Plans that use the MultiPlan network may cover drug and alcohol rehab, detox, outpatient programs, and mental health treatment — but coverage varies by insurer, employer plan, and medical-necessity review.

If your insurance card mentions MultiPlan or PHCS (Private Healthcare Systems), you might wonder what that means for addiction treatment coverage. This guide explains how MultiPlan rehab coverage typically works, which services may be included, what affects out-of-pocket costs, and how to confirm your benefits for treatment at Orlando Recovery Center.

Important: MultiPlan is not an insurance company. It is a large provider network and cost-management platform used by insurers, TPAs, and employer-sponsored plans. Your actual benefits — including deductibles, copays, and authorization rules — come from your underlying health insurance plan.

Quick takeaways (read this first)

  • MultiPlan is a provider network, not a health insurer.
  • Your underlying insurance plan sets the rules for behavioral health and addiction treatment coverage.
  • MultiPlan may expand in-network access to certain facilities, depending on your plan.
  • Medical necessity determines approval for detox, residential, PHP, and IOP.
  • Prior authorization is common for higher levels of care.
  • Benefit verification is essential because MultiPlan participation alone does not determine coverage.

MultiPlan overview

MultiPlan is the largest independent PPO network in the U.S. and includes sub-networks such as:

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  • PHCS (Private Healthcare Systems)
  • MultiPlan PPO
  • MultiPlan Behavioral Health (plan-dependent)

MultiPlan partners with insurance carriers, third-party administrators (TPAs), and employer-sponsored plans to:

  • Negotiate discounted provider rates
  • Expand access to in-network options
  • Support cost-containment and claim review
  • Offer extended network options for out-of-area treatment

However, MultiPlan does not decide whether addiction treatment is covered. That determination comes from the insurer administering your health benefits.

Does MultiPlan cover drug and alcohol rehab?

Plans that use MultiPlan’s network often include behavioral health and substance use disorder (SUD) benefits when treatment is medically necessary. Your exact coverage depends on the insurer or employer plan associated with MultiPlan.

Commonly covered services may include:

  • Medical detox
  • Inpatient or residential treatment
  • Partial Hospitalization Program (PHP)
  • Intensive Outpatient Program (IOP)
  • Standard outpatient therapy
  • Medication-assisted treatment (MAT)
  • Psychiatric services

Because MultiPlan is not an insurer, the level of coverage and your cost-sharing responsibilities vary widely between employers and insurance carriers.

Levels of care MultiPlan-associated plans may cover

Your plan may cover various levels of addiction care depending on medical necessity, safety concerns, and prior treatment history.

Medical Detox

Detox may be covered when medically necessary for withdrawal from alcohol, benzodiazepines, opioids, or other substances. Insurers often require prior authorization before detox begins.

Residential / Inpatient Rehab

Residential treatment provides 24-hour care and structured therapy. Plans using MultiPlan often approve residential care when lower-intensity settings are insufficient or unsafe.

Partial Hospitalization Program (PHP)

PHP offers full-day programming and may be authorized as step-down or initial treatment depending on the patient’s needs.

Intensive Outpatient Program (IOP)

IOP generally includes multiple therapy sessions each week and is commonly covered when patients do not require 24-hour supervision.

Outpatient Counseling

Outpatient therapy, family counseling, and relapse-prevention support are often covered depending on the plan.

How MultiPlan-associated plans determine coverage: medical necessity & authorization

The insurer associated with your MultiPlan network evaluates whether treatment is medically necessary. Many insurers rely on The ASAM Criteria to determine the proper level of care.

During benefit verification or clinical review, you may be asked about:

  • Types and amounts of substances used
  • Withdrawal symptoms and medical risks
  • Past treatment history and relapse patterns
  • Co-occurring mental health symptoms
  • Safety issues such as overdose or self-harm risk
  • Support at home and living environment
  • Ability to function at lower levels of care

If a level of care is not authorized, options may include step-down recommendations, peer-to-peer review, or submitting additional documentation.

What affects your out-of-pocket cost with MultiPlan?

Your costs are determined by your underlying health plan, not MultiPlan directly. Key cost factors include:

  • Deductible: Your required upfront spending before insurance kicks in
  • Copays: Fixed fees for certain services
  • Coinsurance: Your share of covered treatment costs
  • Out-of-pocket maximum: Your annual limit for qualified expenses
  • Network status: Whether Orlando Recovery Center qualifies for network savings or negotiated rates

Some plans that use MultiPlan offer extended network benefits, allowing partial in-network pricing even when traveling outside your home state — often useful for patients seeking specialized addiction treatment out of state.

Dual-diagnosis treatment and MultiPlan

Most plans that use MultiPlan include coverage for co-occurring mental health and substance use disorders, especially when symptoms impact safety or stability.

  • Psychiatric evaluation
  • Medication management
  • Therapy for anxiety, depression, bipolar disorder, trauma, and more
  • Integrated dual-diagnosis treatment

Dual-diagnosis support is often considered medically necessary, which may improve approval likelihood.

Medication-assisted treatment (MAT) coverage

Your pharmacy benefits — not MultiPlan itself — determine MAT coverage. Plans commonly include coverage for:

  • Buprenorphine/naloxone
  • Extended-release naltrexone (Vivitrol)
  • Methadone (through licensed treatment programs)
  • Medications for alcohol use disorder

Some medications may require prior authorization or step therapy depending on the plan.

How to check your MultiPlan rehab benefits

Because MultiPlan partners with many insurers, verifying your benefits directly is the most accurate way to understand coverage.

Option 1: Verify benefits with the Orlando Recovery Center admissions team (recommended)

We can confirm network status, authorization requirements, and estimated treatment costs. Verify your insurance online.

Option 2: Contact your insurance plan administrator

Ask whether your plan uses MultiPlan or PHCS networks and whether Orlando Recovery Center is eligible for contracted rates or extended-network pricing.

Rehab accepting MultiPlan in Florida

If your insurance plan uses the MultiPlan or PHCS network, Orlando Recovery Center can help you understand your benefits and treatment options before you begin care.

Disclaimer: This page is for informational purposes only and does not guarantee coverage or payment. Benefits vary by insurer and are subject to authorization and medical-necessity review.