Private Insurance Treatment in Virginia
250 facilities accept this payment option
Using private health insurance for addiction treatment, including how to verify benefits and understand your coverage.
How to Check Coverage
- Call the member services number on your insurance card to verify behavioral health benefits
- Ask specifically about substance use disorder treatment coverage
- Inquire about in-network vs out-of-network benefits and costs
- Understand prior authorization requirements for different levels of care
- Ask about any annual or lifetime limits on behavioral health services
- Verify deductible, copay, and coinsurance amounts for treatment services
- Ask if there are specific facilities or programs your plan covers
Information to Collect
- Your insurance card with member ID and group number
- Phone number for member services (usually on the back of your card)
- Understanding of your plan type (HMO, PPO, etc.)
- Information about your deductible and out-of-pocket maximum
- Any referral requirements if you have an HMO
Counties with Private Insurance Facilities
Fairfax
18 facilities
Richmond
5 facilities
Virginia Beach
8 facilities
Roanoke
9 facilities
Henrico
9 facilities
Chesterfield
4 facilities
Prince William
3 facilities
Norfolk
7 facilities
Arlington
11 facilities
Chesapeake
5 facilities
Hampton
3 facilities
Lynchburg
9 facilities
Montgomery
3 facilities
Loudoun
4 facilities
Washington
4 facilities
Frequently Asked Questions
Does my insurance have to cover addiction treatment?
Under the Mental Health Parity and Addiction Equity Act and the Affordable Care Act, most health plans must cover substance use disorder treatment and cannot impose stricter limits than for medical/surgical benefits.
What's the difference between in-network and out-of-network?
In-network providers have contracts with your insurance and typically cost less in deductibles, copays, and coinsurance. Out-of-network care may still be covered but at higher cost to you.
Do I need prior authorization?
Many plans require prior authorization, especially for residential treatment or intensive programs. Your treatment provider typically handles this process. Outpatient services may not require authorization.
What if my insurance denies coverage?
You have the right to appeal denials. Treatment providers often assist with appeals. You can also file complaints with your state insurance commissioner if you believe parity laws are being violated.
How do I find in-network treatment?
Check your insurance company's provider directory, call member services for referrals, or ask treatment facilities directly if they are in-network with your plan.
Is MAT covered by private insurance?
Most private insurance plans cover medication-assisted treatment. Coverage includes office visits and medications, though specific medications and their tier placement on formularies may vary by plan.