Looking for drug rehab centers that accept First Health? If the First Health Network logo appears on your health insurance card, you may have access to participating hospitals, medical providers, and treatment facilities through a national preferred provider network.
However, there is an important distinction to understand before arranging drug or alcohol rehabilitation: First Health is a provider network, not the insurance company responsible for paying your treatment claims.
First Health helps participating health plans connect members with contracted healthcare providers. Whether your insurance covers medical detoxification, inpatient addiction treatment, residential rehabilitation, or outpatient counseling depends on the actual health benefit plan associated with your membership.
Some plans using First Health provide comprehensive medical and behavioral health benefits. Others have limited coverage or use a separate network for mental health and addiction treatment.
This guide explains how the First Health Network works, why the name on your card does not guarantee rehab coverage, and how to identify the treatment options available through your insurance.
Have First Health Network Benefits and Need Drug Rehab?
Addiction No More provides nationwide information and referral assistance for individuals and families exploring drug and alcohol treatment.
If your health plan uses First Health, call to discuss possible inpatient and residential rehabilitation options and the questions to ask about your coverage.
1-800-513-5423
Our telephone line accepts calls around the clock, although live assistance may not always be available. Calling does not obligate you to enter treatment. Insurance benefits, provider participation, authorization, admission, availability, costs, and outcomes cannot be guaranteed.
Before calling, look at both sides of your insurance card. In addition to First Health, look for the name of your insurance company, employer benefit plan, or third-party administrator. This information is essential when checking addiction treatment benefits.
What Is the First Health Network?
First Health is a national healthcare provider network operated under the First Health Group Corporation name, which is part of the Aetna corporate organization.
Its role is to maintain relationships with participating healthcare providers and make those providers available to health insurance companies, employers, and organizations that purchase access to its networks.
First Health is commonly associated with preferred provider organization (PPO) arrangements.
However, the presence of a PPO network does not automatically mean the member has comprehensive PPO insurance benefits.
What First Health Does and Does Not Do
First Health may:
- Maintain a network of contracted healthcare providers
- Provide a directory of participating doctors, hospitals, and facilities
- Help health plans access negotiated provider rates
- Support network-related administrative services
First Health does not:
- Sell health insurance policies
- Determine your individual treatment benefits
- Pay your finalized insurance claims
- Guarantee that a rehabilitation program is covered
- Decide whether your health plan will authorize residential treatment
According to First Health's official explanation, the insurer, employer, or benefit plan administrator is responsible for determining benefits, handling applicable authorization requirements, and paying eligible claims.
First Health's Official Explanation
Why Does First Health Appear on Insurance Cards?
Some insurance companies and employers use First Health to give their members access to an established healthcare provider network.
For example, an employer may sponsor a health plan, hire a third-party administrator to process claims, and use First Health for access to certain doctors and hospitals.
In that situation, First Health may be listed prominently on the insurance card even though a different organization is responsible for coverage decisions.
For addiction treatment, identifying that other organization is often the most important step.
Does First Health Cover Drug and Alcohol Rehab?
First Health does not independently provide addiction treatment coverage. It supplies access to participating healthcare providers for health plans that use its network.
Your underlying health insurance policy determines whether medically necessary addiction treatment services are covered.
If your plan includes comprehensive mental health and substance use disorder benefits, the following services may be eligible:
Treatment Services Your Health Plan May Cover
- Medically supervised drug and alcohol withdrawal management
- Inpatient hospital addiction treatment
- Eligible residential substance use disorder treatment
- Partial hospitalization programs (PHP)
- Intensive outpatient programs (IOP)
- Standard outpatient addiction counseling
- Individual and group behavioral therapy
- Co-occurring mental health treatment
- Certain medications used to treat addiction
- Continuing care and follow-up treatment
Not every plan using First Health includes all these services.
For example, one employer-sponsored policy may provide comprehensive inpatient behavioral health benefits, while another membership or limited-benefit plan using the same network may exclude most residential addiction treatment.
A participating provider discount is also different from insurance paying a claim.
Does the Affordable Care Act Require Rehab Coverage?
Affordable Care Act-compliant Marketplace health insurance plans include mental health and substance use disorder treatment as essential health benefits.
