescue Plan for youth mental health services.

The primary reason for seeking inpatient care in New Jersey is to address opioid withdrawal symptoms. In New Jersey and correctional facilities nationwide, synthetic drugs are infiltrating prisons, posing risks to both inmates and staff exposed to the resulting smoke and airborne chemicals. Substance use disorder (SUD) affects about 6.1% of New Jersey residents, and between 2016 and 2021, approximately 312,000 individuals in the state received treatment for substance abuse.

Exploring in and Around New Jersey

Nestled along the northeastern U.S. coast, New Jersey, often nicknamed “The Garden State,” boasts a diverse landscape featuring serene beaches, rolling hills, and vibrant urban hubs. Its proximity to the Atlantic Ocean grants residents and visitors access to captivating shorelines, with the renowned Jersey Shore offering beach towns and lively boardwalks, drawing those in search of a coastal escape.

Urban enthusiasts can immerse themselves in the dynamic cityscapes of Newark and Jersey City, marked by iconic skyscrapers contributing to unique skylines and breathtaking views of New York City. Union City stands out for its lively atmosphere and diverse communities, while Atlantic City is renowned for its animated boardwalk, casinos, and entertainment options.

Nearby Cities

Visit our facility at 4065 Quakerbridge Road, Princeton Junction, NJ 08550, strategically located to offer the peace of suburban living with easy access to city amenities. Our surroundings feature lush greenery and a serene atmosphere, creating an ideal setting for recovery. Close to well-known cities, our facility is easily accessible to diverse populations and attractions.

Princeton, known for its culture and academics, is just a short distance away. Trenton, the state capital, is nearby, blending history with modern life. If you’re seeking urban excitement, Philadelphia and New York City are close, providing opportunities for culture, entertainment, and employment—all within the supportive environment of our rehabilitation facility.

Who is Carelon Behavioral Health?

Carelon Behavioral Health, formerly known as Beacon Health Options, is a subsidiary of a major U.S. healthcare organization. With a mission to eliminate barriers to complete health, Carelon manages and delivers behavioral health services to a diverse clientele, including health plans, employers, governments, and labor organizations, currently serving over 47 million clients, including Fortune 500 companies.¹

Their comprehensive health solutions prioritize the mind, body, and spirit,² aiming to address disparities in behavioral health and enhance accessibility. Carelon collaborates with therapists, counselors, and treatment facilities to provide personalized solutions while strongly emphasizing monitoring and improving the quality of behavioral healthcare services, ensuring evidence-based care, and actively participating in mental health advocacy efforts. Additionally, the company offers educational resources to clients and the public as part of its commitment to advancing mental health awareness and support.³

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Some of Carelon Brands, Products, and Services

Carelon Behavioral Health provides a wide range of services, including pharmacy, behavioral health, complex care delivery, medical benefits management, payment integrity, palliative care, advocacy, research, digital platforms, and operations and technology services. With this diverse range of brands, products, and services, you can explore the following options:

Carelon Brands 

  • CarelonRx: Formerly Ingenio Rx, this pharmacy benefit manager provides prescription drug benefits to health plans and employers and manages a network of over 60,000 pharmacies, dispensing over 1 billion prescriptions annually.4
  • Beacon Health Options: Now called Carelon Behavioral Health, this provider of behavioral health services offers a comprehensive range of treatments such as individual therapy, group therapy, family therapy, and medication management. With its vast network of over 200,000 providers, the company caters to more than 40 million individuals.
  • Carelon Post Acute Solutions: Formerly known as myNEXUS, this home healthcare provider offers various services, including nursing care, physical therapy, occupational therapy, and speech therapy. They serve over 200,000 patients annually through their network of more than 10,000 providers.5

Carelon Products and Services

  • Behavioral health services: A broad network of licensed clinicians.
  • Carelon Well-being: Employee Assistance Programs (EAPs) provide counseling, digital tools, and educational resources to enhance work-life balance and overall wellness.
  • Medical benefits management services: Claims processing, network management, and utilization review.6
  • Palliative care services: Comfortable, supportive care services for patients and their families suffering from chronic or life-limiting illnesses.7
  • Advocacy services: Help with navigating the healthcare system and accessing the necessary care.8
  • Digital Platforms: Digital tools and data-driven insights for healthcare providers and members, ensuring transparency, connection, and affordability.9

What is Carelon Rehab Coverage in New Jersey?

Carelon focuses primarily on managing and coordinating behavioral health services, encompassing mental health and substance abuse treatment, rather than offering traditional insurance coverage for rehabilitation services. Rehab coverage, however, includes a wide range of services and programs related to the treatment of substance use and mental health conditions, including but not limited to outpatient care, counseling, and medication-assisted treatment (MAT).

