Insurance

Mass General Brigham Health Plan Coverage for Addiction Treatment in Massachusetts

Mass General Brigham Health Plan is on the list of plans accepted at our Needham program. Here is what its plans typically cover for outpatient addiction treatment in Massachusetts, how authorization and copays usually work, and how to get an answer about your own plan in one call.

What happens when you call

One call starts everything. Here is what to expect.

You call, we answer
The admissions line is answered 24/7. A real person picks up, no menu and no callback queue.
Benefits check within minutes
We check your insurance with the carrier at no cost and tell you what your plan covers.
A short clinical assessment
A clinician talks through what is going on and matches you to the right level of care.
You start
We schedule your first day, same day in many cases, at the office closer to you.

What we will ask: your name, a callback number, which state, and only if you have it, your insurance card.

What Mass General Brigham Health Plan typically covers

Mass General Brigham Health Plan and outpatient addiction treatment in Massachusetts

(603) 769-8981

Mass General Brigham Health Plan is the health plan owned by the Mass General Brigham hospital system. It was called AllWays Health Partners until 2023, and some cards and employer documents still use the old name. It sells commercial plans to employers and on the Health Connector, and it runs a MassHealth accountable care organization. The plan's behavioral health benefits, including substance use care, are administered by Optum.

At our Needham center, Mass General Brigham Health Plan members typically use these levels of care:

Day Treatment. Many plans cover it when a clinical assessment supports it. Optum will call it partial hospitalization, and authorization is usually approved before the first day.
Evening Treatment. Many plans cover it under their own program name. Whether authorization is needed first depends on the plan.
Medication-Assisted Treatment (MAT). The visits are covered like other outpatient care. The medication runs through your pharmacy benefit and its formulary.

Coverage depends on your plan. A commercial HMO, a Health Connector plan and the MassHealth ACO carry different rules and networks, and the ACO has no copays at all. We verify your benefits in one call before anything is scheduled.

Levels of care

Levels of care Mass General Brigham Health Plan members use at our Needham center

Every level is outpatient. You sleep at home and keep your life around treatment. Detox, when it is needed first, is arranged by referral to a partner facility.

Prior authorization and copays

How the paperwork usually works with Mass General Brigham Health Plan

Admissions and our clinical team handle every step of this. Here is what it looks like from your side.

01

Optum reviews behavioral health: Substance use care is reviewed by Optum against the ASAM Criteria, the same framework our clinicians use to recommend a level of care. Requests are entered through the plan's provider portal.
02

Authorization before Day Treatment: Day Treatment usually needs approval before day one. We send the assessment and treatment plan and manage the continued-stay reviews while you are in the program.
03

Evening Treatment and outpatient: Some plans authorize Evening Treatment up front, others only ask for notification. Routine outpatient visits generally need no approval. We check your plan's rule during the benefits call.
04

Commercial copays, ACO with none: Commercial plans apply the deductible first, then a copay per visit or coinsurance, and HMO designs usually mean flat copays. Members of the MassHealth ACO pay nothing for substance use treatment, because MassHealth removed those copays in 2020.
05

Massachusetts parity: State law requires most plans to cover medically necessary substance use treatment on the same terms as other medical care. Outpatient care can still need authorization, and that is the part we handle.

Mass General Brigham Health Plan is listed among the plans accepted at our Massachusetts program, at 392 Chestnut Street, Suite 200, Needham, MA 02492, just off Route 128 and about 30 minutes from downtown Boston, with Newton, Wellesley and Dedham each under 15 minutes away. Networks are plan-specific, so during the benefits check we confirm your exact plan against our contract.

Mass General Brigham Health Plan is a Massachusetts plan, so members are seen at our Needham office. If you live in New Hampshire, call anyway and admissions will tell you plainly whether your plan pays for care at our Londonderry center.

One thing we say plainly: we are not in network with Medicare at this time. If Medicare is your primary coverage, call anyway. Admissions can point you to options, and FindTreatment.gov, the federal treatment locator, lists programs that accept it.

Where you are covered

Our Needham, MA center is the office for Mass General Brigham Health Plan members

Get directions How admissions works

Mass General Brigham Health Plan questions

Mass General Brigham Health Plan and rehab in Massachusetts: common questions

Short answers here, and a real one for your plan when you call (603) 769-8981.

Does Mass General Brigham Health Plan cover Evening Treatment in Massachusetts?

Many of its plans cover our Evening Treatment program when a clinical assessment supports it, authorized by Optum. Whether approval is needed first, and what you pay per session, depends on your plan. Call (603) 769-8981 and we will check before you start.

Does Mass General Brigham Health Plan cover Day Treatment?

Day Treatment is a covered level of care on most of its plans, reviewed by Optum as partial hospitalization, and it usually needs approval before day one. Our clinicians send the assessment and treatment plan and handle the reviews.

My card still says AllWays Health Partners. Does that matter?

No. AllWays Health Partners became Mass General Brigham Health Plan in 2023, and the coverage is the same plan. Read us the member ID and we will check your benefits.

I am in the Mass General Brigham ACO through MassHealth. Am I covered?

The ACO covers substance use treatment as a MassHealth benefit with no copays. Whether our Needham program is inside its network is something we confirm during the benefits check.

Do you take Medicare?

We are not in network with Medicare at this time. If Medicare is your primary insurance, admissions can point you to options, and FindTreatment.gov lists programs that accept it.

Check my coverage

Find out what your plan covers before you decide.

Most insurance accepted. Your name and a number is all we need. Admissions checks your benefits with the carrier at no cost and calls you back with what your plan covers. Admissions line answered 24/7.

Free, confidential, no obligation.

Find out what your Mass General Brigham Health Plan covers today.

Call (603) 769-8981 and admissions checks your benefits within minutes, at no cost and with no obligation.

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Mass General Brigham Health Plan Coverage for Addiction Treatment in Massachusetts

One call starts everything. Here is what to expect.

You call, we answer

Benefits check within minutes

A short clinical assessment

You start

Mass General Brigham Health Plan and outpatient addiction treatment in Massachusetts

Levels of care Mass General Brigham Health Plan members use at our Needham center

Day Treatment

Evening Treatment

Medication-Assisted Treatment (MAT)

Mental health treatment