Recreate Life Counseling provides partial hospitalization (PHP) and intensive outpatient (IOP) treatment for substance use and mental health in Boynton Beach, Florida. If your insurance card or paperwork says Carelon Behavioral Health or Beacon Health Options, this page explains what that company does, what it typically covers for addiction treatment, and how to find out what you will pay before you start.
Our admissions team checks Carelon and Beacon benefits for free. Network status depends on your specific plan, so we confirm it during the benefits check and give you a written estimate before you commit to anything.
Beacon Health Options is now Carelon Behavioral Health
In March 2023, Beacon Health Options changed its name to Carelon Behavioral Health. It is part of Carelon, the health services business of Elevance Health, the company behind Anthem. Before it was Beacon, the company was known as ValueOptions, so you may see any of the three names on older cards, letters or explanation of benefits statements.
If your card still says Beacon, it is still valid. The name changed, not your coverage.
Carelon is usually not your insurance company. It is a behavioral health manager. Your employer, health plan or public program contracts with Carelon to run the mental health and substance use part of your benefits: the provider network, authorizations, utilization review and claims for that care. Your medical coverage may sit with a different company entirely. Two common examples:
- Anthem members often have behavioral health managed by Carelon. See our Blue Cross Blue Shield page for how Anthem medical coverage works in Florida.
- New York State employees on The Empire Plan have their Mental Health and Substance Use Program administered by Carelon. See our NYSHIP and Empire Plan page.
Does Carelon cover addiction treatment?
In most plans, yes. The Affordable Care Act lists mental health and substance use disorder services as essential health benefits, and the Mental Health Parity and Addiction Equity Act stops plans from limiting that care more strictly than medical or surgical care. Carelon applies the rules of the plan it manages, so what is covered, and at what cost, comes from your plan, not from Carelon itself.
Recreate provides the outpatient levels of care. If you need detox or residential treatment first, our admissions team refers you to a partner program and brings you into ours when you are ready to step down.
| Level of care | Typical Carelon coverage | At Recreate |
|---|---|---|
| Detox, including detox at a hospital | Covered when medically necessary, usually with authorization | Referral to a partner program |
| Residential treatment and hospital inpatient care | Covered when medically necessary, with authorization | Referral |
| Partial hospitalization program (PHP) | Covered, usually with authorization before you start | Yes |
| Intensive outpatient program (IOP) | Covered, often with authorization | Yes |
| Individual therapy and group therapy | Covered | Yes, as part of PHP and IOP |
| Medication management and medication-assisted treatment | Covered, with medications usually billed to your pharmacy benefit | Coordinated with prescribing providers |
| Co-occurring mental health conditions | Covered under the same behavioral health benefit | Yes, through dual diagnosis treatment |
| Recovery coaching and relapse prevention | Varies by plan | Relapse prevention and aftercare planning |
Insurance requirements: medical necessity and authorization
Carelon approves care one level at a time. Before PHP or IOP begins, it usually needs to see that the level of care is medically necessary, which means a clinical assessment shows you need that amount of structure, not more and not less. The assessment looks at withdrawal risk, medical and psychiatric conditions, readiness to change, relapse risk and your living situation.
Our clinicians complete that assessment at intake and send the medical documentation to Carelon on your behalf. Once you are in treatment, Carelon reviews progress every several days and approves continued care in blocks. That is normal. If a review approves less time than our clinicians recommend, we tell you, and we can support an appeal with clinical records.
Two other things to know:
- Limitations or exclusions. Your plan’s summary of benefits lists anything not covered. Recovery housing rent, transportation and some holistic services are common examples.
- Coverage policies differ by plan. Two people with Carelon cards can have very different benefits, because the employer or health plan sets the rules. That is why the benefits check matters more than any general answer.
In-network, out-of-network and single case agreements
Network status is the biggest driver of cost. A Carelon network provider has a contract that sets the rate and limits what you can be billed. If your plan has out-of-network benefits, you can use a provider outside the network, but you usually meet a separate, higher deductible and pay a larger share. If your plan has no out-of-network benefits, care outside the network is not covered except in emergencies.
There is a third route. When a plan’s network has no suitable program available, a provider can ask Carelon for a single case agreement (SCA): a one-time contract that lets an out-of-network provider treat one member at in-network cost. SCAs are not guaranteed. They depend on your plan, your clinical needs and whether a network option exists. If one could apply to you, our admissions team will tell you and handle the request.
What you will pay
Your out-of-pocket expenses come from your plan’s cost sharing:
- Deductibles: what you pay each year before the plan starts paying.
- Copayment amounts or coinsurance: a flat fee per day or session, or a percentage of the allowed amount.
- Out-of-pocket maximum: the most you pay in a plan year for covered in-network care.
We do not list figures here because they vary by plan and change each year. The benefits check pulls your actual numbers and turns them into an estimate for the program we recommend. If any part of care is not covered, ask admissions about payment options.
How to verify your Carelon benefits
- Have your Carelon Behavioral Health insurance card ready, or your medical card if Carelon is listed on the back for behavioral health.
- Call us or complete the confidential form on this page. An admissions counselor takes your information and a few details about what is going on.
- We contact Carelon to confirm active coverage, network status, coverage details for PHP and IOP, deductible and cost sharing, and what authorization is needed.
- You get a written estimate before you agree to anything.
- If you move forward, we complete the clinical assessment, request authorization and schedule your start date.
You can also confirm on your own by calling the behavioral health number on your card and asking whether Recreate Life Counseling in Boynton Beach, Florida is a network provider for your plan, and what your services covered are for partial hospitalization and intensive outpatient treatment.
Finding a rehab that accepts Carelon
Many addiction treatment centers accept Carelon plans. Acceptance tells you about billing, not quality. These are the things worth checking with any program, including ours.
- Accreditation and licensing. Look for Joint Commission accreditation or CARF, and a current state license. Recreate Life Counseling holds Joint Commission accreditation and a Florida Department of Children and Families license.
- The right level of care. A good program assesses you before recommending anything, and tells you when another level of care would serve you better.
- Evidence-based therapies. Cognitive behavioral therapy, dialectical behavior therapy, trauma-focused therapy and medication-assisted treatment have research behind them.
- Care for the substance and the condition. If you have anxiety, depression, trauma or another condition alongside addiction, ask how the program treats both at once.
- A clear answer on network status and cost before you arrive, in writing.
Carelon’s own provider directory is the final word on network status, and FindTreatment.gov lets you check licensed programs by location and insurance accepted.
Frequently asked questions
Is Beacon Health Options the same as Carelon Behavioral Health? Yes. Beacon became Carelon Behavioral Health in 2023. Before that it was ValueOptions.
Does Carelon cover partial hospitalization and IOP? In most plans, yes, when the level of care is medically necessary. Authorization is usually required before PHP starts.
Does Carelon cover mental health treatment without a substance use problem? Yes. PHP and IOP for depression, anxiety, trauma and related conditions fall under the same behavioral health benefit, and Recreate treats them alongside addiction.
What is a single case agreement? A one-time agreement that lets an out-of-network provider treat one member at in-network cost when the network has no suitable option. It is decided case by case.
Will my employer find out? No. Claims go to Carelon, not your employer. Your records are protected by HIPAA, and substance use treatment records have added protection under 42 CFR Part 2.
What if Carelon denies or cuts short my treatment? You can appeal. Our admissions team can explain the next step and support it with clinical documentation.
Written by: The Recreate Life Counseling Editorial Team
Published on: April 1, 2019
Updated on: November 11, 2026
