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ElderONE

Rehabs That Take ElderONE

ElderONE is a PACE program, or Program of All-Inclusive Care for the Elderly, serving older adults in the Rochester, New York area. PACE programs combine Medicare and Medicaid benefits and arrange all of a participant’s care through an interdisciplinary team. That care can include drug and alcohol treatment, with services varying by the participant’s needs, the program’s provider network and the level of care.New York centers listed here mention ElderONE on their websites. Before admission, speak with the ElderONE care team, which must arrange and approve services, and with the center about network status and any cost.

Rehab Centers Near You

Drug and Alcohol Rehab Centers That Accept ElderONE

Rochester General Hospital – Rochester

1381 East Ridge Road, Rochester, NY, 14621

3.6★★★★☆28

State licensed

DetoxOutpatientTelehealth+1

Accepts InsuranceAccepts MedicaidAccepts Medicare+5

Co-occurring DisordersMATTeens+7

Deaf and HoH

The site sits at 1381 East Ridge Road in Rochester, New York. According to the federal listing this provider runs intensive outpatient and outpatient care. Approved medication is used alongside counseling, which is what medication-assisted treatment means in practice. People attend appointments and go home afterwards, which is how outpatient care works. Remote appointments appear on the record, useful where travel is difficult. Support for veterans appears on the record. The facility is federally registered…

4.1 miCobbs Hill7.2 miFrederick Douglass Greater Rochester International AirportServes3 towns

Substances treated

Adderall Rehab · Alcohol MAT Friendly · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Beer Addiction Treatment · Binge Drinking Treatment · Carfentanil Rehab · Codeine Rehab · Concerta Rehab · +35 more

Levels of care

Aftercare and Continuing Care · Clonidine and Lofexidine Detox · Continuing Care · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Non-12-Step Rehab · Online Rehab and Telehealth · Outpatient MAT Clinic · +4 more

Therapies

Addiction Counseling · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Couples Counseling · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · Motivational Interviewing · +1 more

Mental health

Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Social Skills Training

Groups served

Adult Rehab · Couples Rehab · Hepatitis Support Services · HIV and Hepatitis Care · HIV Support Services · Men's Dual Diagnosis Rehab · Men's Medicare Rehab · Men's Outpatient Rehab · Men's Rehab · Men's Telehealth · +28 more

Support services

Case Management · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Peer Support · Practical Support · PrEP Services · Recovery Coaching · Recovery Support Services · +2 more

Languages

Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab

Insurance accepted

Aetna · Carelon Behavioral Health · Cigna Healthcare · ElderONE · Elderplan · Emblem Health · Excellus Blue Cross · Fidelis Care of New York · Highmark Health · Martin's Point US Family Health Plan · +9 more

Canton Potsdam Hospital – Potsdam

12 Elm Street, Potsdam, NY, 13676

5.0★★★★★4

SAMHSA listed

DetoxOutpatientTelehealth+1

Accepts InsuranceAccepts MedicaidAccepts Medicare+4

MATTeensSeniors+5

Deaf and HoH

This provider is listed at 12 Elm Street, Potsdam, New York. It is recorded as offering intensive outpatient and outpatient care. Co-occurring treatment is listed, which matters where both are present. Treatment runs on an outpatient footing, with people returning home between appointments. Telehealth is listed, so some contact can happen without traveling in. Registration is federal, through SAMHSA; licensing is held with the New York State Office of Addiction Services and Supports.

