By We Level Up | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: March 13, 2023

CareFirst insurance may help pay for care for drug or alcohol use and mental health needs. The care you can use depends on your CareFirst health plan. Some plans may include medical detox, inpatient treatment, residential rehab, partial hospitalization programs (PHP), intensive outpatient programs (IOP), outpatient care, and therapy.

Each plan has its own rules. These rules may affect where you can get care and what you pay. Your deductible, copay, coinsurance, and provider network can also affect your costs. It is a good idea to check your benefits before you start treatment.

You can check your plan through your CareFirst member account or by calling the number on your insurance card. Ask about coverage for addiction treatment, mental health care, and the level of care you need. You can also ask if you need approval before treatment starts.

We Level Up can review the insurance details you provide and talk with you about care options. Call (844) 597-1011 to discuss your CareFirst benefits. You can also use our insurance verification service. A benefits check can help you understand your plan, but it does not guarantee payment or coverage. Your CareFirst plan makes the final decision.

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What Is CareFirst Insurance?

CareFirst insurance is health coverage from CareFirst BlueCross BlueShield. CareFirst offers health plans in Washington, D.C., Maryland, and Northern Virginia. It also has national plans that may give members access to care outside the local area. A CareFirst health plan may help pay for doctor visits, hospital care, mental health services, and treatment for drug or alcohol use.

You can review your member account or plan documents. You can also call the number on your CareFirst insurance card to ask about your benefits, costs, network, and treatment options.

CareFirst Health Plan Types

CareFirst offers more than one type of health plan. Common plan types include HMO, PPO, and POS plans. Each plan can have different rules for finding a doctor or treatment center. It can also change how much you pay for care. Knowing your plan type can help you understand your CareFirst insurance coverage.

CareFirst HMO Plans

A CareFirst HMO plan uses a set group of doctors and health providers. CareFirst regional HMO plans use the BlueChoice network. Your plan may require you to use providers in this network for most care.

Care outside the network may not be covered for non-emergency needs. Because of this, check the network before you choose a treatment center. This can help you avoid unexpected costs.

CareFirst PPO Plans

A CareFirst PPO plan can give you more choice when you need care. You may be able to use both in-network and out-of-network providers. Your plan may pay part of the cost for either type of provider.

Out-of-network care often costs more. You may have a higher deductible, copay, or coinsurance. Check your plan to see how these costs work before you begin treatment.

CareFirst POS Plans

A CareFirst POS plan has features of both HMO and PPO plans. It may let you get care from providers outside your main network. However, your costs may be higher when you go out of network.

CareFirst Insurance Coverage and Precertification

Some health plans require approval before certain types of care begin. This process is often called precertification or prior approval. Your plan may require this step for certain treatment services. The rules can vary based on your plan and the type of care you need.

Ask CareFirst if approval is needed before treatment. You can also ask the treatment center if they can help you understand what information may be needed. Approval does not guarantee that all treatment costs will be paid. Your plan’s benefits, limits, exclusions, and cost-sharing rules still apply.

In-Network and Out-of-Network Care With CareFirst

Your provider’s network can affect your treatment choices and costs.

CareFirst explains that in-network providers take part in its health plan network. Using these providers can give members a higher level of coverage and lower out-of-pocket costs under many plans.

In-Network Care

An in-network treatment center has an agreement with the CareFirst network. Your plan may provide better coverage when you use an in-network provider. You may still have a deductible, copay, or coinsurance. Before treatment, check that the treatment center is in your network. Also ask if the specific service you need is covered at the in-network level.

Out-of-Network Care

An out-of-network provider does not take part in the same CareFirst network. Some CareFirst plans may provide out-of-network benefits. HMO plans generally do not cover out-of-network care except in certain cases, such as emergencies. PPO and POS plans may offer out-of-network benefits, but your costs may be higher.

You may also have to pay the difference between what the provider charges and the amount allowed by your plan in some situations.

How Much Does CareFirst Rehab Treatment Cost?

There is no single rehab cost for every CareFirst member. Your CareFirst insurance coverage and your share of the cost depend on your plan and the care you receive.