Other employer-sponsored plans may also be subject to applicable federal and state behavioral health coverage requirements.
However, a First Health network logo alone does not establish that a particular membership or benefit arrangement is comprehensive, ACA-compliant major medical insurance.
Always review the actual coverage document instead of relying on the network name.
How to Understand Your First Health Insurance Card
If your card says First Health, don't stop there. Look for the organization that administers or pays claims under your healthcare plan.
This can be especially important when a family is trying to arrange addiction treatment quickly.
Four Things to Look for on Your Insurance Card
1. Insurance Company or Plan Sponsor
Look for the name of the actual insurer, employer plan, or organization providing benefits.
2. Claims Administrator
Some cards identify a third-party administrator (TPA) that processes claims and answers benefit questions.
3. Network Logo
First Health, Cofinity, or another network name may identify which healthcare providers offer contracted network rates.
4. Member Services Telephone Number
This is generally the best place to begin when checking inpatient and residential addiction treatment benefits.
What If My Card Only Says First Health?
Look on the back for a claims mailing address, administrator name, website, or member services telephone number.
Contact that organization and ask who is responsible for behavioral health benefits and medical-necessity authorization.
If you are unsure, First Health's provider network support line is 1-800-226-5116. First Health can provide network-related information, but your plan administrator is the source for specific benefits and claim payment questions.
What If My Employer Provides the Insurance?
Ask your employer's benefits department for the current Summary of Benefits and Coverage or full plan document.
These documents can help identify exclusions, deductibles, treatment requirements, and the company responsible for administering claims.
Is First Health the Same as Aetna Insurance?
First Health is associated with Aetna through corporate ownership, but a First Health Network card does not automatically mean you have an Aetna health insurance policy.
Aetna issues certain health insurance products. First Health operates provider networks that other organizations can use.
These are different functions.
Can I Use My First Health Benefits at Any Rehab That Accepts Aetna?
Not necessarily.
A rehabilitation center that participates in an Aetna insurance network may not participate in the First Health network.
Likewise, a rehabilitation center participating in First Health may not accept every Aetna insurance product.
Provider contracts and covered benefits must be verified separately.
What About Cofinity?
Cofinity is another provider network associated with First Health's network operations.
The official First Health provider locator includes separate search options for the First Health Network, the Cofinity Network, and certain client-specific networks.
Use the network that matches your insurance card or the instructions provided by your plan administrator.
How to Find Drug Rehab Centers in the First Health Network
First Health provides an online directory for searching participating healthcare providers.
However, finding a facility in that directory is only one part of verifying coverage for addiction treatment.
Step 1: Identify Your Exact Network
Check whether your plan uses the First Health Network, Cofinity Network, or a client-specific provider network.
Step 2: Search Participating Providers
Use the official First Health provider locator to search available categories of medical professionals and facilities.
Search the First Health Provider Network
Step 3: Verify the Type of Rehabilitation Services
A hospital may participate in First Health for general medical services without offering residential addiction treatment.
Likewise, a facility may provide outpatient counseling but not medically supervised detoxification or inpatient rehabilitation.
Contact the facility to confirm its actual services, licensing, and ability to treat the individual's condition.
Step 4: Check Your Behavioral Health Network
Your plan may use another organization for substance use disorder and mental health services.
Ask whether the facility participates in that behavioral health arrangement, not only the general First Health medical network.
Step 5: Confirm Coverage and Authorization
Contact the actual insurer or plan administrator to confirm eligible treatment benefits, authorization procedures, and expected personal costs.
A Facility Appearing in the Directory Is Not Proof of Coverage
First Health's official provider locator states that a provider listing does not guarantee benefits for the services provided. The facility's network participation and your insurance benefits must both be confirmed before admission.
Inpatient Rehab, Residential Treatment, Medical Detox, and Outpatient Care
The type of addiction treatment needed should be determined by a qualified healthcare professional. Your underlying health plan then determines which eligible services can be covered.
Inpatient Drug and Alcohol Treatment
Inpatient treatment may be appropriate when a person needs hospital-level medical or psychiatric care, intensive monitoring, or stabilization.
Some health plans using First Health may offer inpatient benefits, but the network itself does not establish those benefits.
