Partial Hospitalization Program: Insurance Accepted Options

Understand PHP basics

Define PHP model

A partial hospitalization program, often called PHP, occupies a middle ground between inpatient care and traditional outpatient treatment. In this day treatment option, you spend structured hours—typically 4 to 8 per day—at a facility, five to seven days a week, returning home each evening. PHPs rank as level 2.5 on the American Society of Addiction Medicine continuum, offering medical supervision without overnight stays. This format makes PHP ideal for individuals who need intensive support but have a stable, sober living environment at home.

Who qualifies for PHP

PHPs are designed for people with substance use disorders or co-occurring mental health conditions who do not require medically managed detox or 24-hour monitoring. You may be a good candidate if:

• You’ve completed inpatient detox or don’t medically require it
• You have safe, substance-free housing each night
• You need more support than a typical outpatient program provides
• You have a history of relapse risk or complex psychosocial needs
• You benefit from daily structure but prefer living at home

Individuals without a stable home setting may need to start in inpatient care before stepping down to PHP.

Explore program features

PHP treatment structure

Partial hospitalization blends group therapy, individual counseling, and medical oversight. On a typical day, you might:

1. Attend morning check-ins and vital sign monitoring
2. Join multiple group sessions covering relapse prevention, life skills, and co-occurring disorders
3. Receive one-on-one therapy tailored to your needs
4. Participate in holistic activities such as yoga, meditation, or fitness
5. Meet with a physician or nurse to adjust medications or address health concerns

This balanced schedule ensures you practice coping strategies in a supervised setting while gradually reintegrating into everyday life.

Integrated therapy modalities

PHPs rely on evidence-based approaches to treat addiction comprehensively. Common modalities include:

• Cognitive behavioral therapy to reframe negative thought patterns
• Dialectical behavior therapy for emotional regulation and distress tolerance
• Motivational interviewing to strengthen your commitment to change
• Family therapy to rebuild communication and support systems
• Peer support groups that foster camaraderie and shared accountability

Selecting a program that offers a mix of therapies ensures your treatment plan addresses both the addiction and underlying triggers.

Aftercare and support

Continuing care is crucial for lasting recovery. After PHP, programs often transition you to less intensive services, such as an insurance-covered intensive outpatient program for addiction or an outpatient relapse prevention program with insurance accepted. You may also join alumni groups, 12-step fellowships, or local support meetings to maintain momentum.

Review insurance coverage

ACA and parity laws

Under the Affordable Care Act, most health plans must cover mental health and substance use disorder services without annual or lifetime caps. In addition, the Mental Health Parity and Addiction Equity Act ensures that benefits for PHPs can’t be more restrictive than those for medical or surgical care (American Addiction Centers).

Medicaid and Medicare

Many state Medicaid programs, including Ohio Medicaid, cover PHP when deemed medically necessary. Medicare also provides partial hospitalization benefits for beneficiaries diagnosed with a mental health condition or substance use disorder. Coverage details vary, so verify your specific plan requirements and prior authorization processes.

Private insurance plans

Most private insurers—Aetna, Cigna, Anthem, Blue Cross Blue Shield—offer some level of PHP coverage. You may encounter:

• Co-pays or coinsurance for each day of treatment
• Deductible requirements before benefits kick in
• Limits on the number of covered treatment days per year

Contact your insurance carrier to understand in-network providers, preauthorization steps, and out-of-pocket estimates.

Identify coverage options

Insurance-covered PHP options

To find a PHP that accepts your plan:

• Check provider directories on your insurer’s website
• Ask treatment centers if they participate in network contracts
• Confirm that the program’s services—therapy, medical oversight, medications—are covered under your benefits

You can also explore related services such as outpatient mental health and substance use treatment covered by insurance or insurance-covered outpatient counseling for substance abuse if PHP isn’t fully covered.

Financial assistance options

If your plan doesn’t cover full PHP costs, ask about:

• Sliding scale fees based on income
• Payment plans or financing options
• Scholarships or grant funds offered by nonprofit centers

Some facilities also accept government-sponsored programs like Tricare, Medicaid, and Medicare, broadening your financial choices.

Verify your benefits

Before beginning PHP, you’ll want to:

1. Obtain a benefits summary from your insurer that details coverage limits, co-pays, and prior authorization rules
2. Request a written preapproval for the expected treatment duration
3. Confirm any out-of-pocket maximums to anticipate expenses
4. Keep records of all authorizations and communications

This proactive verification helps you focus on recovery rather than billing surprises.

Compare care levels

PHP vs IOP

PHP provides a more immersive experience with medical oversight and extended therapy blocks, whereas IOP suits those ready for greater autonomy. For details on IOP coverage, see our insurance covered intensive outpatient program for addiction.

PHP vs inpatient care

If you need 24-hour supervision or medical detox, inpatient care may be your starting point. Afterward, PHP can help you transition back to daily life.

Choose your treatment

Evaluate your readiness

Assess your personal and clinical needs:

• Is your home environment free of substances?
• Do you need daily medical monitoring or medication management?
• Can you commit to a structured schedule five to seven days per week?
• Are you prepared to engage fully in group and individual therapy?

Your answers guide whether PHP is the right match or if you should consider an insurance accepted outpatient dual diagnosis rehab or a more intensive option.

Plan for intake

Once you decide on PHP:

1. Schedule an assessment with the treatment provider
2. Gather your insurance information and benefits summary
3. Prepare a list of current medications and health history
4. Arrange reliable transportation and home support

A smooth intake ensures you begin care without administrative delays.

Contact your provider

Reaching out to a care team is your first step toward recovery. Discuss your coverage, treatment goals, and any concerns you have. If you need additional services—like family therapy—ask about programs such as outpatient family therapy for addiction covered by insurance.

Moving forward with confidence

Choosing a partial hospitalization program that aligns with your insurance coverage enables you to focus on healing rather than finances. With structured treatment, comprehensive therapies, and the reassurance of medical oversight, PHP offers a bridge from intensive inpatient care to independent sobriety.

For more information on related outpatient options, explore our guides to outpatient relapse prevention program with insurance accepted and outpatient drug and alcohol treatment services covered by insurance. Your path to lasting recovery starts with understanding your choices and taking that first step toward a supportive, personalized plan.