Your plan may use several types of cost sharing:

• Deductible: The amount you may pay before your plan starts paying its share.
• Copay: A set amount you pay for certain covered care.
• Coinsurance: A part of the covered cost that you pay.
• Out-of-pocket maximum: A limit on your costs for covered care during the plan year.
• Network status: Your cost may change when you use an in-network or out-of-network provider.
• Type of care: Detox, inpatient care, residential care, PHP, IOP, and therapy may have different benefits.

CareFirst explains that cost sharing can include deductibles, copays, and coinsurance. The amount you pay depends on your plan. For example, your cost for medical detox may not be the same as your cost for outpatient therapy. Your costs may also be higher when you use a provider outside your network.

CareFirst Insurance Coverage at We Level Up

We Level Up offers different levels of addiction and mental health care at locations in several states. Services can vary by location, so the care available depends on the center and your treatment needs.

Locations With Detox

• California
• Washington
• New Jersey
• Lake Worth, Florida
• Texas

Locations With Inpatient Care

• Lake Worth, Florida
• Lake Elsinore, California
• Lawrenceville, New Jersey
• Texas
• Washington

Locations With Residential Care

• Lake Worth, Florida
• Lake Elsinore, California
• Lawrenceville, New Jersey
• Texas
• Washington, for residential mental health care
• Palm Beach, Florida, for mental health residential care
• Tamarac, Florida, for mental health residential care

Location With PHP

• Lawrenceville, New Jersey, for mental health PHP

Locations With IOP

• Lake Worth, Florida, for substance use
• Pompano Beach, Florida, for substance use
• Texas, for substance use and mental health

CareFirst Insurance and Dual Diagnosis Treatment

Some people have both a substance use problem and a mental health condition. These issues can affect each other and may need care at the same time. Dual diagnosis treatment focuses on both needs. Care may include therapy, mental health support, substance use treatment, and recovery planning.

We Level Up offers dual diagnosis treatment in Lake Worth, FL; Palm Beach, FL; Tamarac, FL; Lake Elsinore, CA; Lawrenceville, NJ; Texas; and Washington.

Does We Level Up Take CareFirst Insurance?

We Level Up can look at the CareFirst insurance details you provide. Our team can help you see what benefits may be available for addiction or mental health care. Your coverage may depend on your plan, the type of care you need, and the We Level Up location you choose.

CareFirst plans can have different rules for networks, costs, and out-of-network care. Some plans may offer access to care across the country. Other plans may use a local network.

Why Check Your CareFirst Benefits Before Treatment?

Checking your insurance before treatment can help you plan for care. It can also help you understand your possible costs before you enter a program. You can find out if your plan may cover the type of care you need. You can also learn if the treatment center is in-network and whether you need approval before treatment starts.

Your plan may have rules for deductibles, copays, coinsurance, and out-of-pocket costs. CareFirst notes that these costs can vary by plan. Knowing these details can make it easier to compare your treatment options.

FAQs About CareFirst Mental Health Providers

Check Your CareFirst Benefits

Your CareFirst insurance may help with the cost of addiction or mental health treatment. Your plan may include benefits for medical detox, inpatient care, residential treatment, PHP, IOP, therapy, and other services. The amount your plan pays can vary. It may depend on your CareFirst health plan, deductible, copay, coinsurance, network, and the type of care you need.

Checking these details before treatment can help you better understand your possible costs. To review your CareFirst benefits, call We Level Up at (844) 597-1011. Our team can review the insurance details you provide and help you explore available treatment options.

You can also use our insurance verification service to check your benefits. A benefits check can help you learn what your plan may cover. It does not guarantee payment or approval. Your CareFirst plan determines your final coverage.

Carefirst Mental Health Providers Video

To help you take the initial step toward recovery, our team of admissions coordinators is here to help. They are also accessible to address any queries or worries you may have. We are aware that starting something new can be challenging, especially when struggling with addiction. Our team is familiar with your situation firsthand. We want you to know that you are not alone on this path and that we are here to help.