Residential Addiction Treatment
Residential rehabilitation involves living at a treatment facility while participating in structured addiction counseling and recovery services.
Some comprehensive health plans may cover medically necessary residential substance use disorder treatment.
Others may exclude residential treatment entirely or restrict services to a specific network.
Before entering a 30-day program, ask whether the plan covers the actual residential level of care. Do not assume that hospital coverage automatically includes residential rehabilitation.
Medical Detoxification
Medical detoxification may involve treatment for alcohol withdrawal, opioid withdrawal, or withdrawal from certain prescription medications.
Depending on clinical needs, services may be provided in an inpatient hospital setting or another appropriate medical environment.
Coverage depends on the actual insurance policy and eligible provider.
Medical safety: Alcohol and certain sedative medication withdrawal can cause seizures and other dangerous complications. Do not assume withdrawal is painless or safe to manage without medical supervision. Call 911 for an immediate medical emergency.
Intensive Outpatient and Partial Hospitalization Programs
Some health plans cover structured outpatient addiction services, including intensive outpatient programs (IOP) and partial hospitalization programs (PHP).
These services may be suitable for people who do not require continuous residential supervision or who are transitioning to a lower level of care.
Dual Diagnosis and Addiction Medications
Depending on the plan, eligible services may include treatment for co-occurring mental health conditions and certain medications used for opioid or alcohol use disorders.
Prescription medication benefits may be administered by a separate pharmacy benefit manager.
What If Your Plan Uses First Health for Medical Care but Another Network for Addiction Treatment?
This is an especially important issue when searching for drug rehab with First Health.
Some health plans use First Health for their general medical provider network while contracting with a different organization to administer behavioral health services.
For example, Sharp Health Plan's employer PPO offers access to the First Health Network for certain medical services outside its regional network, while its behavioral health services are administered through Optum Behavioral Health.
In a plan structured this way, searching only the First Health medical directory may not identify the appropriate network for residential addiction treatment.
How to Find the Correct Behavioral Health Provider
Ask your insurance company or plan administrator:
- Who administers my mental health and substance use disorder benefits?
- Is the behavioral health network different from my First Health medical network?
- Which directory should I use to find inpatient or residential addiction treatment?
- Who handles prior authorization for substance use disorder treatment?
- Does the selected rehabilitation facility participate in the correct behavioral health network?
Do not assume that a treatment provider accepts your behavioral health benefits merely because it participates in First Health's general medical network.
Not Sure Which Network Handles Your Rehab Benefits?
Call Addiction No More to discuss possible addiction treatment options and questions to ask about your insurance's behavioral health network.
Only the applicable health plan or authorized administrator can confirm benefits and make coverage decisions.
First Health Network and Limited-Benefit Health Plans
Not every membership arrangement using the First Health provider network is comprehensive major medical insurance.
Some plans provide limited benefits, such as a fixed payment toward certain medical expenses, selected preventive services, or access to discounted network rates.
Other arrangements may be healthcare sharing memberships rather than insurance policies.
These differences matter because a membership card can look similar to an insurance card even when the available benefits are substantially different.
What Is a Limited-Benefit Health Plan?
A limited-benefit plan may cover only certain listed healthcare services or pay specified amounts toward eligible expenses.
It may not cover comprehensive inpatient hospital care, residential addiction treatment, or other medically necessary services in the same manner as major medical insurance.
Does Access to a PPO Network Guarantee Rehab Coverage?
No. A provider network can offer contracted rates without guaranteeing that the individual's benefit plan pays for the services.
For example, a participating rehabilitation facility might offer a network rate, while the underlying plan excludes residential substance use disorder treatment.
In that situation, the member could still be responsible for substantial expenses.
Check That Your Plan Actually Covers Addiction Treatment
Ask your benefit administrator whether you have comprehensive major medical insurance or a limited-benefit, fixed-indemnity, discount, or healthcare sharing arrangement.
Then ask whether medically necessary residential substance use disorder treatment is specifically included.
A First Health logo alone cannot answer either question.
Can I Use First Health Network Benefits for Out-of-State Rehab?
First Health operates a nationwide provider network, and some health plans use it to provide access to participating healthcare facilities outside their primary service areas.