Review your policy documents for a more comprehensive understanding of your rehabilitation coverage through Carelon Behavioral Health. Our team is here to assist you in clarifying the extent of your Carelon rehab coverage and ensuring you have access to the necessary resources for your specific treatment needs.

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Does Carelon Cover Rehab?

Carelon offers coverage for various drug and alcohol rehabilitation services as part of its comprehensive behavioral health services. This support extends to multiple aspects of substance abuse treatment, including detoxification, outpatient care, counseling, and more. To thoroughly understand your coverage details and any potential co-pays or deductibles, review the details of your particular plan or call (888) 995-6311.

Our team is available to assist and provide personalized, detailed information regarding Carelon alcohol rehab or Carelon drug rehab services.

Does Carelon Cover Medical Detox Treatment?

Medical detoxification is a crucial part of substance abuse treatment, and Carelon’s behavioral health services typically cover it. This process helps individuals safely withdraw from addictive substances under medical supervision. The coverage specifics may differ depending on your plan, so it’s wise to check your insurance policy or contact us to understand your coverage comprehensively.

Does Carelon Cover Residential Treatment in New Jersey?

Carelon usually provides coverage for residential treatment, focusing on aiding individuals dealing with substance abuse and mental health challenges. Residential programs offer a structured, supportive environment, allowing individuals to engage in intensive 24/7 therapy and care. The scope of your coverage for residential treatment may vary depending on your unique plan and other factors.

For a thorough understanding of your coverage, we advise reviewing your policy details or calling (888) 995-6311. Your journey to recovery is our foremost priority, and we are dedicated to providing the support you or your loved one needs.

Does Carelon Cover Mental Health Therapy Treatment in New Jersey?

Carelon Behavioral Health usually includes mental health therapy treatment coverage as part of its comprehensive array of services, as mandated by the Mental Health Parity and Addiction Equity Act.10 These services incorporate diverse therapeutic methods, including counseling, cognitive-behavioral therapy (CBT), motivational interviewing, and others tailored to address mental health challenges.

However, it’s crucial to recognize that the details of your coverage may differ based on your policy and other factors. Your mental well-being is a top priority for us, and we are committed to supporting your path toward improved mental health. For a more in-depth understanding of your mental health therapy treatment coverage, call (888) 995-6311.

Does Carelon Cover EMDR Therapy in New Jersey?

Carelon Behavioral Health typically offers Eye Movement Desensitization and Reprocessing (EMDR) therapy as part of its behavioral health services. EMDR is an evidence-based therapy often used to treat conditions like post-traumatic stress disorder (PTSD), anxiety, and other mental health challenges. However, the specific coverage for EMDR therapy can vary depending on your Carelon plan and other factors.

To fully understand the extent of your coverage, it is recommended that you review your policy details, reach out to Carelon directly, or contact us for further assistance.

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Other Rehab Treatment Programs Covered by Carelon

Understanding the specifics of your insurance coverage for different treatment programs is vital to ensuring that you or your loved one receives the necessary care. For a comprehensive understanding of your specific coverage and available treatment options, call (888) 995-6311. Your well-being is our priority, and we are here to support your journey toward improved mental health, recovery, and sobriety.

Coverage for Partial Hospitalization Programs in New Jersey

Partial Hospitalization Programs, or PHPs, are intensive, structured treatment programs that provide comprehensive care for individuals with mental health and substance use issues. These programs offer therapy, medical monitoring, and support for several hours a day but do not require round-the-clock inpatient supervision, making them more flexible than traditional inpatient programs.

PHPs are a crucial tool in addressing a wide range of mental health conditions, including depression, anxiety, and substance use disorders. They typically involve individual and group therapy sessions, medication management, aftercare, and educational components that equip participants with coping strategies for relapse prevention and life skills. This blend of comprehensive care and flexibility can be a determining factor in promoting recovery, as it enables individuals to apply newly acquired skills in real-life situations while receiving vital therapeutic support.

Coverage for Intensive Outpatient Programs in New Jersey

Carelon usually offers coverage for Intensive Outpatient Programs (IOPs), designed as a step-down level of care for individuals requiring ongoing support in mental health or substance abuse treatment. IOPs include regular therapy sessions, group therapy, and counseling, enabling individuals to uphold their daily routines while receiving essential treatment.

Coverage for Acute Treatment Programs in New Jersey

Carelon often broadens its coverage to include acute treatment programs specifically tailored to address immediate, severe mental health issues. These programs serve as a vital lifeline during crises, offering intensive, short-term care. This level of care is essential for individuals grappling with acute mental health challenges, as it aids in stabilizing their conditions and preventing further deterioration.

