Health plans associated with Healthcare Solutions Group (HSG) may cover drug and alcohol rehab, detox, mental health services, and outpatient treatment — but coverage depends on your employer plan, network access, and medical-necessity review.
If your insurance materials reference Healthcare Solutions Group (HSG), you may be wondering what your plan covers for addiction treatment. This guide explains how HSG rehab coverage typically works, what services may be included, what affects your out-of-pocket cost, and how to verify your benefits quickly for treatment at Orlando Recovery Center.
Important: HSG is not a traditional insurance company. It is a health benefits administrator that works with employers, third-party administrators, and insurance networks to coordinate benefits, claims, and negotiated rates. Your exact coverage depends on the underlying employer-sponsored health plan.
Quick takeaways (read this first)
- HSG administers employer health benefits but does not set the plan’s coverage rules.
- Coverage varies significantly by employer and the network your plan uses.
- Prior authorization is common for detox, residential treatment, PHP, and IOP.
- Medical necessity determines approval for addiction treatment levels of care.
- You can verify benefits without committing: It’s free and informational only.
HSG (Healthcare Solutions Group) overview
Healthcare Solutions Group is a benefits administration platform that supports self-funded employers, brokers, and third-party administrators (TPAs). Many companies partner with HSG to manage claims processing, provider network access, and specialty benefits such as behavioral health and substance use disorder (SUD) treatment.
New Year. Real Recovery.
The pressures of the season are real. Find lasting peace and expert support.
HSG typically works behind the scenes by:
- Integrating with PPO or EPO provider networks
- Supporting behavioral health benefit managers
- Processing claims and verifying eligibility
- Negotiating contracted provider rates
- Coordinating prior authorizations with partner organizations
Because HSG supports many employer plans and networks, your specific benefits depend on your employer’s coverage design.
Does HSG cover drug and alcohol rehab?
Plans associated with HSG often include coverage for substance use disorder (SUD) treatment and mental health care, but the specifics vary by employer and network. Most plans that use HSG cover medically necessary treatment, including:
- Detoxification services
- Inpatient or residential rehab
- Partial Hospitalization Program (PHP)
- Intensive Outpatient Program (IOP)
- Outpatient counseling and therapy
- Medication-assisted treatment (MAT)
- Psychiatric services
Your precise benefits depend on what your employer plan covers under behavioral health benefits, medical benefits, and pharmacy benefits.
Levels of care HSG-supported plans may cover
Depending on medical necessity, plans associated with HSG may cover several levels of addiction treatment:
Medical Detox
Detox services are often covered when withdrawal symptoms create medical risks, such as with alcohol, benzodiazepines, or opioids. Prior authorization is typically required.
Inpatient / Residential Treatment
Residential rehab offers 24/7 supervision and structured therapy. Plans may approve residential care when outpatient treatment would not be safe or effective.
Partial Hospitalization Program (PHP)
PHP provides intensive daily programming without overnight stays and may be authorized as either step-down care or an initial treatment level.
Intensive Outpatient Program (IOP)
IOP involves multiple therapy sessions per week and is often approved for individuals transitioning from higher levels of care or who need more structured support.
Standard Outpatient Services
Outpatient care includes individual therapy, group counseling, family therapy, and medication management.
How HSG determines coverage: medical necessity & authorization
HSG collaborates with insurance networks, TPAs, and behavioral health managers to determine whether requested services meet medical necessity. Many plans use The ASAM Criteria to guide decisions.
During clinical review, you or your provider may be asked about:
- Types and patterns of substance use
- Withdrawal symptoms or medical instability
- Co-occurring mental health symptoms
- Past treatment history or relapse episodes
- Home environment and available supports
- Safety concerns such as overdose or self-harm risk
If a requested level of care is not authorized, options may include step-down treatment, additional documentation, clinical appeals, or peer-to-peer review.
What affects your out-of-pocket cost with HSG?
Your out-of-pocket cost is determined by your employer’s plan design. HSG helps administer claims but does not set cost-sharing rules. Cost factors include:
- Deductible: Amount you pay before coverage applies
- Copays: Fixed service fees, if applicable
- Coinsurance: Percentage you pay after meeting your deductible
- Network tier: Whether Orlando Recovery Center is in-network under your plan
- Out-of-pocket maximum: Annual spending limit
Tip: Many employer plans offer significantly lower costs when you choose an in-network or network-affiliated provider.
Dual-diagnosis treatment and HSG
Many HSG-supported plans include coverage for co-occurring mental health and substance use disorders, an essential component of effective long-term recovery.
- Psychiatric evaluations
- Medication-assisted treatment (MAT)
- Therapy for depression, anxiety, trauma, bipolar disorder, and more
- Integrated dual-diagnosis therapy
Dual-diagnosis coverage varies by plan but is often approved when symptoms are intertwined with substance use.
Medication-assisted treatment (MAT) coverage
Employer plans administered by HSG often include coverage for MAT medications used to treat opioid or alcohol use disorders. Depending on your pharmacy benefits, coverage may include:
- Buprenorphine/naloxone combinations
- Naltrexone (oral or injectable forms)
- Methadone through certified opioid treatment programs
- Acamprosate, disulfiram, or other alcohol use disorder medications
Certain MAT medications may require prior authorization or ongoing clinical review.
How to check your HSG rehab benefits
Because HSG works with a wide range of employer plans and networks, verifying your benefits directly is the best way to understand coverage.
Option 1: Verify benefits with our admissions team (recommended)
Our admissions specialists can confirm eligibility, authorization requirements, and estimated out-of-pocket costs by reviewing your plan. Verify your insurance online.
Option 2: Contact your employer plan administrator
Ask whether your plan uses HSG and whether Orlando Recovery Center is in-network or eligible for contracted rates.
Rehab accepting HSG Healthcare Solutions Group in Florida
If your employer-sponsored plan uses HSG, Orlando Recovery Center can help you understand your benefits and available treatment options before beginning care.
Disclaimer: This page is for informational purposes only and does not guarantee coverage or payment. Benefits vary by employer and are subject to authorization and medical-necessity review.