However, a national provider network does not automatically mean your insurance will cover planned residential addiction treatment anywhere in the country.
The underlying plan determines whether out-of-state services are eligible and which authorization rules apply.
What if My Employer Plan Uses First Health as an Extended Network?
Some employer plans use First Health as a secondary or extended network when employees and dependents need healthcare outside a regional service area.
For example, certain First Choice Health arrangements use First Health to provide access to contracted providers outside the regional First Choice service area.
But the applicable benefit level can differ by employer plan and provider network tier.
Will an Out-of-Network Rehab Be Covered?
Possibly, if the underlying plan offers eligible out-of-network benefits for the proposed treatment.
Some plans have restrictions or exclusions for nonemergency out-of-network services.
Others may require prior authorization, network exceptions, or specific clinical documentation.
Before traveling, determine whether the selected rehabilitation center participates in the network that applies to your substance use disorder benefits.
How Much Does Drug Rehab Cost With a Plan Using First Health?
There is no single First Health deductible, copayment, or residential treatment benefit.
The amount paid toward addiction treatment depends on the insurer or benefit plan administrator responsible for the member's coverage.
Before entering treatment, ask about the following expenses:
- Deductible: The amount you may need to pay before certain benefits begin.
- Copayment: A fixed amount for some eligible services.
- Coinsurance: A percentage of allowed treatment costs.
- Out-of-Network Costs: Additional expenses when using nonparticipating providers.
- Excluded Services: Treatment or accommodations that the plan does not cover.
- Benefit Limits: Any applicable restrictions or payment limits, including those associated with limited-benefit arrangements.
Will First Health Pay for 100% of Drug Rehab?
First Health does not independently pay insurance claims, so it would be incorrect to promise that First Health will pay for an entire rehabilitation program.
Some comprehensive health plans using its network may provide substantial coverage for eligible addiction treatment.
Other plans may pay less or exclude the proposed treatment entirely.
A rehabilitation facility should confirm benefits through the responsible insurer or plan administrator before discussing expected insurance payment.
How Do I Know What I Will Owe?
Request a written estimate of expected charges and ask the plan administrator to explain which amounts are covered, which are your responsibility, and whether additional authorization is needed.
Also ask the facility whether individual clinicians, laboratory services, or other charges may be billed separately.
Questions to Ask Before Entering a Rehab Center With First Health Network Access
These questions are particularly useful if you have a First Health logo on your insurance card but are uncertain about who provides your benefits.
First Health Rehab Verification Checklist
- Who is my actual insurance company or benefit plan administrator?
- Is my coverage comprehensive major medical insurance?
- Does my plan include inpatient substance use disorder benefits?
- Does it cover residential addiction rehabilitation?
- Is medical detoxification included?
- Does another organization manage behavioral health benefits?
- Which provider network should I use for residential treatment?
- Does the selected rehab facility participate in that network?
- Does the plan provide coverage outside my home state?
- Is prior authorization required?
- Who will submit the clinical documentation?
- Are there any exclusions or benefit limitations?
- What deductible or coinsurance will I owe?
- Are any provider, medication, or laboratory charges billed separately?
- Can the treatment facility explain expected personal expenses before admission?
Where Should I Start?
Begin with the member services or claims administrator number listed on your insurance card.
If the provider network is unclear, the official First Health provider locator can help you identify potential network participants.
Remember that provider participation and insurance payment are separate issues that must both be verified.
Frequently Asked Questions About First Health and Drug Rehab
Is First Health an Insurance Company?
No. First Health operates healthcare provider networks. The actual insurer, employer health plan, or benefit administrator determines your covered treatment services and is responsible for applicable claim payments.
Does First Health Cover Inpatient Drug Rehab?
First Health does not establish insurance coverage. Some health plans using its network may provide eligible inpatient addiction treatment benefits. You must verify the benefits of your actual policy.
Does First Health Cover 30-Day Residential Rehab?
A 30-day residential rehabilitation program may be eligible under some comprehensive health plans, but coverage and duration are not automatic. A First Health network membership does not itself guarantee residential treatment benefits.
Does First Health Cover Alcohol Detox?
Some underlying insurance plans may cover medically necessary alcohol withdrawal management. Coverage depends on the actual policy, treatment setting, provider participation, and clinical requirements.
