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Quest Behavioral Health: Drug & Alcohol Rehab Coverage

Are your company's behavioral health benefits being handled through Quest Behavioral Health? If so, you are likely wondering what it means for your rehab coverage.

First of all, Quest Behavioral Health is not an insurance provider, nor does it carry or maintain health plans of its own. Instead, it is a managed behavioral health organization that administers the behavioral health portion of your employer's self-funded health plan.

This is significant to know because it means that any services you need must first be approved by Quest and not your health insurance company. The Banyan admissions team can walk you through this process.

Call us for free verification of your health plan benefits so we can help you understand your coverage for drug and alcohol treatment services.

What Quest Behavioral Health members should know

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What Is a Behavioral Health Carve-Out?

"Carving out" behavioral health is a phrase used when a company chooses to have its behavioral health benefits, which includes mental health and substance use disorder treatment, managed by a separate third-party company instead of through the primary health insurer.

Quest Behavioral Health, founded in 1997, manages the behavioral health benefits for more than 125,000 members through a network consisting of more than 8,000 behavioral health treatment providers.

Their services include employee assistance programs (EAP), case and care management, provider networking, claims processing, and more for behavioral health.

What this boils down to is that your behavioral health benefits, or your drug and alcohol rehab coverage, are handled by Quest's clinical review team — not your primary health insurer.

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Does Quest Behavioral Health Cover Drug & Alcohol Rehab?

Yes, because Quest Behavioral Health is a behavioral health carve out and is responsible for managing mental health and substance abuse benefits for self-funded employer plans, it must comply with the Mental Health Parity and Addiction Equity Act.

This federal statute says that a plan's mental health and substance abuse benefits must be covered at a level comparable to its medical and surgical benefits.

Treatment services generally covered in a Quest managed plan include:

Medical Detox

The safe, medically monitored withdrawal from substances.

Partial Hospitalization (PHP)

Intensive day treatment.

Outpatient Treatment & MAT

Individual and group counseling and other therapies, including medication-assisted treatment using FDA-approved medications.

Dual Diagnosis & Medication Management

Care for the combination of an addiction and a mental health disorder, plus regular administration and monitoring of psychiatric medication.

Telehealth Intensive Outpatient Programs (IOP)

Some Quest-managed plans may include coverage for virtual IOP and tele-mental health visits. Banyan Treatment Center can help verify your Quest coverage and determine eligibility for telehealth services.

Note: Your copays will usually range from $0 to $75 per session for in-network plans administered by Quest, though you should confirm your specific copay with our admissions team.

Does Quest Behavioral Health Cover Mental Health Treatment?

Yes. Since Quest is a behavioral health carve-out, mental health treatment is a core part of what it administers. Quest's clinical review team evaluates mental health treatment needs alongside substance use disorder treatment.

Because Quest employs clinical reviewers who specialize in behavioral health, the review process is often more nuanced than that of a general insurer.

Inpatient Mental Health Coverage

Quest-managed plans may cover inpatient mental health treatment for co-occurring disorders. Contact Banyan's admissions team to confirm your employer's arrangement with Quest covers this level of care.

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How Much Does Rehab Cost With Quest Behavioral Health?

How much your plan covers for rehab depends on the plan's arrangement with Quest Behavioral Health. Your copays will usually range from $0 to $75 per session for in-network plans.

Factors That Affect Your Out-of-Pocket Cost

Your employer's specific arrangement with Quest
In-network vs. out-of-network provider status
Copay amount ($0-$75 typical range for in-network)
Level of care required (detox, inpatient, outpatient)
Whether prior authorization is needed

What You Can Do Right Now

Call for a free insurance verification. Our admissions team understands the intricacies of behavioral health carve-outs and can break down your Quest coverage and expected costs.

Questions? Get help now

If You Call Quest Behavioral 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 Do I Use My Quest Behavioral Health Benefits at Banyan?

Call or fill out an online form for verification.

Provide your Quest behavioral health member information and employer plan information, we will take it from there.

Our team will verify your behavioral health carve-out benefits, including in-network status, copays, deductibles, and prior authorization requirements.

During intake, our clinical team will assess you and coordinate care that is appropriate for your needs.

Because Quest manages behavioral health as a carve-out rather than under your primary insurance, it is necessary to confirm your benefits through Quest's system directly.

How to Find Treatment That Accepts Quest Behavioral Health

For Pennsylvania residents, Clearbrook PA and Banyan Philadelphia offer the closest nearby facilities, although our locations across the country plus our virtual programs give Quest members options in multiple states.

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 Quest Behavioral Health coverage or speak with an admissions specialist today.

Questions? Get help now

Frequently Asked Questions

1Does Quest Behavioral Health cover drug and alcohol rehab?

Yes. Quest covers drug and alcohol rehab as part of a behavioral health carve-out. Quest plans are governed by the Mental Health Parity and Addiction Equity Act (MHPAEA) which requires substance use disorder treatment to be on par with medical and surgical benefits. Generally covered services include detox, inpatient, PHP, IOP, outpatient, MAT, dual diagnosis, and medication management.

2How long will Quest Behavioral Health pay for rehab?

As a behavioral health carve-out for self-funded employer plans, authorization policies are determined by each employer's arrangement with Quest. The Quest clinical team reviews treatment in a stepwise manner based on medical necessity. Your clinical team at Banyan will be the main point of contact for continuing treatment approvals.

3Does Quest Behavioral Health require prior authorization?

This is plan-dependent; however, Quest generally reviews for higher levels of care such as inpatient, PHP, and IOP. Authorization is typically required before beginning treatment at these levels of care.

4Can I use Quest Behavioral Health for telehealth addiction treatment?

Some plans managed by Quest cover virtual programming through Banyan’s online telehealth platform. Quest provides carve-out behavior health for self-funded employer plans, which means that telehealth is only covered if your employer has a telehealth plan in place with Quest. Our admissions team will know your eligibility to access the virtual IOP and all other telehealth options.

5How do Quest Behavioral Health copays work for rehab?

For in-network plans covered by Quest, you should expect copays to fall between $0 and $75 depending on your employer’s deal with Quest. Because Quest separately administers the behavioral health part of your benefits, you will have your specific behavior health copay in addition to your medical copay. Your admissions team will have knowledge of the exact copay that you need to pay.

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