When you need an outpatient mental health and addiction program under your Health Net insurance plan, you want to know exactly what’s covered and how to access care. Health Net’s behavioral health benefits include coverage for therapy, medication-assisted treatment, telehealth services, and various levels of outpatient care for substance use disorders and co-occurring conditions. In this guide, you’ll learn how to work with Health Net to find the right program, navigate authorization processes, control out-of-pocket costs, and plan for lasting recovery.
Health Net provides coverage for medically necessary mental health and substance use treatment using nationally recognized guidelines to review clinical records and proposed treatment plans (Health Net). Whether you’re seeking support for alcohol use, opioid dependence, stimulant misuse, benzodiazepine tapering, or polysubstance recovery, this overview will give you the clarity and confidence you need to focus on healing.
HealthNet behavioral health benefits
Health Net’s behavioral health benefits comply with federal and state requirements, including the Mental Health Parity and Addiction Equity Act and the Affordable Care Act’s essential health benefits. Coverage varies by plan type—HMO, PPO, EPO, HSP—but all plans must cover medically necessary mental health and substance use disorder treatment.
Key features of Health Net coverage:
- Outpatient visits with therapists, psychiatrists, psychologists
- Medication-assisted treatment (MAT) for opioid use disorder
- Intensive outpatient and partial hospitalization programs
- Group therapy, family therapy, and dual diagnosis support
- Crisis intervention and peer support services
- Teladoc mental health digital program with self-help tools and e-learning
According to Health Net, preauthorization is not required for most covered outpatient services such as office visits with a therapist or psychiatrist, but certain services do require review before you begin care (Health Net).
Plan comparison at a glance:
| Plan type | Network | Referral requirement | Out-of-network coverage |
|---|---|---|---|
| HMO | In-network only | Primary care referral | Not covered except emergencies |
| PPO | In- and out-network | Not required | Covered at higher cost share |
| EPO | In-network only | Not required | Not covered except emergencies |
| HSP | In-network only | Not required | Not covered except emergencies |
Review your Summary of Benefits and Coverage (SBC) to confirm network rules, cost-sharing, and any referral requirements for specialists.
Explore outpatient program options
Health Net supports a range of tailored outpatient treatment programs. You can choose the level of care that fits your schedule and recovery needs, from weekly therapy to structured day programs. Options include:
- Individual therapy and counseling
- Group therapy sessions for shared experiences
- Family therapy to involve loved ones in support
- Dual diagnosis outpatient program (dual diagnosis outpatient program covered by insurance)
- Outpatient drug detox (outpatient drug detox program covered by insurance)
- Intensive outpatient program (insurance covered intensive outpatient program for addiction)
- Partial hospitalization program (partial hospitalization program substance abuse insurance accepted)
- Outpatient telehealth addiction treatment (outpatient telehealth addiction treatment covered by insurance)
- Relapse prevention planning (outpatient relapse prevention program with insurance accepted)
- Medication-assisted treatment (buprenorphine, naltrexone, methadone)
- Recovery support and sober living guidance (outpatient recovery support program covered by insurance)
If you’re a man, you might consider mens outpatient drug rehab covered by insurance. If you’re a woman, explore womens outpatient alcohol treatment covered by insurance. You’ll find programs that address your unique challenges, offer a supportive environment, and build camaraderie with peers on similar journeys.
Navigate authorization and reviews
Understanding review processes helps you avoid unexpected delays in care. Health Net employs several review types:
| Review type | Timing | Purpose |
|---|---|---|
| Pre-service | Before certain services | Confirm medical necessity |
| Concurrent | During ongoing care | Ensure appropriate level of treatment |
| Post-service | After emergency care | Determine coverage for unplanned visits |
| Appeal | After denial/modification | Request reconsideration of decisions |
Pre-service review (preauthorization) may be required for programs such as partial hospitalization, inpatient detox, or MAT induction. Concurrent reviews occur throughout your program to confirm you’re in the right setting as your needs change. If you receive emergency care or can’t obtain pre-service review, Health Net conducts post-service reviews to decide coverage eligibility.
If Health Net modifies or denies a request, you’ll receive clear explanations and recommendations for alternatives. You have the right to appeal any decision. Contact Health Net Behavioral Health or call member services to start an appeal or discuss treatment options.
Access telehealth addiction care
Health Net’s Teladoc Mental Health digital program offers self-help tools, action plans, and daily tips on stress, sleep, depression, anxiety, chronic pain, substance use, and trauma (HealthNet CanopyCare). Key features:
- 24/7 access to e-learning modules and guided lessons
- Video and phone sessions with licensed therapists or psychiatrists
- Customized action plans for coping strategies
- Confidential support on your schedule
You can also choose live outpatient telehealth addiction treatment for therapy or medication management (telehealth addiction recovery programs covered by insurance). Telehealth expands your options, especially if you live in a rural area, have mobility challenges, or need flexible scheduling.
Manage out-of-pocket costs
Even with coverage, understanding your financial responsibility is crucial. Health Net plans include:
- Deductible: Amount you pay before insurance begins to share costs
- Copay: Fixed amount per visit (eg, $20–$50)
- Coinsurance: Percentage you pay after deductible (eg, 10–20%)
- Out-of-pocket maximum: Cap on your annual cost share
Approximate cost-sharing by plan type:
| Plan type | Deductible | Copay per session | Coinsurance | Out-of-pocket max |
|---|---|---|---|---|
| HMO | $500–$2,000 | $20–$40 | N/A | $3,000–$7,000 |
| PPO | $1,000–$3,000 | $30–$60 | 20% | $3,500–$8,000 |
| EPO | $750–$2,500 | $25–$50 | N/A | $3,000–$7,500 |
| HSP | $1,500–$3,500 | After deductible | 10–20% | $4,000–$9,000 |
Actual costs vary by plan and location. To manage expenses:
- Verify any pre-service estimates with Health Net and your provider
- Ask about sliding-scale fees or payment plans
- Confirm network status before scheduling services
- Track your deductible and out-of-pocket maximum online or via the member portal
Plan for lasting recovery
Your coverage doesn’t end when acute treatment does. Health Net supports ongoing care to help you sustain progress:
- Outpatient relapse prevention (outpatient relapse prevention program with insurance accepted)
- Continued individual or group therapy (outpatient therapy for addiction and depression insurance coverage)
- Peer support and recovery coaching
- Sober living referrals and community resources
- Family education and therapy sessions (outpatient family therapy for addiction covered by insurance)
In a crisis or if you experience suicidal thoughts, you can call 988 for trained counselors or go to the nearest emergency department for immediate help. Planning ahead for aftercare builds a strong foundation for lasting change.
You don’t have to navigate recovery alone. Talk with a Health Net representative and your treatment provider to verify your benefits and start a program that fits your needs. With comprehensive outpatient options, clear authorization processes, and support every step of the way, you can focus on healing and reclaiming your life.
