The short answer: more than you think
Under the Affordable Care Act and California state law, insurance companies are required to cover mental health and substance use disorder treatment at the same level as physical health benefits. This is called mental health parity — and it applies to most plans sold in California.
Whether you have Medi-Cal, a Covered California plan, or employer-sponsored insurance, there is likely coverage available for:
- Medical detox and withdrawal management
- Residential inpatient treatment (30, 60, or 90-day programs)
- Intensive outpatient programs (IOP)
- Medication-assisted treatment (MAT) including Suboxone and Vivitrol
- Dual-diagnosis treatment for co-occurring mental health conditions
What "in-network" vs. "out-of-network" means for rehab
Your deductible and out-of-pocket costs will depend heavily on whether the facility is in your insurance network. An in-network facility has pre-negotiated rates with your insurer — meaning you pay significantly less. An out-of-network facility may still be partially covered, especially if it's deemed medically necessary, but your cost-sharing will be higher.
At Empathix, we verify your specific benefits before recommending a facility. We match you only with programs your insurance will cover at the strongest benefit level possible.
Medi-Cal and Drug Rehab
California's Medi-Cal program (Medicaid) covers a full continuum of substance use disorder treatment at no cost to eligible members. This includes detox, residential treatment, and outpatient services through the Drug Medi-Cal Organized Delivery System (DMC-ODS), which is available in most California counties.
How to check your coverage in minutes
You don't have to navigate this alone. Empathix will verify your coverage for free — all we need is your insurance provider and member ID. We'll tell you exactly what you're entitled to before you take any next steps.
Recovery is possible. And most of the time, it's already paid for.