Addiction Treatment

Mental Health Treatment

Delaware First Health Rehab Coverage at Banyan Treatment Centers

If you or someone you care about has a substance use disorder or a mental health problem, your Delaware First Health rehab coverage may help make treatment possible.

Delaware First Health is a Medicaid managed care organization (MCO) that runs the Diamond State Health Plan (DSHP) and DSHP Plus long-term services and supports.

It is a Medicaid plan that pays for behavioral health services, such as inpatient and outpatient treatment for substance use disorders, for Delaware residents who qualify.

Banyan Treatment Centers in Milford, Delaware, accepts Delaware First Health and is ready to help you understand your benefits.

To get started, call for a free insurance check.

What First Health members should know

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How Delaware First Health Pays for Behavioral Health and Rehab Services

As part of its Medicaid managed care benefits, Delaware First Health covers a number of behavioral health services. This includes inpatient hospitalization, outpatient counseling, substance use treatment, and Delaware substance use disorder services.

Members of DSHP or DSHP Plus can get medically necessary treatment for substance use disorders and mental health issues, but some services may need to be authorized first.

The Mental Health Parity and Addiction Equity Act says that Medicaid managed care plans must offer behavioral health benefits that are the same as medical and surgical benefits in terms of cost sharing and access.

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What Treatment Services May Be Covered by Delaware First Health?

The Diamond State Health Plan was made to make it easier for people in Delaware to get medical care. Its behavioral health part includes services like:

Medical Detox

Supervised withdrawal management to help stabilize patients safely as drugs or alcohol leave the system.

Residential / Inpatient Treatment

24/7 structured care for addiction and co-occurring mental health conditions at Banyan Delaware.

Telehealth

Virtual programming for ongoing therapy, check-ins, and recovery support.

Outpatient Programs

SUD outpatient services including therapy, counseling, and structured outpatient programming.

Note: Members of DSHP Plus, who usually qualify because they need more long-term care, may be able to get even more supportive services that help with addiction recovery.

Does Delaware First Health Cover Mental Health Treatment?

Yes. Delaware First Health can't make addiction and mental health treatment visits, copays, or authorization requirements stricter than it does for physical health services — that's what parity law requires.

Our clinical team at Banyan Delaware provides personalized care that treats both substance abuse and mental health problems that happen at the same time.

Inpatient Mental Health Coverage

Banyan Delaware offers inpatient care for co-occurring mental health and substance use conditions. Contact our admissions team to confirm your Delaware First Health coverage includes this level of care.

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How Much Does Rehab Cost With Delaware First Health?

Since Delaware First Health is a Medicaid managed care plan, you usually pay little to nothing out of pocket. Medicaid covers most essential health services at minimal or no cost to the member.

Factors That Affect Your Out-of-Pocket Cost

Your DSHP or DSHP Plus enrollment category
Level of care required (detox, inpatient, outpatient)
Whether prior authorization is needed
What your treatment team recommends for you

What You Can Do Right Now

In case of uncertainty regarding your eligibility and coverage, request a free insurance verification over the phone. Admissions counselors are experienced working with Medicaid managed care plans and will give you an accurate and straightforward answer regarding your benefits.

Questions? Get help now

If You Call Delaware First 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

What to Expect When Using Delaware First Health for Rehab

After reaching out to Banyan's admissions department, we'll walk you through the process of verifying your insurance. We'll work with you to determine the right level of care, and our clinical team will handle any pre-authorization paperwork.

How to Find Treatment That Accepts Delaware First Health

Our location in Milford makes us well-placed to cater to the needs of the people in Kent and Sussex Counties and even beyond to the larger Delmarva Peninsula region.

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 Delaware First Health coverage or speak with an admissions specialist today.

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Frequently Asked Questions

1Does Delaware First Health cover addiction treatment?

Yes, Delaware First Health covers substance use disorder treatment through its Medicaid managed care plan, Diamond State Health Plan. You can get inpatient and outpatient services, detox, and telehealth. Sometimes you'll need prior approval, and what's covered follows Delaware Medicaid's rules for medical necessity.

2How long does Delaware First Health cover rehab?

Delaware First Health follows the state's Medicaid rules under the Diamond State Health Plan. That means how long you can stay in rehab depends on medical necessity. Your care gets reviewed throughout your stay, and your treatment team sends in paperwork to keep your coverage going. Basically, the state's guidelines decide the timeline.

3Do I need a referral to use Delaware First Health for rehab?

With Medicaid managed care, you usually need approval from your primary care doctor or to go through some kind of managed care process. If you call Banyan's admissions team, we'll check your enrollment and let you know right away if you need a referral or any authorization, and we'll walk you through it.

4Does Delaware First Health cover telehealth for addiction treatment?

If you have Delaware First Health, you're in luck — telehealth for addiction treatment is covered. You can use telehealth for ongoing therapy, check-ins, and staying connected to support once you've stepped down from more intensive care.

5What is the Diamond State Health Plan?

The Diamond State Health Plan (DSHP) is Delaware's Medicaid managed care program, administered by organizations like Delaware First Health. DSHP covers essential health services including behavioral health treatment for substance use disorders and mental health conditions. DSHP Plus provides additional long-term care services for members who qualify. Your specific DSHP enrollment category determines which services are covered and at what level.

Coverage varies by Delaware First Health plan and state. Insurance verification is required to confirm eligibility and benefits.