Drug & Alcohol Rehab Covered By GEHA Health Insurance
If you’re insured through GEHA (Government Employees Health Association) and live in the Midwest, here’s what to know about addiction treatment coverage, network access, and how to verify your benefits.
Does GEHA Health Insurance Cover Inpatient Addiction Rehab in Wisconsin and Ohio?
Yes. GEHA FEHB plans cover mental health and substance use disorder (SUD) services across the continuum of care when medically necessary. Covered services include professional SUD treatment, detoxification, therapy/counseling, and facility-based care such as Residential Treatment Centers (RTC), as well as Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs (see definitions below).
If you receive health insurance through your federal job and it’s a GEHA plan, you can use it for covered addiction rehab services in Wisconsin. Our expert admissions team will verify your benefits directly with GEHA (fully confidential -by law) and explain in simple terms what your plan covers.
If any copays or out-of-pocket costs are required by your GEHA plan, we will work with you to set up flexible, interest-free payment plans, ensuring that financial concerns are never a barrier to receiving care.
What levels and types of substance abuse care are covered by GEHA?
GEHA defines and covers these SUD levels of care (when medically necessary):
GEHA coverage for Inpatient Detox (DTX) and Residential Treatment Centers (RTC): 24/7 residential care, withdrawal and medication management, and individual, group and family therapy, under physician and/or therapist direction. Detox and RTCs must be licensed/accredited.
GEHA coverage for Partial Hospitalization Program (PHP): Facility-based, structured outpatient day treatment while living at home or in sober housing, treatment services are typically approximately 20 hours/week.
GEHA coverage for Intensive Outpatient (IOP): Structured but more flexible therapy, typically approximately 9 hours/week.
Certain policies cover some types of Telehealth.
Is GEHA accepted at all drug and alcohol rehab centers in Wisconsin and Ohio or do I need prior authorization?
GEHA is accepted by various addiction treatment centers in Wisconsin and Ohio. For inpatient behavioral health admissions—including inpatient treatment—precertification is required. If it isn’t obtained, GEHA reduces benefits (penalties differ in- vs out-of-network).
At Wellbrook Recovery, we have extensive experience working with GEHA and some of its unique policy limitations. Our team will confirm that our facility is eligible under your plan. Once confirmed, we immediately take care of all precertifications and pre-authorizations that are required -and leave you out of it- so that you can focus on getting yourself into treatment in a most relaxed manner.
Our expert team will work with your specific GEHA Insurance to obtain the best coverage for your drug and alcohol rehabilitation while you are with us at our addiction treatment program.
I have GEHA health insurance, are there any hidden costs that may come for my stay at the addiction rehab program?
Unfortunately, some programs may surprise patients with hidden fees that weren’t disclosed up front. At Wellbrook Recovery, we never charge anything beyond what your GEHA plan outlines for required copays or out-of-pocket expenses. Any costs are clearly explained during pre-admission, and we offer generous, interest-free payment plans to support affordability.
Even in the rare case that your insurance company doesn’t follow through with expected payment, we will never charge you more than we initially quoted. We stand by our word and have a long-standing policy of honoring all pre-admission agreements—even if it means absorbing costs ourselves due to insurance complications.
What insurance network does GEHA use in Wisconsin and Ohio?
In Wisconsin, GEHA uses the UnitedHealthcare Choice Plus network.
Is GEHA UHC? What’s Unique About GEHA’s federal Version of UHC Coverage?
GEHA offers five main plan designs under FEHB/PSHB. Each uses the UHC Choice Plus network, but the premiums, cost shares, and out-of-network benefits differ from UHC’s commercial products.
Benefit Structures
Federal-employee–negotiated cost shares — often lower than comparable commercial PPOs.
Broader National Access
Because the plans are federal, coverage is uniform across states. You can live in Wisconsin and still access in-network care nationwide (or even abroad for emergencies). That’s different from many state-specific UHC employer or marketplace plans, which may have narrow networks.
Behavioral Health Integration
GEHA’s UHC partnership includes UHC Behavioral Health (Optum). Precertification for inpatient/RTC and case management are handled through UHC systems, but under GEHA’s FEHB rules.
Is GEHA a PPO? Are out-of-network benefits available?
GEHA’s High and Standard Options are fee-for-service plans with a preferred provider network (i.e., PPO-style). GEHA offers both in-network and out-of-network cost sharing options for mental health/SUD, with higher member costs when going out-of-network. Check your specific plan for exact numbers.
Some GEHA plan options you may see: Elevate, Elevate Plus, HDHP, Standard, and High. Benefits and cost sharing differ based on the plan option.
How can I get GEHA insurance coverage?
GEHA health plans are offered through the Federal Employees Health Benefits (FEHB) Program for federal employees and annuitants; GEHA also has Postal Service Health Benefits (PSHB) plan pages for USPS members.
GEHA does not sell individual or employer group health insurance to the general public outside these federal/PSHB channels.
Who can enroll in GEHA health insurance?
- Federal employees and retirees (civilian employees of the federal government and their families) through FEHB.
- U.S. Postal Service employees and retirees (and dependents) through PSHB.
- Eligible family members (spouse, children under age 26, disabled dependents) of federal/USPS employees who are enrolled.
How can I verify my GEHA substance abuse rehab benefits (fast)?
The admissions process at Wellbrook Recovery is fast and efficient. Contact our Wellbrook Recovery admissions team. With extensive experience handling GEHA policies, we are well-equipped to guide you through the full insurance and intake process.
We can expertly run a completely confidential Verification Of Benefits with GEHA, confirm coverage status and any out-of-pocket costs for your specific plan at this given time, and immediately handle any required clinical reviews and precertification. Most importantly, we’ll explain to you clearly what to expect and what your coverage and options are.
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