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Does HealthSmart Cover Rehab?
HealthSmart plans can cover addiction treatment when the care is medically necessary and approved through your plan's prior authorization process. Bliss Recovery is in-network with HealthSmart, and our admissions team can verify your HealthSmart benefits at no cost before you commit to anything.
Verify your HealthSmart benefitsWhat HealthSmart Covers for Addiction Treatment
Many HealthSmart plans include behavioral health benefits that apply to substance use disorder treatment. When care is medically necessary, those benefits can reach across the full continuum, from withdrawal management through outpatient programming.
Higher levels of care usually need prior authorization before admission. Approvals tend to come in set increments, with check-ins as treatment moves forward.
- Medically supervised detox usually needs prior authorization for planned admissions, while urgent admissions may follow a notification process instead
- Residential treatment typically needs prior authorization before admission, with continued-stay reviews along the way
- Partial hospitalization (PHP) often needs prior authorization before care begins, whether it's your first step or a step-down
- Intensive outpatient (IOP) may need prior authorization, depending on how your plan is set up
Care for Co-Occurring Conditions
Behavioral health benefits generally extend to mental health treatment, so dual-diagnosis care can fall under the same benefit when both conditions are documented. We treat addiction alongside depression, anxiety, PTSD, and other conditions in one integrated plan.
How HealthSmart Plans Work and What You Might Pay
HealthSmart is a third-party administrator and PPO network that works with self-funded employer health plans. Your employer funds the plan, and HealthSmart handles administration, claims, or network access, depending on how your plan is set up.
Coverage details live in your employer's plan document rather than one standard HealthSmart policy. Deductibles, coinsurance, visit limits, and authorization rules can look different from one employer to the next.
In-network care generally keeps out-of-pocket costs lower. You may still owe a deductible, copays, or coinsurance depending on your plan. We'll walk you through all of it once your verification comes back.
What Happens Next
Share your plan details
We handle verification and authorization
Review your summary
Ready to Start Your Recovery?
Call our admissions team and we can verify your insurance in the same conversation.
BEGIN ADMISSIONS
What to Have Ready
You bring:
- Your insurance card, front and back
- The subscriber's full name and date of birth
- Your employer or group name, as it appears on your card
- The level of care you're considering, if you know it
- Your preferred admission dates
- A brief treatment history, including current medications and past programs
We handle the clinical assessment, treatment plan, provider details, and the authorization request itself. For packing and arrival, our guide on what to bring to treatment covers the rest.
If an Authorization Is Denied or Delayed
You can appeal a denial. Your denial letter explains how and by when, and most employer plans give you at least 180 days to file.
We'll gather records and clinical notes to support the appeal, and we can request a peer-to-peer review between our medical team and the plan's reviewer. If a delay affects your safety or medical stability, we can ask for an expedited review.
Our Hollywood Hills Residences
Care for HealthSmart members happens at one of our two private Hollywood Hills residences, each capped at twelve clients. You can explore our residences to see where you'd stay.
- Lakeview Creston is our primary residence on Creston Drive
- Spanish Villa Durand is our second residence, a short distance away on Durand Drive
Why HealthSmart Members Choose Bliss Recovery
Our care is small, private, and shaped around you. Every plan starts with a personalized assessment and moves between levels of care based on clinical need, not a set calendar.
- Discreet residential care means small residences, no clinical signage, and confidential admissions from the first call
- One clinical team runs detox, residential, PHP, and IOP, so stepping down never means starting over
- Trauma-informed dual-diagnosis care pairs EMDR and Brainspotting with individual psychotherapy
- Hands-on insurance support means our admissions team works directly with your plan while you focus on getting ready
- Our medical and psychiatric team works alongside your therapists, so care for both conditions stays coordinated
Bliss Recovery is licensed by the California Department of Health Care Services (DHCS), accredited by The Joint Commission, LegitScript certified, and a member of the National Association of Addiction Treatment Providers (NAATP).
Ready to Check Your HealthSmart Benefits?
We'll verify your coverage confidentially and explain your options. Call admissions at 877-509-0639, reach our main line at (323) 798-4411, or contact our team.
Frequently Asked Questions
Does Bliss Recovery accept HealthSmart?
Yes. Bliss Recovery is in-network with HealthSmart. Your individual benefits still need verification, which we handle at no cost.
Will I pay anything out of pocket with HealthSmart?
Possibly. Depending on your employer's plan, you may owe a deductible, copays, or coinsurance. In-network care usually costs less, and we'll confirm your specifics during verification.
Does HealthSmart require prior authorization for rehab?
Usually, for higher levels of care. Detox, residential, and PHP typically need approval before admission, and some plans require it for IOP too. We submit the request for you.
How long does prior authorization take?
It depends on your plan and how quickly clinical documentation comes together. We submit everything your plan needs and follow up for you. If your situation is urgent, we can request an expedited review.
Can I appeal a HealthSmart denial?
Yes. Your denial letter explains the appeal steps and deadline. We'll help gather the medical records and clinical notes that support your case, and we can request a peer-to-peer review.
Does HealthSmart cover dual-diagnosis treatment?
Often, yes. Behavioral health benefits typically include mental health care as well as substance use treatment, so integrated care can be authorized when both conditions are documented. Our guide on why treating only the addiction doesn't work explains the approach.
Is my information kept private?
Yes. Verification and admissions conversations are confidential, and we handle your information under HIPAA. You'll find more answers in our admissions FAQ.