6.7 miAllen Falls20 miMassena International Airport Richards FieldServes4 towns

Substances treated

Adderall Rehab · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Beer Addiction Treatment · Binge Drinking Treatment · Carfentanil Rehab · Codeine Rehab · Concerta Rehab · Dexedrine Rehab · +34 more

Levels of care

Therapies

Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · Matrix Model Treatment · +2 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Family Education Programs · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Social Skills Training

Groups served

Adult Rehab · Court Ordered Rehab · DUI and DWI Programs · Hepatitis Support Services · HIV and Hepatitis Care · HIV Support Services · Men's Medicare Rehab · Men's Outpatient Rehab · Men's Rehab · Men's Telehealth · +24 more

Support services

Case Management · Community Outreach · Health and Wellness Support · Health Education · Hepatitis C Treatment · Housing and Employment Support · Housing Assistance · Nutrition and Fitness Counseling · Peer Support · Practical Support · +4 more

Languages

Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab

Insurance accepted

Aetna · Carelon Behavioral Health · Cigna Healthcare · ElderONE · Elderplan · Emblem Health · Excellus Blue Cross · Fidelis Care of New York · Martin's Point US Family Health Plan · Medicare · +8 more

Unity Hospital of Rochester – Rochester (1565 Long Pond Road)

1565 Long Pond Road, Rochester, NY, 14626

2.8★★★☆☆~~420~~

State licensed

DetoxOutpatientTelehealth+1

Accepts InsuranceAccepts MedicaidAccepts Medicare+4

Co-occurring DisordersMATTrauma-informed+8

Spanish spokenDeaf and HoH

Unity Hospital of Rochester occupies 1565 Long Pond Road in Rochester, New York. According to the federal listing this provider runs detox, intensive outpatient and outpatient care. Medication-assisted treatment is part of what is listed, which for opioid dependence means buprenorphine, methadone or naltrexone alongside counseling. People attend appointments and go home afterwards, which is how outpatient care works. Video appointments are recorded as an option here. The listing notes provision for veterans and serving…

7.0 miGenesee River5.2 miFrederick Douglass Greater Rochester International AirportServes4 towns

Substances treated

Adderall Rehab · Alcohol Detox · Alcohol MAT Friendly · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Beer Addiction Treatment · Binge Drinking Treatment · Carfentanil Rehab · Codeine Rehab · +36 more

Levels of care

Aftercare and Continuing Care · Alcohol Detox Program · Continuing Care · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Medical Detox · Non-12-Step Rehab · Online Rehab and Telehealth · +7 more

Therapies

Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Couples Counseling · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · +3 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and Trauma · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · Trauma Treatment

Groups served

Support services

Languages

Deaf and Hard of Hearing Detox · Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab · Spanish Speaking Rehab

Insurance accepted

Unity Hospital of Rochester – Rochester (81 Lake Avenue)

81 Lake Avenue, Rochester, NY, 14608

1.8★★☆☆☆5

Federally certified

DetoxOutpatientTelehealth+1

Accepts InsuranceAccepts MedicaidAccepts Medicare+6

Co-occurring DisordersMATTrauma-informed+10

Spanish spokenDeaf and HoH

Records place Unity Hospital of Rochester at 81 Lake Avenue, Rochester, New York. According to the federal listing this provider runs intensive outpatient and outpatient care. The record shows medication-assisted treatment, so buprenorphine or methadone may be available. Care is provided on an outpatient basis, so people continue living at home. Remote appointments appear on the record, useful where travel is difficult. Veterans and military families are recorded as a served group. The facility is…

3.2 miCobbs Hill4.0 miFrederick Douglass Greater Rochester International AirportServes3 towns

Substances treated

Levels of care

Therapies

Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Cognitive Remediation Therapy · Counseling and Therapy · Couples Counseling · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · +8 more

Mental health

Assertive Community Treatment (ACT) · Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · First Episode Psychosis · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · +7 more

Groups served

Active Duty Military Dual Diagnosis Rehab · Active Duty Military Medicare Rehab · Active Duty Military Outpatient Rehab · Active Duty Military PTSD Rehab · Active Duty Military Rehab · Active Duty Military Suboxone · Active Duty Military Telehealth · Active Duty Military Trauma Rehab · Active Duty Military TRICARE Rehab · Adult Rehab · +75 more

Support services

Case Management · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Peer Support · Practical Support · Recovery Coaching · Recovery Support Services · Suicide Prevention Services · +4 more

