If your insurance card or benefits documentation references MultiPlan or Claritev, you may
have access to one of the broadest provider networks in the country — and that access could
significantly reduce the cost of addiction treatment for you or a loved one. At Guardian
Recovery, we work with plans that utilize the MultiPlan – Claritev network to help members
verify their benefits, understand their coverage, and begin the path to recovery without
unnecessary financial barriers. Our admissions team is here every step of the way to make
the process as simple and stress-free as possible.
What Is MultiPlan – Claritev?
MultiPlan, now officially rebranded as Claritev, is not a health insurance company.
Rather, it is one of the largest Preferred Provider Organization (PPO) networks in the
United States — a technology-driven, third-party cost management organization that has been
operating for nearly 45 years. Claritev does not sell insurance policies, administer benefit
plans, or pay claims directly. Instead, it functions as a network facilitator: negotiating
discounted rates with contracted providers and enabling insurance companies to offer their
members access to a significantly expanded directory of hospitals, physicians, specialists,
and behavioral health facilities at pre-negotiated, reduced rates.
Claritev’s network is among the most extensive in the country, serving:
- Over 700 healthcare payors
- More than 100,000 employers
- Approximately 60 million consumers
- Over 1.4 million contracted providers nationwide
When your insurance carrier partners with MultiPlan – Claritev, they are granting you access
to this expansive network of care options, often at lower out-of-pocket costs than you would
incur with out-of-network providers. Your actual coverage, benefit limits, copays,
deductibles, and preauthorization requirements are determined by your individual insurance
carrier — not by Claritev. This distinction is important and is exactly why our team
works directly with your insurer to verify your specific benefits before you begin treatment.
Does MultiPlan – Claritev Cover Addiction Treatment?
Yes — insurance plans that operate within the MultiPlan – Claritev network are legally
required to provide coverage for substance use disorder treatment. The Mental Health Parity
and Addiction Equity Act (MHPAEA), passed in 2008, and the subsequent Affordable Care
Act (ACA) both mandate that health insurance plans provide coverage for mental health and
substance use disorder treatment at a level comparable to coverage for physical health
conditions. Claritev does not impose any blanket exclusions limiting coverage for any
specific substance, meaning treatment must simply be deemed medically necessary and meet
the requirements of your individual insurance policy.
Because coverage details vary significantly across the many insurance carriers and employer
plans that utilize the Claritev network, our insurance specialists work directly with your
insurer on your behalf — confirming what is covered under your specific plan, identifying any
out-of-pocket costs, and clarifying any preauthorization requirements before treatment
begins. We offer a free, confidential benefits check so you have a complete, transparent
picture of your coverage before taking the next step.
Have Insurance Coverage with
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coverage and take the first step toward recovery.
Addiction Treatment Programs Accessible Through MultiPlan – Claritev
Insurance plans that partner with the MultiPlan – Claritev network typically provide coverage
across a full continuum of addiction treatment services, from medically supervised
detoxification through long-term recovery support. Our clinical team works in coordination
with your specific insurance carrier to maximize your benefits across all applicable levels
of care.
Medical Detoxification
Medical detox is the essential first phase of addiction recovery — a clinically
supervised process in which the body safely withdraws from harmful substances under
continuous professional oversight. Our detox program provides around-the-clock monitoring,
evidence-based withdrawal management protocols, psychological support throughout the
withdrawal phase, and medication-assisted treatment (MAT) as clinically appropriate.
Medical detoxification through MultiPlan – Claritev affiliated insurance plans is typically
covered when medically necessary, though coverage levels, copays, and preauthorization
requirements vary by carrier and plan type. Our team handles the verification and
authorization process on your behalf.
Residential Inpatient Treatment
For individuals whose recovery requires a fully structured, immersive treatment environment
with 24-hour clinical support, residential inpatient treatment removes clients from the
triggers, stressors, and instability of their daily environment and places them within a
focused, therapeutic setting. Programming typically ranges from 30 to 90 days and
incorporates individual therapy, group counseling, psychiatric support, medication
management, life skills development, and holistic wellness activities into a comprehensive
daily schedule. Inpatient rehab is typically covered through Claritev-affiliated insurance
plans when clinically indicated and deemed medically necessary. Preauthorization is commonly
required for residential stays, and our admissions team manages this process completely on
your behalf.
Partial Hospitalization Program (PHP)
PHP delivers structured, high-intensity therapeutic programming during daytime hours,
allowing individuals to return home or to a sober living environment each evening. These
programs integrate individual counseling, group therapy, psychiatric consultation, and
medical monitoring within a coordinated, multidisciplinary care framework — offering a
clinically robust level of care without requiring overnight residential admission. Most
MultiPlan – Claritev affiliated insurance policies cover PHP services as part of their
behavioral health benefits when medically necessary, and our team handles all benefit
verification and prior authorization on your behalf.
Intensive Outpatient Program (IOP)
IOP offers consistent, structured clinical support for individuals who are ready to
manage daily responsibilities — such as work, school, or family commitments — while
continuing to engage in meaningful treatment. Sessions typically convene multiple times per
week and focus on relapse prevention, coping skill development, peer accountability, and
therapeutic reinforcement. Claritev-affiliated insurance plans frequently include IOP as part
of a comprehensive behavioral health continuum, and PPO plan holders generally do not require
a referral to access these services.
Medication-Assisted Treatment (MAT)
Medication-Assisted Treatment combines FDA-approved medications with counseling and
behavioral therapies to treat substance use disorders at the neurological, psychological, and
social levels simultaneously. MAT is particularly effective for opioid use disorder and
alcohol use disorder, helping to reduce cravings, manage withdrawal symptoms, and lower
the risk of relapse. Most MultiPlan – Claritev affiliated insurance plans include coverage
for FDA-approved MAT medications when integrated into a comprehensive care plan. Medications
that may be covered include:
- Buprenorphine / Suboxone / Sublocade — used to treat opioid use disorder
- Methadone — a long-acting opioid agonist used in opioid maintenance therapy
- Naltrexone / Vivitrol — monthly injections used to reduce cravings and support
recovery from opioid and alcohol use disorders
Coverage for specific MAT medications depends on your individual carrier’s formulary and
plan design. Our team can confirm your specific MAT benefits during the insurance
verification process.
Virtual Addiction Treatment
For members who face geographic, logistical, or personal barriers to in-person care,
virtual addiction treatment offers a flexible and clinically effective pathway to
recovery. Many MultiPlan – Claritev affiliated insurance policies now support telehealth
addiction treatment, allowing clients to access individual therapy, group counseling
sessions, and medication management consultations from the privacy and comfort of their own
home — without sacrificing the quality or clinical integrity of the care they receive. Our
team can confirm whether your specific plan includes telehealth-delivered behavioral health
coverage during the benefits verification process.
Coverage Options Made Simple
Mental Health and Co-Occurring Disorder Coverage
Substance use disorders and mental health conditions frequently occur together. Research
consistently shows that approximately half of all individuals with a substance use disorder
are also managing a co-occurring mental health condition such as depression, anxiety, PTSD,
bipolar disorder, or a trauma-related presentation — a clinical reality known as a
co-occurring disorder or dual diagnosis. Under the Mental Health Parity and
Addiction Equity Act (MHPAEA), insurance plans operating within the MultiPlan – Claritev
network are required to provide mental health and substance use disorder coverage that is
comparable to physical health benefits — meaning integrated dual diagnosis care is a
protected, covered benefit.
Our clinical team specializes in dual diagnosis treatment, addressing substance use and
co-occurring mental health conditions simultaneously through coordinated, evidence-based care
planning. Services typically accessible through MultiPlan – Claritev affiliated plans include
psychiatric evaluations, medication management, individual therapy, group
counseling, family therapy, and specialized behavioral health programming tailored to
each client’s unique clinical profile.
Psychiatric Services
Access to licensed psychiatrists and psychiatric nurse practitioners is a foundational
element of comprehensive addiction and mental health care. Insurance plans within the
MultiPlan – Claritev network typically cover psychiatric evaluation and ongoing medication
management, ensuring clients receive the level of specialized psychiatric support their
diagnosis requires throughout the recovery process. Claritev’s expansive provider network
means members have access to a wide range of qualified psychiatric professionals at
negotiated, reduced rates.
