Insurance · Community Health Options
Using Community Health Options for rehab in Maine
In-network provider
Portland Treatment is in-network with Community Health Options.
Community Health Options is a Lewiston-based nonprofit plan built for Mainers, and many people in York and Cumberland counties carry it through CoverME.gov or a small employer. We're in-network, so outpatient addiction treatment in Biddeford is billed at contracted rates.
- Network status
- In-network with Community Health Options
- Levels covered
- PHP · IOP · OP · medication management
- Verification time
- Usually the same day
Accredited & Licensed
LegitScript Certified
Joint Commission Accredited
Maine DHHS Licensed
Psychology Today Verified
What's covered
What Community Health Options typically covers at Portland Treatment
Community Health Options plans include substance use treatment as an essential health benefit, covered at parity with medical care. These are the services we commonly bill:
Partial Hospitalization (PHP)
Our most structured outpatient level, full days of clinical programming. Community Health Options plans typically cover PHP with prior authorization, which our admissions team requests for you.
More about partial hospitalization (php)Intensive Outpatient (IOP)
Three to five sessions a week, mornings or evenings, so you can keep working. IOP is the most commonly authorized level of care under Community Health Options behavioral health benefits.
More about intensive outpatient (iop)Outpatient Program (OP)
Weekly individual and group therapy for step-down and long-term maintenance. Usually the lowest-cost level under a Community Health Options plan.
More about outpatient program (op)Medication-Assisted Treatment (MAT)
Buprenorphine, naltrexone and related medications, billed through your medical and pharmacy benefits. Coverage and preferred formulary vary by Community Health Options plan.
More about medication-assisted treatment (mat)Dual diagnosis care
Depression, anxiety, PTSD and bipolar disorder treated alongside substance use, one treatment plan, one set of clinicians, billed under your behavioral health benefit.
More about dual diagnosis careDetox placement
We don't run a detox unit. We coordinate placement with licensed Maine detox providers and confirm they take your Community Health Options plan before you go.
More about detox placementPlan details
Know which Community Health Options plan you actually have
Community Health Options offers a few kinds of coverage, and the details shift between them.
Individual and family Marketplace plans
Bought through CoverME.gov, often with premium tax credits. Metal level (Bronze, Silver, Gold) drives your deductible and coinsurance.
Small business plans
Group coverage for Maine employers. Behavioral health benefits mirror the individual plans, with cost sharing set by the plan your employer picked.
HSA-eligible plans
Higher deductibles paired with a health savings account. Treatment costs count toward the deductible, and HSA dollars can cover your share.
Prior authorization
Higher levels of care like PHP usually need authorization. We handle the clinical paperwork as part of admission.
What you'll pay
What determines your out-of-pocket cost
What you pay depends on your plan's metal level, deductible and how much of it you've already met this year.
- Whether you've met your deductible for the plan year, in January this is the single biggest driver of what you pay.
- Your coinsurance or copay per session or per program day once the deductible is satisfied.
- Network status, and this one is usually in your favor: Portland Treatment is in-network with major Maine payers, including Cigna, so most clients are billed at the lower contracted in-network rate.
- Whether the level of care requires prior authorization and how many days or sessions are authorized at a time.
- Your out-of-pocket maximum, once you hit it, covered treatment for the rest of the plan year is paid at 100%.
How verification works
- 1. You call or submit. We take your Community Health Options member ID and date of birth, nothing more invasive than that.
- 2. We call the plan. Our team gets the behavioral health benefit read directly from Community Health Options, in writing.
- 3. You get a real number. Deductible remaining, coinsurance, authorization requirements and an estimated cost per week, before you commit.
- 4. We handle the rest. Prior authorizations, concurrent reviews and appeals are our job, not yours.
Southern Maine
Using Community Health Options coverage close to home
Because Community Health Options was built for Maine, we see it often among self-employed clients, tradespeople and small-business families from Biddeford, Saco, Sanford and Kennebunk. Our day PHP, evening IOP and Virtual IOP let people keep working while they get care close to home.
Our admissions team verifies your Community Health Options benefits, secures any authorization, and explains your expected cost before your first session. If a level of care is denied, we appeal with clinical documentation.
Community Health Options coverage questions
- Does Community Health Options cover addiction treatment?
- Yes. Substance use disorder treatment is an essential health benefit on every Community Health Options plan, including PHP, IOP and outpatient therapy, subject to your deductible, coinsurance and authorization rules.
- Is Portland Treatment in-network with Community Health Options?
- Yes. We're in-network, which means contracted rates, lower out-of-pocket costs and no balance billing.
- I bought my plan on CoverME.gov. Does that change anything?
- No. Marketplace plans carry the same behavioral health benefits. Your metal level and any cost-sharing reductions affect what you pay, and we check that during verification.
- Do I need prior authorization for IOP or PHP?
- PHP usually requires authorization and IOP sometimes does, depending on the plan. We submit the request for you after your assessment.
- How fast can I start?
- Verification is usually same-day and admission commonly follows within a few days, sooner when clinical urgency requires it.
Coverage details described here are general and change by plan year and plan design. Nothing on this page is a guarantee of benefits or payment. The only way to know your coverage is a benefit verification on your specific policy.
Keep exploring
Using Community Health Options at Portland Treatment
Programs your plan may cover
- Partial hospitalization program (PHP) in Biddeford
Our most structured day treatment, five days a week, home each night.
- Intensive outpatient program (IOP) in Southern Maine
Nine-plus clinical hours a week with day and evening tracks.
- Virtual IOP for anywhere in Maine
The same IOP curriculum by secure telehealth, statewide.
- Outpatient program (OP) for ongoing recovery
One to two sessions a week that fit around work and family.
Other plans we accept
- Anthem coverage for rehab in Maine
What Anthem BCBS typically covers for PHP, IOP and OP.
- MaineCare (Medicaid) addiction treatment coverage
MaineCare members are welcome here.
- Cigna coverage for addiction treatment
Verify your Cigna benefits in a few minutes.
- UMR coverage for addiction treatment
UMR/UnitedHealthcare plans and outpatient rehab.
Helpful reading
- Does insurance cover rehab?
Coverage, costs and what to ask your plan.
- Working during rehab
Evening IOP, FMLA and keeping your job in treatment.
- Maine recovery resources directory
Local meetings, crisis lines and state programs.
- All Southern Maine areas we serve
Every city and town within driving distance of Biddeford.
Find out what Community Health Options covers
today
855-449-7674Answered 24 hours a day, 7 days a week. Free and confidential.