Insurance
MassHealth Coverage for Addiction Treatment in Massachusetts
MassHealth covers substance use treatment through its plans, and we help MassHealth members confirm their benefits at our Needham program. Here is what MassHealth typically covers for outpatient addiction treatment, what it costs you, and how to get an answer about your own coverage 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 MassHealth typically covers
MassHealth and outpatient addiction treatment in Massachusetts
MassHealth is the Massachusetts Medicaid program, and substance use disorder treatment is one of its covered benefits. Most adult members are enrolled in an accountable care organization (ACO) or a managed care plan (MCO), and each one runs its own behavioral health network. Members in the Primary Care Clinician plan use the Massachusetts Behavioral Health Partnership for the same benefit. That is why the first thing we ask is the plan name on your card, not just whether you have MassHealth.
At our Needham center, MassHealth members typically use these levels of care:
- Day Treatment. Our most structured program, several hours a day on weekdays. MassHealth plans recognize this level under their own names, often as a structured outpatient addiction program or partial hospitalization, and usually authorize it before the first day.
- Evening Treatment. Monday to Thursday, 6 to 9 pm. Plans authorize it under their own program name, and whether that happens before day one or after a set number of sessions depends on the plan.
- Medication-Assisted Treatment (MAT). Suboxone, Vivitrol and the visits that go with them are covered benefits, with the medication subject to the MassHealth drug list.
The part people are most relieved to hear: MassHealth stopped charging copays for substance use treatment, including the medications, in July 2020. Coverage at our Needham program still depends on your specific MassHealth plan and the level of care it approves, so we verify your benefits in one call before your first visit.
Levels of care
Levels of care MassHealth 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.
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Day Treatment
Our most structured program, several hours a day on weekdays. Your plan may call it partial hospitalization or PHP.
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Evening Treatment
Monday to Thursday, 6 to 9 pm, so work and family stay in place. Your plan may authorize it under its own program name.
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Medication-Assisted Treatment (MAT)
Suboxone, Vivitrol and related medication visits, overseen by our medical director.
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Mental health treatment
Care for depression, anxiety and trauma alongside substance use.
Our Massachusetts program is 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. Because MassHealth is a state program, it pays for care at our Massachusetts office. New Hampshire residents should read our NH Medicaid page instead.
If you do not have MassHealth yet but think you qualify, you can apply through the Massachusetts Health Connector, and the state's Substance Use Helpline at 800-327-5050 can connect you to care while the application is in progress. Call us either way.
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 MassHealth members
MassHealth questions
MassHealth and rehab in Massachusetts: common questions
Short answers here, and a real one for your plan when you call (603) 769-8981.
Does MassHealth cover Evening Treatment in Massachusetts?
Does MassHealth cover Day Treatment?
Do you take MassHealth at Clear Steps?
Does MassHealth cover Suboxone and Vivitrol?
Do you take Medicare with MassHealth?
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 MassHealth plan covers today.
Call (603) 769-8981 and admissions checks your MassHealth benefits within minutes, at no cost and with no obligation.
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