Coverage for Inpatient Rehab in New Jersey

Inpatient rehabilitation is an all-encompassing, highly structured treatment program providing 24/7 care for severe mental health or substance abuse issues. This program entails residing in a specialized facility and receiving constant monitoring, therapy, and medical support. This level of care proves particularly advantageous for those with significant challenges who require a secure, focused setting for recovery.

Carelon typically includes coverage for inpatient care, ensuring individuals have access to the intensive care, support, and aftercare necessary to initiate their journey to recovery. For further details on these treatment programs and more, call (888) 995-6311.

Rehab Center in New Jersey That Takes Carelon

Dedicated to aiding individuals on the journey to recovery from substance abuse and mental health challenges, our outpatient treatment center in Princeton Junction, New Jersey, uses a holistic approach. Our personalized, evidence-based treatment methods are the beginning of a transformative journey toward well-being. We accept various insurance plans and may be able to take your Carelon Behavioral Health plan.

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How Much is Rehab with Carelon Insurance?

Rehabilitation expenses under Carelon vary, influenced by factors such as the specifics of your policy and the required treatment duration. On average, psychotherapy sessions without insurance typically range from $100 to $200 per hour,11 while a three-month outpatient rehabilitation program generally costs around $5,000. It’s important to note that these figures are estimates and subject to significant variation.12

Although Carelon benefits typically cover some rehabilitation costs, it’s crucial to be aware that financial responsibilities, including copayments and deductibles, may still apply. The primary objective is to ensure that you or your loved one can access essential care, and our team is available to assist you in obtaining that care. Check your insurance details today for peace of mind and personalized support.

How To Check Carelon Coverage Levels for Rehab Treatment in New Jersey

We recommend carefully reviewing your insurance policy details by calling (888) 995-6311. Our dedicated team is prepared to connect with your insurance provider on your behalf, ensuring a confidential and obligation-free process. After the verification process, we will reach out to you to discuss your policy details, answer questions, and provide guidance on the next steps.

For a more in-depth understanding of the specifics of your Carelon insurance policy and to explore rehab centers that take Carelon, contact us. We are here to assist you in navigating insurance coverage details and finding the right resources for your or your loved one’s rehabilitation needs.

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How To Get Carelon to Pay for Rehab Treatment in New Jersey

Embark on your rehabilitation journey by thoroughly reviewing the detailed documentation outlining your benefits. For the most up-to-date and personalized information on how to get Carelon to cover your rehab treatment in New Jersey, call (888) 995-6311.

  • Factor in your needs and preferences to optimize your benefits when considering rehab centers that take Carelon.
  • If needed, secure a referral from your primary care physician and provide Carelon with any necessary pre-authorization details.
  • Select a treatment facility that will submit claims to Carelon on your behalf.

After completing your treatment, initiate follow-up communication with Carelon to verify claims processing and receive any owed reimbursements or coverage benefits. Enhance the likelihood of your rehabilitation treatment costs being covered by choosing approved providers within the Carelon network and adhering to your prescribed treatment plan. Your path to recovery is personalized, and we are here to guide you at every step.

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How Many Times Will Carelon Pay for Rehab in New Jersey?

The coverage provided by Carelon Behavioral Health for rehab is contingent on factors like your healthcare plan’s terms and conditions and medical necessity, as determined by healthcare professionals when considering the nature and duration of your mental health or substance abuse condition.

Insurance plans usually cover rehab treatment costs when deemed medically necessary, yet limitations or exclusions on the number of days or sessions within a specific timeframe may apply. For additional details, call (888) 995-6311.

Addiction Statistics in New Jersey

  • The main reason for seeking inpatient care in New Jersey is related to managing opioid withdrawal symptoms by providing medication such as methadone.13
  • As per a 2021 report by the Substance Abuse and Mental Health Services Administration (SAMHSA), 14% of individuals aged 13–17 encounter mood disorders, 32% face anxiety disorders, and 19% grapple with behavior disorders.14
  • In 2020, 10.7% of children in New Jersey faced challenges with anxiety and depression, marking an increase from 7.6% in 2016.15
  • New Jersey’s 2023 budget includes over $50 million in funding from the American Rescue Plan to enhance youth mental health services.
  • In New Jersey and correctional facilities nationwide, synthetic drugs are infiltrating prisons and being consumed by incarcerated individuals, posing risks to both inmates and staff exposed to the resulting smoke and airborne chemicals within the facilities.16
  • About 6.1% of New Jersey residents reported experiencing substance use disorder (SUD).17
  • About 312,000 people in New Jersey received treatment for substance abuse from 2016 to 2021.18
  • In 2019, treatment admissions in New Jersey were primarily driven by heroin, constituting 42% of admissions, with alcohol closely following at 31%.19
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