GEHA (Government Employee Health Association) is a not-for-profit insurance provider offering medical and dental coverage for federal employees, retirees, and their families. Founded in Missouri in 1937, GEHA has grown to serve approximately 1.8 million members worldwide.
Both GEHA’s Standard and High health plans offer coverage for some or all substance abuse treatment services. Common covered treatments include:
GEHA places a strong emphasis on accreditation. To qualify for coverage, clients must receive care from programs that are nationally accredited by organizations such as CARF or The Joint Commission and licensed by the state in which they operate. These standards help ensure that you receive safe, high-quality addiction treatment.
To qualify for GEHA’s rehab coverage, you must meet specific criteria demonstrating that treatment is medically necessary. When evaluating your situation, an addiction specialist or primary care physician will likely ask the following questions:
While both GEHA plan types provide varying levels of addiction coverage, each is designed to address substance abuse comprehensively. If you meet the eligibility criteria, GEHA typically covers treatment for alcohol, opioids, cocaine, methamphetamines, benzodiazepines, and other substance use disorders.
Addiction and mental health conditions often occur together, a situation known as dual diagnosis. GEHA provides a range of behavioral health coverage options that can be used both within rehab and through outpatient services. When exploring treatment options, ask about programs that address both mental health and addiction to support full recovery of mind and body.
Medication-assisted treatment (MAT) combines prescribed medications with therapy to support recovery from addiction. It’s most commonly used for opioid and alcohol dependence, utilizing FDA-approved medications proven to improve treatment outcomes.
GEHA covers a broad selection of prescription medications and may pay for some or all MAT-related prescriptions, depending on your plan and treatment needs. While medications are usually billed separately from rehab, your medical team can verify coverage in advance to ensure your treatment remains affordable and within your insurance benefits.
Like all insurance providers, GEHA is federally required to cover essential health services. While exact coverage depends on your specific plan, substance abuse treatment and behavioral health care are both considered essential benefits, meaning you may qualify for insurance assistance.
Generally, GEHA’s Standard plan features lower monthly premiums but higher out-of-pocket costs, while the High plan provides broader coverage with a higher monthly rate.
If you face out-of-pocket expenses or need to meet a deductible, you may be able to use a Health Care Flexible Spending Account (HCFSA). This account offers tax advantages and can help make addiction treatment more affordable.
The length of treatment covered by GEHA varies based on your plan and individual needs. GEHA provides coverage for treatment deemed medically necessary, which often includes about 1–6 weeks of inpatient rehab and approximately 4–12 weeks of intensive outpatient care. However, the exact duration of coverage will depend on your personal progress and medical assessment.
Although rehab is considered an essential service, your specific GEHA plan will determine how much is covered and what portion you’ll pay out-of-pocket. In most cases, you’ll need to meet your deductible before GEHA coverage begins. If you haven’t reached your deductible yet this year, there are several payment options available to help you manage rehab costs until your insurance takes effect:
Arizona IOP is a luxury rehab program based in Scottsdale, Arizona, with two serene locations nestled in the desert mountains. Both of our facilities partner with GEHA to help ease the financial burden of addiction treatment. We offer comprehensive treatment programs, integrated mental health care, upscale amenities, and executive options designed for professionals.
Our team will work directly with your insurance provider to review your benefits and ensure you receive the maximum coverage possible, making your treatment experience as smooth and stress-free as possible.
Both. GEHA is available to federal employees nationwide and generally provides coverage for treatment in all 50 states, not just your home state. However, your exact benefits and coverage details must be verified before beginning treatment, whether in-state or out-of-state.
GEHA is one of several national insurance providers that offer coverage for addiction treatment. If you or a loved one are covered under a different insurance policy, be sure to review that provider’s specific benefits and coverage details:
