Rehabs That Take Community Health Group

Does Community Health Group Cover Drug and Alcohol Rehab?

Yes, but through two separate systems. Medicare members get substance misuse treatment, inpatient psychiatric care, day treatment, partial hospitalization, intensive outpatient and acute medical detox from CHG, with no stated limits on inpatient days or outpatient visits. Medi-Cal members get the same ladder of care from the County of San Diego instead.

That split comes from how California organises Medi-Cal. Managed care plans such as CHG hold the physical health benefit, enhanced care management, community supports and non-specialty mental health, including medication-assisted treatment delivered in primary care, hospitals and emergency departments. Specialty mental health and the whole substance use continuum sit with County Behavioral Health Services. For a Medicare member on one of CHG’s special needs plans, no carve-out applies and the plan pays.

What Does Each Plan Cover at Each Level of Care?

The County continuum follows ASAM levels: early intervention, outpatient, intensive outpatient, partial hospitalization, residential and inpatient care, narcotic treatment programs, withdrawal management, medication-assisted treatment, peer support, recovery services and care coordination. CHG’s Medicare benefit lists the clinical levels rather than ASAM numbers, and both routes place a member by clinical need rather than by preference.

Medical Detox

Acute medical detox is named in CHG’s Medicare behavioral health benefits. For Medi-Cal, withdrawal management is a County DMC-ODS service in both residential and ambulatory settings, and County rules state that admission to withdrawal management does not require a full ASAM assessment first. Alcohol and benzodiazepine withdrawal can produce seizures, so acute withdrawal belongs in an emergency department regardless of which plan pays.

Residential and Inpatient

County DMC-ODS covers residential treatment at ASAM levels 3.1, 3.3 and 3.5 for Medi-Cal. The statewide average length-of-stay goal is 30 days, which the County describes as an average rather than a cap, with the actual stay set by clinical need. CHG’s Medicare plans cover inpatient psychiatric treatment and substance misuse treatment with no stated day limit.

PHP, IOP and Outpatient

CHG lists day treatment, partial hospitalization and intensive outpatient for Medicare members. Medi-Cal members reach the equivalent levels, 2.1 and 2.5, through the County. CHG also covers individual and group psychotherapy, psychological testing, outpatient drug therapy monitoring and psychiatric consultation for mild to moderate conditions, with no visit limit stated.

Does Community Health Group Need Prior Authorization for Rehab?

CHG publishes a Service Authorization List covering both Medi-Cal and Medicare, so the answer for a given level of care comes from that list. A first mental health evaluation with an in-network provider needs no prior authorization. Behavioral health treatment such as applied behavior analysis does require CHG authorization when a physician or psychologist prescribes it.

Contracted providers file authorization requests through the CHG provider portal; a non-contracted program faxes a Referral and Service Request Form, and status questions go to the authorizations mailbox at CHG. The plan does not publish authorization rules or medical necessity criteria for Medicare detox, PHP and IOP on its member pages, so an admissions team should ask CHG which review standard applies before a date is held.

How Does a Medi-Cal Member Reach County Rehab?

Call the San Diego County Access & Crisis Line on 1-888-724-7240, walk into or phone a County substance use program directly, or ask a community partner to refer. Placement uses ASAM criteria across all six dimensions, and the County handbook sets out a separate residential service authorization step. Optum is the County’s administrative services organization for DMC-ODS, hosting the provider handbook and forms, and it works for the County rather than for CHG.

How Much Does Rehab Cost With Community Health Group?

For Medi-Cal, nothing: CHG states there are no co-payments, premiums or out-of-pocket expenses, and no deductibles or annual or lifetime maximums. For CommuniCare Advantage, CHG states no premiums, no deductibles and no copays for doctor visits, emergency services or hospitalization, with drug copays of $0 to $10.35 depending on income and most generics at $0.

Community y Más is listed as free to join with no premium shown, drug copays of $0 to $11.20 by income, and copays on some Medicare services such as emergency care, worldwide urgent care and ground ambulance. CHG states that mental health services carry no copays for Medicare members, and a third-party 2026 listing for CommuniCare Advantage shows $0 for outpatient individual and group therapy and $0 per day for inpatient psychiatric days 1 to 150, alongside a 3.5 out of 5 star rating for contract H4733-001-0. That same third-party listing shows a $12 monthly premium and a $9,250 out-of-pocket maximum, which does not match CHG’s own wording, so ask member services on 1-888-244-4430 which figures apply to the enrollment in question.

