Are you or a loved one struggling with substance misuse? The Plymouth House, a Guardian Recovery facility, is pleased to announce we are now accepting WellSense Healthcare, a NH Medicaid provider. NH Medicaid offers comprehensive benefits including coverage for mental health conditions and substance use disorder (SUD) treatment. 

Ready to begin your recovery journey? 

This guide will help you understand your MH Medicaid coverage options, including how to verify your eligibility. We’ll also highlight the alcohol and drug rehab programs available at The Plymouth House and offer step-by-step guidance to start your path to lifelong healing. Our compassionate team of experts is here to support you through insurance verification and every step of the healing process.

Does WellSense Health Plan Cover Substance Use Disorder Treatment in New Hampshire? 

Addiction can be overwhelming and impact every aspect of your life. If you or a loved one needs professional treatment, WellSense Health Plan Medicaid can help. They cover comprehensive addiction treatment, making it easier to get the care you need. The Plymouth House, a premier substance use treatment provider, accepts WellSense Health Plan insurance, meaning you can receive outstanding care and support without the added worry of financial stress.

WellSense Health Plan insurance offers various plans, each with different levels of coverage for addiction treatment.

In general, most WellSense Health Plan detox and rehab plans cover the following services:

• Inpatient and residential rehab programs
• Outpatient rehab and therapy
• Detox services
• Medication-assisted treatment (MAT)

Your coverage and out-of-pocket costs depend on your individual WellSense Health Plan coverage. These factors include your plan type, deductible, and coinsurance. If you have WellSense Health Plan insurance, you have coverage for addiction treatment services. To fully understand your benefits, carefully review your policy or contact WellSense directly. You may also access the WellSense New Hampshire Medicaid Handbook here.1

SUD Benefits & Behavioral Services Covered Under New Hampshire Programs

Behavioral services and SUD treatment benefits under NH Medicaid are designed to support individuals in their recovery and improve their overall well-being. These include:

Assessments

New Hampshire Medicaid substance use treatment begins with assessments to diagnose SUDs and determine the individual’s most suitable level of care. These include interviews to collect information on substance use history, health conditions, and social circumstances and to perform urine drug screenings.

Outpatient Services

Outpatient services provide ongoing support while allowing individuals to continue their daily schedules. These typically include individual, group, and family therapy, in addition to MAT and continued monitoring.

Residential Treatment

Residential (inpatient) treatment offers round-the-clock supervision and support in a structured environment for those requiring a high level of intensive care. They include various therapies, such as individual, group, and family therapy, along with MAT and recreational and experiential activities.

Opioid Treatment Programs

Medicaid covers MAT for opioid use disorder, combining medication (methadone, buprenorphine, or naltrexone) with counseling and talk therapies to reduce cravings, alleviate withdrawal symptoms, and prevent relapse.

Recovery Support Services

Recognizing the importance of ongoing support, Medicaid covers support services, such as case management, which assists individuals in navigating the healthcare system, locating resources, and maintaining their recovery plan. It also includes life skills training, helping them to develop skills such as job searching and budget planning.

Recovery Monitoring

New Hampshire Medicaid covers regular drug and alcohol screenings and ongoing assessments to track progress and adjust treatment as needed.

Does WellSense Health Plan Cover Mental Health Disorder Treatment?

When substance use and a psychiatric disorder occur together, it’s called dual diagnosis. Treating both conditions simultaneously is essential to ensure long-term recovery. Like substance use treatment, WellSense Health Plan also covers mental health disorders, offering inpatient treatment, outpatient services, and crisis intervention.

Conditions typically covered include:

• Depression and related disorders
• Anxiety and panic disorders 
• Bipolar disorder
• Attention-deficit hyperactivity disorder (ADD/ADHD)
• Borderline and other personality disorders
• Post-traumatic stress disorder 
• Schizophrenia and related disorders
• Obsessive-compulsive disorder
• Eating disorders and addictive behaviors

Addiction Treatment Levels of Care Covered by WellSense Health Plan

WellSense Health Plan addiction treatment coverage typically includes the following levels of care:

• Residential/inpatient programs that offer round-the-clock supervision in a structured environment
• Partial hospitalization programs (PHPs) that provide intensive day treatment while allowing clients to return home in the evenings and on weekends
• Intensive outpatient programs (IOPs) that provide more intensive care than standard outpatient treatment, consisting of several hours of therapy per week
• Outpatient services, including individual, group, and family therapy, case management, and MAT
• Detox services with medical monitoring to manage withdrawal symptoms safely

The Plymouth House Is In-Network With WellSense Health Plan Medicaid

In-network providers, like The Plymouth House, have a contract with your insurer and have agreed to specific terms, such as offering lower out-of-pocket costs. This means that if you have a Medicaid health plan, such as AmeriHealth Caritas NH, NH Healthy Families/Ambetter, or WellSense Health Plan, choosing an in-network provider will typically save you money compared to out-of-network options for New Hampshire Medicaid addiction treatment.

Verifying Your Medicaid Substance Use Disorder Treatment Benefits

To learn more about your specific plan coverage for SUD treatment services, contact us for a free, no-obligation health insurance benefits check. 

Frequently Asked Questions