Languages

Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab · Spanish Speaking Rehab

Insurance accepted

Gouverneur Hospital – Gouverneur

77 West Barney Street, Gouverneur, NY, 13642

2.4★★☆☆☆40

State licensed

DetoxOutpatientTelehealth+2

Accepts InsuranceAccepts MedicaidAccepts Medicare+6

Co-occurring DisordersMATTrauma-informed+9

Deaf and HoH

The provider's premises are at 77 West Barney Street, Gouverneur, New York. The services listed are intensive outpatient and outpatient care. The listing covers both substance use and mental health treatment. This is outpatient provision, so daily life continues around the appointments. Telehealth is listed, so some contact can happen without traveling in. The record notes group sessions alongside individual work. SAMHSA holds the federal registration and the New York State Office of Addiction Services…

6.0 miEmeryville Falls24 miOgdensburg International AirportServes4 towns

Substances treated

Levels of care

Therapies

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · Psychiatric Walk-In Clinic · PTSD Treatment · +3 more

Groups served

Adult Rehab · Couples Rehab · Court Ordered Rehab · DUI and DWI Programs · Men's Dual Diagnosis Rehab · Men's Medicare Rehab · Men's Outpatient Rehab · Men's Rehab · Men's Telehealth · Men's Trauma Rehab · +33 more

Support services

Peer Support · Recovery Support Services

Languages

Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab

Insurance accepted

Clifton Springs Hospital and Clinic – Canandaigua

35 North Street, Canandaigua, NY, 14424

3.0★★★☆☆2

SAMHSA listed

OutpatientTelehealth

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersSeniorsYoung adults+3

Clifton Springs Hospital and Clinic is based at 35 North Street in Canandaigua, New York. On record, this provider offers intensive outpatient and outpatient care. Substance use is treated alongside mental health rather than separately. This is outpatient provision, so daily life continues around the appointments. Remote appointments appear on the record, useful where travel is difficult. Both federal registration through SAMHSA and New York State Office of Addiction Services and Supports licensing are on…

15 miHoneoye Falls24 miFrederick Douglass Greater Rochester International AirportServes10 towns

Substances treated

Adderall Rehab · Concerta Rehab · Dexedrine Rehab · Nicotine and Tobacco Treatment · Nicotine Replacement Therapy · Prescription Stimulant Rehab · Ritalin Rehab · Smoking Cessation Counseling · Smoking Cessation Medication · Stimulant Rehab · +2 more

Levels of care

Evening Treatment · Non-12-Step Rehab · Online Rehab and Telehealth · Outpatient Rehab · Weekend Rehab

Therapies

Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Group Therapy · Individual Therapy · Integrated Dual Disorder Treatment

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Illness Management and Recovery · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychosocial Rehabilitation

Groups served

Adult Rehab · Court Ordered Rehab · Senior Outpatient Rehab · Senior Rehab · Senior Telehealth · Young Adult Rehab

Support services

Chronic Illness Management · Health and Wellness Support · Suicide Prevention Services

Insurance accepted

Unity Hospital of Rochester – Rochester (2000 Winton Road South)

2000 Winton Road South, Rochester, NY, 14618

2.8★★★☆☆~~420~~

State licensed

DetoxOutpatientTelehealth+1

Accepts InsuranceAccepts MedicaidAccepts Medicare+5

Co-occurring DisordersMATTrauma-informed+8

Deaf and HoH

Unity Hospital of Rochester is based at 2000 Winton Road South in Rochester, New York. Provision here is recorded as intensive outpatient and outpatient care. Medication-assisted treatment is recorded, combining prescribing with regular clinical contact. This is outpatient provision, so daily life continues around the appointments. Remote appointments appear on the record, useful where travel is difficult. Support for veterans appears on the record. Both federal registration through SAMHSA and New York State Office of…

2.2 miCobbs Hill5.0 miFrederick Douglass Greater Rochester International AirportServes7 towns

Substances treated

Levels of care

Therapies

Mental health

Groups served

Support services

Languages

Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab

Insurance accepted

Clifton Springs Hospital and Clinic – Clifton Springs

2 Coulter Road, Clifton Springs, NY, 14432

3.4★★★☆☆~~142~~

State licensed

DetoxOutpatientTelehealth+1

Accepts InsuranceAccepts MedicaidAccepts Medicare+4

Co-occurring DisordersMATSeniors+6

Deaf and HoH

The address on record is 2 Coulter Road in Clifton Springs, New York. The services listed are intensive outpatient and outpatient care. Both addiction and mental health conditions appear on the record. Treatment is delivered without an overnight stay, around existing commitments. Video appointments are recorded as an option here. Registration is federal, through SAMHSA; licensing is held with the New York State Office of Addiction Services and Supports.

21 miClyde River29 miFrederick Douglass Greater Rochester International AirportServes9 towns

Substances treated

Levels of care

Aftercare and Continuing Care · Clonidine and Lofexidine Detox · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Non-12-Step Rehab · Online Rehab and Telehealth · Outpatient MAT Clinic · Outpatient Rehab · +4 more

Therapies

Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Group Therapy · Individual Therapy · +4 more

Mental health

Co-Occurring Mental Health Conditions · Crisis Intervention · Depression and Anxiety · Illness Management and Recovery · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation

Groups served

Adult Rehab · Court Ordered Rehab · Men's Dual Diagnosis Rehab · Men's Medicare Rehab · Men's Outpatient Rehab · Men's Rehab · Men's Telehealth · Men's TRICARE Rehab · Senior MAT · Senior Outpatient Rehab · +10 more

Support services

Chronic Illness Management · Health and Wellness Support · Suicide Prevention Services

Languages

Deaf and Hard of Hearing Dual Diagnosis Rehab · Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab

Insurance accepted

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Common questions

Answered from what is listed here.

What is ElderONE?

ElderONE is a Program of All-Inclusive Care for the Elderly, or PACE, affiliated with Rochester Regional Health. It serves adults 55 and older in Monroe, Ontario and Wayne counties, New York, who need nursing home level care but still live at home, acting as both health plan and care provider.

An interdisciplinary team of geriatricians, registered nurses, licensed social workers, therapists, dietitians, aides and chaplains builds each participant's care plan and meets daily to review it.

Medicare Rehabhttps://rehabseekers.com/insurance-accepted/medicare/

Is ElderONE insurance?

No, not in the conventional sense. ElderONE is a PACE organization paid a fixed monthly amount by Medicare and Medicaid for each participant, and it both pays for and delivers the care. Participants agree to receive all Medicare and Medicaid benefits exclusively through ElderONE.

New York lists it as a PACE plan in the state Managed Long Term Care directory, serving ages 55 and older with Medicaid, Medicare or private pay.

Medicaid Rehabhttps://rehabseekers.com/insurance-accepted/medicaid/

Does ElderONE cover rehab?

Yes, when the interdisciplinary care team approves it. ElderONE covers all Medicare and Medicaid covered services plus anything else the team finds necessary, and its provider network directory includes categories for Addiction Medicine, Inpatient Chemical Dependency and Outpatient Chemical Dependency.

The enrollment agreement does not itemize detox, residential, PHP or IOP, so the level of care comes from the care plan rather than a published benefit list.

Medicare Rehabhttps://rehabseekers.com/insurance-accepted/medicare/

Does ElderONE cover drug and alcohol detox?

Yes, through the contracted network, although detox is not named as a separate benefit. Inpatient hospital care is covered, and the provider directory includes an Inpatient Chemical Dependency category with sites such as Unity Chemical Dependency in Rochester. Non-emergency admissions need interdisciplinary team approval first.

Rochester Regional Health, the parent system, runs inpatient detoxification, outpatient detoxification and integrated medication-assisted treatment; its scheduling number is (585) 922-9900.

Medical Detoxhttps://rehabseekers.com/programs/detox-centers/medical-detox/

Does ElderONE cover inpatient rehab?