Those are the sums a program bills without coverage. Under Medi-Cal and County DMC-ODS the member’s share is nothing, and under the Medicare plans it is the cost share above, which is why the authorization step matters far more than the sticker price.

Does Community Health Group Cover Suboxone, Methadone and Other Addiction Medication?

Yes. CHG covers medication-assisted treatment for Medi-Cal members, arranged through the primary care physician or the CHG Behavioral Health Services Department on 1-800-404-3332. Methadone is dispensed through narcotic treatment programs, which sit inside the County DMC-ODS rather than with CHG, so that referral runs through the County.

Where the Prescription Is Filled

Medi-Cal pharmacy benefits billed on pharmacy claims have been run by the Department of Health Care Services as Medi-Cal Rx since January 1, 2022, not by managed care plans; drugs billed on a medical claim stay with CHG. CommuniCare Advantage and Community y Más include Part D coverage with their own List of Covered Drugs, and the formulary placement of buprenorphine and naltrexone is not published on CHG’s member pages, so ask the Behavioral Health Services Department before discharge rather than at the pharmacy counter.

Medication Inside County Programs

County rules require outpatient, intensive outpatient and residential substance use providers to offer medication-assisted treatment directly or to hold working referral arrangements for it. A Medi-Cal member entering residential care can therefore ask the admissions team which of the two applies there, and whether an existing prescription continues through the stay.

Which Rehab Centers in California Are In-Network With Community Health Group?

For Medi-Cal, addiction treatment providers hold County DMC-ODS contracts rather than CHG network contracts, so County certification is what counts. For CommuniCare Advantage and Community y Más, both HMOs, network status comes from a CHG contract and is settled in the provider directory on chgsd.com or by calling the number on the member card.

How Do I Find a Rehab That Takes Community Health Group?

Medi-Cal members start with the San Diego County Access & Crisis Line on 1-888-724-7240, which handles both specialty mental health and substance use treatment and offers live chat. Medicare members start with CHG Behavioral Health Services on 1-800-404-3332 or the provider directory on chgsd.com. The telephone advice nurse line is 1-800-647-6966.

Enrollment itself runs through Medi-Cal Health Care Options on (800) 430-4263, with eligibility and the BIC card handled by the County of San Diego Social Services Agency; CHG issues its own member ID card on top of that. Anyone comparing options will find that Blue Shield of California Promise Health Plan, Molina Healthcare of California and, for limited eligibility, Kaiser Permanente also hold San Diego Medi-Cal contracts alongside CHG. Outside the county line, the wider list of rehabs in California is the place to look, since CHG coverage does not travel.

Is Community Health Group the Same as Community Health Choice or UnitedHealthcare Community Plan?

No, and the names cause real confusion. Community Health Choice is a Houston nonprofit managed care organization launched by Harris Health System in 1997, covering Texas STAR, STAR+PLUS, CHIP, Marketplace and D-SNP lines. UnitedHealthcare Community Plan is UnitedHealthcare’s Medicaid brand, behind AHCCCS Complete Care in Arizona and TennCare in Tennessee. A separate CommuniCare Advantage, contract H3727, sells Medicare plans in Ohio and Maryland and has nothing to do with CHG’s San Diego plan under contract H4733.

References and Citations

• Community Health Group — Medi-Cal, CommuniCare Advantage and Community y Más plan pages, behavioral health services pages, Service Authorization List and member contact information, 2026.
• California Department of Health Care Services — Medi-Cal managed care plan directory, news release 23-47 of November 15, 2023 naming CHG Foundation d.b.a. Community Health Group Partnership Plan, and the Medi-Cal Rx pharmacy transition.
• County of San Diego Health and Human Services Agency, Behavioral Health Services — Drug Medi-Cal Organized Delivery System service continuum, provider handbook and Access & Crisis Line information.
• Medicare.org — third-party 2026 plan listing for contract H4733-001-0, including star rating and behavioral health cost sharing.
• RehabSeekers directory listings and market rate research, United States, 2026. Ranges are indicative and vary by facility, length of stay and coverage.