Is First Health the Same as Aetna?
First Health is associated with Aetna through corporate ownership, but First Health network membership does not automatically mean you have an Aetna health insurance policy or Aetna's medical benefits.
Can I Go to Any Rehab That Accepts Aetna?
Not necessarily. Aetna and First Health network contracts can differ. Confirm the selected rehab facility participates in the network associated with your actual insurance policy.
Why Does My Card Have First Health but Another Insurance Company?
Your health plan may purchase access to First Health's provider network while using another insurer or third-party administrator to manage benefits, authorization, and claim payments.
Does First Health Cover Suboxone Treatment?
Prescription medication coverage is determined by your actual health plan and its pharmacy benefit arrangements. Some plans may cover eligible buprenorphine/naloxone medications, but a First Health logo does not establish that coverage.
Can I Use First Health for Rehab in Another State?
First Health operates a nationwide network, but out-of-state addiction treatment coverage depends on the underlying health plan. The selected facility and behavioral health services must qualify under your actual benefits.
Does First Health Cover Out-of-Network Rehab?
Out-of-network benefits vary by the insurer or benefit plan using First Health. Some plans allow eligible out-of-network services, while others exclude planned nonemergency treatment outside their networks.
Can My First Health Plan Exclude Residential Treatment?
Yes, depending on the type of health benefit arrangement and applicable laws. Not every plan using First Health is comprehensive major medical insurance. Review the policy's substance use disorder benefits and exclusions.
How Do I Find Drug Rehab Centers That Accept First Health Near Me?
Start with the First Health provider directory, then confirm the facility participates in the appropriate network and provides the treatment services needed. Contact your underlying insurer or plan administrator to verify coverage before admission.
What if My Plan Denies Rehab Coverage?
Ask the responsible insurer or benefit administrator for the denial reason and any available appeal rights. The process depends on the underlying policy and applicable laws. A treatment provider may be able to supply additional clinical documentation.
Find Drug and Alcohol Treatment With First Health Network Benefits
If your insurance card displays First Health and you need help finding drug or alcohol rehabilitation, the most useful first step is identifying the health plan responsible for your benefits.
Once you know the actual insurer or plan administrator, you can determine whether the policy covers inpatient rehabilitation, residential addiction treatment, medical detoxification, or other services.
That information also helps identify which facilities participate in the appropriate network and what personal expenses may apply.
Have First Health on Your Insurance Card? Need Rehab?
Addiction No More provides nationwide information and referral assistance for people exploring drug and alcohol treatment options.
Call to discuss possible rehabilitation programs and the insurance questions that matter before selecting a facility.
1-800-513-5423
Calling does not guarantee coverage, authorization, placement, treatment availability, admission, or a specific cost. Contact your insurer or plan administrator for official benefit decisions.
Related Addiction Treatment and Insurance Resources
Explore additional information about insurance networks and rehabilitation services.
Find Rehab by Insurance Company
Inpatient Rehabilitation Programs
About This Treatment Information
Written by Erik Epp
Read Erik Epp's author biography to learn more about his experience helping individuals and families explore addiction treatment options.
Last updated:
Disclosure: Addiction No More is an independent addiction treatment information and referral service. We are not affiliated with or endorsed by First Health, First Health Group Corporation, Aetna, or any associated insurer or benefit administrator. We do not operate treatment facilities, provide medical diagnoses, determine insurance benefits, or authorize treatment. Coverage, participating providers, admission, costs, and treatment availability must be confirmed with the applicable organizations.
Emergency information: Addiction No More is not an emergency or crisis service. Call 911 for an overdose, seizure, loss of consciousness, severe withdrawal symptoms, difficulty breathing, or another medical emergency. Call or text 988 for an immediate mental health or suicide crisis.
Sources and Further Reading
- First Health: What the Network Does and Does Not Cover
- First Health: Official Provider Locator
- Sharp Health Plan: Example of First Health Medical Network and Separate Behavioral Health Benefits
- CMS: Confirming Provider Participation Before Treatment
- HealthCare.gov: Mental Health and Substance Use Disorder Coverage
- CMS: Understanding Your Health Plan's Benefits
