Addiction Treatment

Mental Health Treatment

Contigo Health Rehab Coverage for Drug & Alcohol Addiction

If your insurance card displays either Contigo Health or Three Rivers Provider Network, you may be unsure about what that actually means in terms of rehab coverage.

Most often, Contigo Health isn't the company that truly decides your benefits; rather, Contigo collaborates with both employer-sponsored health plans and provider networks in order to better help plan members access care and manage claims.

Therefore, your Contigo rehab coverage is dependent on the specific health plan with which your Contigo card is linked, not merely its Contigo branding.

What Contigo Health / Three Rivers members should know

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Does Contigo Health Cover Drug and Alcohol Rehab?

Contigo Health does not typically make the determination as to whether rehab is covered. Your plan is most likely determined by the employer-sponsored plan you have that utilizes Contigo's network or management services.

Most employer-sponsored plans provide some level of coverage for substance use disorder treatment and mental health services. Plans that do provide coverage are generally required by federal parity laws to provide treatment that isn't less accessible than similar medical or surgical treatment: Mental Health and Substance Use Parity Requirements.

The quickest way to determine what your plan actually covers is to verify your benefits with Banyan's admissions team, since we're able to see the employer plan behind your Contigo or Three Rivers card, tell you what levels of care will likely be covered, whether prior authorization is needed, and what your out-of-pocket costs are going to be.

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What Can Contigo / Three Rivers Cover at Banyan?

Since it really depends on the details of your plan design, the level of care you qualify for at Banyan varies considerably across members. If you meet the criteria for medical necessity, and if your plan offers behavioral health benefits, Banyan might be able to cover the following:

Medical Detox

Medical detox provides supervised withdrawal management and is often the first step in treatment for individuals recovering from drugs or alcohol.

Inpatient / Residential Rehab

Residential or inpatient treatment provides round-the-clock care in a structured setting for substance use disorders and co-occurring conditions.

Outpatient Services

Outpatient services include intensive outpatient program (IOP) and standard outpatient programming, available at certain Banyan sites.

Mental Health Treatment

Inpatient mental health treatment is available for eligible members with dual diagnoses.

Telehealth

Telehealth services are available in certain states for eligible members.

Note: It all comes down to your company's policy as well as other factors like medical necessity, the particular treatment facility, and any prior authorization that may be needed.

Does Contigo Health Cover Mental Health Treatment and Therapy?

Yes, mental health treatment may be covered depending on whether the employer-sponsored plan associated with your Contigo access has behavioral health coverage.

Parity laws mandate generally that plans that offer mental health and substance use disorder services do so in a way that is comparable to the financial restrictions and treatment limits for medical and surgical treatment services.

Inpatient Mental Health Coverage

If your employer-sponsored plan includes inpatient mental health benefits, coverage through Contigo may extend to residential care for co-occurring disorders. Contact Banyan's admissions team to confirm whether your specific plan covers this level of care and to verify your benefits before starting treatment.

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How Much Does Rehab Cost With Contigo Health?

The out-of-pocket costs of rehab with Contigo vary based on your underlying employer-sponsored plan.

Factors That Affect Your Out-of-Pocket Cost

In-network vs. out-of-network facility status
Your plan's deductible amount
Copayments and coinsurance rates
Your plan's out-of-pocket maximum
Level of care required (detox, inpatient, outpatient)
Whether prior authorization is needed

HealthCare.gov notes that deductibles, copayments and coinsurance can significantly increase your overall annual treatment costs.

What You Can Do Right Now

Banyan Treatment Centers can help verify your Contigo insurance benefits and provide cost estimates based on your specific employer-sponsored plan. Call for a free, confidential verification — our admissions team will break down your coverage and expected costs before you begin treatment.

Questions? Get help now

If You Call Contigo Health Directly, Ask:

Is medical detox covered?
Are inpatient or residential programs covered under my plan?
Are PHP or intensive outpatient programs covered?
Do I need prior authorization?
Is this facility in-network?
What are my deductibles, copays, and coinsurance?
Are there limits on the number of treatment days or sessions?

Or, We Can Verify for You (Recommended)

We contact your insurance provider directly
We review coverage details and medical necessity requirements
We explain the benefits clearly and confidentially

How Contigo / Three Rivers Coverage Works With Banyan

Banyan Treatment Centers is an in-network provider with Contigo / Three Rivers for many locations, along with telehealth in some states.

We urge you to reach us for a free insurance verification to determine what your plan covers specifically when it comes to addiction or mental health care, noting that coverage, costs, prior authorization, and approved levels of care are contingent upon the employer-sponsored plan attached to the back of your Contigo card.

Because Contigo may serve as the network or administrative entity, and not necessarily the ultimate entity determining benefits, we may need to confirm your card's coverage one step further than a more traditional payer. This allows us to ensure the actual employer-sponsored plan behind the card is known and that the coverage is verified.

How to Find Treatment That Accepts Contigo Health

Rehabs that accept Contigo typically have to either participate in the specific provider network or fall under coverage with the underlying employer-sponsored plan.

HealthCare.gov notes that some plan types encourage or even require you to seek services from the plan's own network of providers, with coverage varying for out-of-network treatment, usually at a greater cost.

Getting Matched to the Right Level of Care

A clinical assessment helps determine the most appropriate treatment program based on substance use severity, mental health needs, and insurance coverage.

Next Steps: Verify your Contigo Health coverage or speak with an admissions specialist today.

Questions? Get help now

Frequently Asked Questions

1Is Contigo Health insurance?

No, in the same way a traditional insurer is not. Contigo refers to itself as a health benefits platform, and Premier says it works with self-funded employer health plans and health systems. That means, in practical terms, your rehab coverage is determined more by the underlying employer-sponsored plan that is associated with your card, rather than the Contigo platform alone.

2Does Contigo Health Require Prior Authorization for Rehab?

Maybe. Prior authorization means you'll have to obtain authorization to receive covered treatment before services are rendered, and HealthCare.gov notes some plans require it for certain covered services. Parity guidance also notes that any prior authorization rules pertaining to mental health and substance use disorder services generally have to be similar to those that apply to medical and surgical treatment services.

3What is Three Rivers Provider Network?

Three Rivers Provider Network (TRPN) was a provider network company acquired by Contigo Health, a subsidiary of Premier, Inc. If your insurance card shows Three Rivers, it means your employer plan accesses providers through this network. Like Contigo, Three Rivers is not an insurance carrier — it's a network intermediary. Your actual coverage depends on the employer-sponsored plan behind the card.

4How long will Contigo / Three Rivers pay for rehab?

Because Contigo is a network intermediary and not the entity that determines your benefits, the length of coverage depends entirely on the employer-sponsored plan linked to your card. Your plan will have its own authorization process, medical necessity criteria, and review timelines. Banyan's admissions team can identify your underlying plan and explain how the authorization process works.

5Can I use Contigo Health for telehealth addiction treatment?

Banyan offers telehealth services in certain states for eligible members. Whether your Contigo-linked plan covers virtual treatment depends on your underlying employer-sponsored plan's behavioral health benefits. Call for a free insurance verification to confirm telehealth eligibility.

Coverage varies by Contigo plan and state. Insurance verification is required to confirm eligibility and benefits.