Therapy and Counseling
Therapeutic services form the backbone of sustainable, lasting recovery. Whether engaging
in one-on-one sessions with a licensed therapist or participating in structured group
counseling, our qualified clinical staff deliver targeted, evidence-based care within the
scope of your MultiPlan – Claritev affiliated insurance benefits. Treatment modalities
available through our program include Cognitive Behavioral Therapy (CBT), Dialectical
Behavior Therapy (DBT), trauma-informed care, motivational interviewing, family therapy,
and relapse prevention programming.
Understanding Your MultiPlan – Claritev Benefits
Because Claritev operates as a network rather than a direct insurer, understanding your
coverage requires a direct conversation with your insurance carrier. A few important
considerations to keep in mind:
- No referral required for PPO plan holders seeking in-network behavioral health
services — you can access treatment directly without a primary care referral - Preauthorization is commonly required for higher levels of care such as inpatient
residential treatment and PHP — our team handles this process on your behalf - Coverage levels, deductibles, copays, and out-of-pocket maximums vary significantly
depending on your specific insurance carrier and plan tier - No blanket substance exclusions — treatment is available for all substance types
provided it is deemed medically necessary under your plan
Our admissions coordinators are experienced in working with the wide range of insurance
carriers and employer plans that partner with MultiPlan – Claritev. We know how to navigate
the nuances of network-based coverage and will work efficiently to get you a clear, complete
picture of your benefits so nothing comes as a surprise.
Clinical Assessments and Diagnostic Services
Every effective, individualized treatment plan begins with a thorough clinical and medical
evaluation. Upon entering our program, each client undergoes a comprehensive intake
assessment that examines physical health status, substance use history, mental health
presentation, co-occurring conditions, and relevant psychosocial factors. Our team uses
standardized psychological screening tools, comprehensive psychiatric examinations, substance
use screening protocols, and integrated mental health appraisals to develop a complete
clinical profile that directly informs each client’s personalized course of care. Clinical
assessment and diagnostic services are typically covered through MultiPlan – Claritev
affiliated insurance plans when medically necessary.
Aftercare and Continuing Support
Long-term sobriety depends as much on what happens after primary treatment ends as on the
intensity of the treatment itself. MultiPlan – Claritev affiliated insurance plans may extend
coverage to aftercare and continuing care services designed to reinforce the skills and
progress developed during treatment while providing the ongoing accountability and community
connection that sustains recovery over time. Our aftercare planning team collaborates with
each client to connect them with the resources best suited to their individual needs,
including continued outpatient therapy, alumni programming, peer support groups, relapse
prevention check-ins, and connections to local recovery support organizations. Many
Claritev-affiliated plans also provide access to ongoing support groups and alumni
programs — critical tools for long-term recovery maintenance.
Questions About Insurance?
Find out exactly what your plan covers. We make insurance verification fast, easy, and private.
How to Verify Your MultiPlan – Claritev Benefits at Guardian Recovery
Starting treatment using insurance that operates within the MultiPlan – Claritev network is
a manageable process, and our admissions team is here to guide you through every step with
clarity and compassion. Here is what to expect when you reach out:
Our dedicated admissions coordinators will collect your insurance information, work directly
with your carrier to conduct a thorough review of your specific plan details, and clearly
explain which services are covered — including any applicable copays, deductibles,
out-of-pocket maximums, and prior authorization requirements. Because coverage is
determined by your individual insurance carrier rather than Claritev itself, this
verification step is especially important, and our team is experienced in navigating the full
range of plans that utilize the Claritev network. From there, we will schedule your initial
clinical assessment and ensure you feel fully informed and confident as you move forward with
your treatment decisions.
Whether you are reaching out for yourself or on behalf of a loved one, our team is available
24 hours a day, 7 days a week to answer questions, address concerns, and provide the
knowledgeable, compassionate guidance that makes the first step feel a little less
overwhelming.
Do not let uncertainty about your MultiPlan – Claritev benefits delay your path to
healing. Contact us today for your free, no-obligation benefits verification and take the
first step toward lasting recovery.
