Insurance · Martin's Point Health Care
Using Martin's Point for addiction treatment
In-network provider
Portland Treatment is in-network with Martin's Point Health Care.
Martin's Point is headquartered in Portland and covers a lot of Maine's military-connected families through US Family Health Plan, plus a large Generations Advantage Medicare membership. We're in-network with them, so both product lines are billed at contracted rates rather than out-of-network prices.
- Network status
- In-network with Martin's Point
- Main products
- US Family Health Plan · Generations Advantage
- Levels covered
- IOP · OP · MAT · counseling
Accredited & Licensed
LegitScript Certified
Joint Commission Accredited
Maine DHHS Licensed
Psychology Today Verified
What's covered
What Martin's Point typically covers at Portland Treatment
Martin's Point covers behavioral health and substance use treatment across both its main product lines. Levels of care we commonly bill:
Partial Hospitalization (PHP)
Our most structured outpatient level, full days of clinical programming. Martin's Point 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 Martin's Point 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 Martin's Point 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 Martin's Point 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 Martin's Point plan before you go.
More about detox placementPlan details
Know which Martin's Point plan you actually have
Two Martin's Point products dominate in Southern Maine, and they work differently.
US Family Health Plan (TRICARE Prime)
A TRICARE Prime option for military families in Maine. Care is coordinated through the plan, and referrals or authorizations are often required for specialty behavioral health.
Generations Advantage (Medicare Advantage)
Medicare Advantage plans covering outpatient behavioral health with plan-specific copays. Substance use treatment is a covered benefit.
Veterans and military families
If you're a veteran, you may have both VA eligibility and Martin's Point coverage. We help you figure out which pathway gets you in the door fastest.
Referrals and coordination
Martin's Point tends to run a more coordinated model than open PPOs. We work with your care team rather than around it.
What you'll pay
What determines your out-of-pocket cost
Costs differ sharply between the TRICARE-based and Medicare Advantage products.
- Which Martin's Point product you have, US Family Health Plan and Generations Advantage have very different cost structures.
- Whether a referral or prior authorization is required for the level of care you need.
- Your plan's copay for outpatient behavioral health visits or program days.
- Whether Portland Treatment is contracted for your specific product line.
- For veterans, whether VA or Community Care coverage is the better financial pathway.
How verification works
- 1. You call or submit. We take your Martin's Point 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 Martin's Point Health Care, 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 Martin's Point coverage close to home
Maine has one of the highest per-capita veteran populations in the country, and Martin's Point is deeply woven into military-connected care here. If you're a veteran or military family member in York or Cumberland County, our veterans treatment guide walks through how VA benefits, Community Care and private coverage fit together.
Our Biddeford campus is roughly half an hour from Portland and close to Saco, Old Orchard Beach and Kennebunk. Our admissions team verifies your Martin's Point benefits, handles referral and authorization steps, and tells you plainly if another coverage pathway would cost you less.
Martin's Point coverage questions
- Does Martin's Point cover addiction treatment?
- Yes. Both US Family Health Plan and Generations Advantage cover outpatient substance use treatment, including counseling, intensive outpatient programming and medication-assisted treatment, subject to plan rules.
- Is Martin's Point the same as TRICARE?
- Martin's Point administers US Family Health Plan, a TRICARE Prime option available to eligible military families in Maine. It's a TRICARE product, but coverage is coordinated through Martin's Point.
- Do I need a referral for treatment with Martin's Point?
- Often yes, especially under US Family Health Plan. Martin's Point runs a coordinated care model, and we help obtain any needed referral or authorization during admission.
- I'm a veteran, should I use Martin's Point or the VA?
- It depends on wait times, eligibility and cost. Sometimes VA Community Care is the faster route; sometimes your Martin's Point benefit is. We'll walk through both honestly rather than steering you to whichever bills us more.
- Does Generations Advantage cover IOP?
- Medicare Advantage plans cover intensive outpatient services when medically necessary, with plan-specific copays. We verify the exact terms of your plan before you start.
- Does Martin's Point cover Suboxone or naltrexone?
- Medication-assisted treatment is covered under both product lines, subject to formulary rules and occasional prior authorization requirements.
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.
Other plans we work with
Keep exploring
Using Martin's Point 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 Martin's Point covers
today
855-449-7674Answered 24 hours a day, 7 days a week. Free and confidential.