Yes, inpatient hospital care is covered, including medical, surgical, intensive and coronary care, and nursing home care is covered when it is needed. Inpatient chemical dependency providers appear in the network directory, though specific residential rehab terms are not published.

Federal PACE rules set aside Medicare and Medicaid limits on amount, duration and scope, so length of stay follows the care plan rather than a benefit cap.

Inpatient Rehabhttps://rehabseekers.com/programs/inpatient/

Does ElderONE cover mental health counseling?

Yes. Outpatient services include general medical, psychiatric and specialist care, and ElderONE social workers provide individual and family counseling after assessing social, medical, psychosocial and spiritual needs. The network adds psychiatry, psychology, outpatient and inpatient mental health, ACT and PROS programs.

Network clinics include Genesee Mental Health Center at 224 Alexander Street, Rochester, (585) 922-7770, and Rochester Mental Health Center on East Ridge Road, (585) 922-2500.

Medicare Mental Health Treatmenthttps://rehabseekers.com/insurance-accepted/medicare/medicare-mental-health-treatment/

Does ElderONE cover Suboxone or methadone?

Yes, where a network provider orders it. ElderONE supplies all prescription coverage, acting as the participant's Medicare Part D plan, and covers prescription and over-the-counter medications obtained through a network pharmacy. No public formulary or drug-specific policy for buprenorphine, naltrexone or methadone has been published.

Joining a separate Medicare drug plan while in PACE ends enrollment, so medications should stay with the ElderONE network pharmacies.

Medication Assisted Treatment (MAT)https://rehabseekers.com/medications/mat/

Does ElderONE need prior authorization for rehab?

Yes. Every non-emergency service must be approved by the interdisciplinary care team as part of the care plan, and the team has to jointly agree before any service is added, changed or stopped. That team approval replaces insurer-style prior authorization.

The 24-hour on-call line is (585) 922-2800, toll free 1-855-457-4636; urgent care counts as approved if the program does not respond within one hour.

Intensive Outpatient Program (IOP)https://rehabseekers.com/programs/outpatient/iop/

Does ElderONE cover out-of-network rehab?

No. Participants must receive all health care from providers in the ElderONE network, and anyone using unauthorized or out-of-network services can be held fully and personally liable for the cost. The single exception is emergency care, which needs no prior approval.

Out-of-area emergency costs are reimbursed on a written receipt. Notify ElderONE as soon as possible, and within 48 hours if a hospital admission happens.

Self Pay Rehabhttps://rehabseekers.com/payment/self-pay/

How much does rehab cost with ElderONE?

There are no copayments, deductibles or coinsurance for approved services; the enrollment agreement states there are no hidden costs and no co-payments, and federal PACE rules bar cost sharing. Participants with both Medicare and Medicaid pay no monthly premium for the long-term care portion.

A Medicaid spend-down set by the local social services department may apply, and Medicare-only or private pay participants pay a monthly premium plus a drug premium.

Medicaid Rehabhttps://rehabseekers.com/insurance-accepted/medicaid/

Who is eligible for ElderONE?

Eligibility means being 55 or older, living in Monroe, Wayne or Ontario County, being assessed as needing nursing home level care, needing at least one community-based long-term service for more than 120 days, and being able to live safely in the community.

Applicants should have Medicaid or be Medicaid eligible unless paying privately, and anyone Medicare-eligible needs Parts A and B. An in-home assessment is required.

Medicare Rehabhttps://rehabseekers.com/insurance-accepted/medicare/

Does ElderONE take Medicare and Medicaid?

Yes. Funding comes from Medicare and Medicaid, and enrollment replaces Original Medicare or a Medicare Advantage plan: every Medicare benefit, including Part D prescription coverage, arrives through ElderONE. A private pay option exists for someone with neither program.

You cannot stay in another HMO, Managed Long Term Care plan or Home and Community Based waiver while enrolled, and disenrollment is allowed at any time.

Medicaid Rehabhttps://rehabseekers.com/insurance-accepted/medicaid/

What states does ElderONE operate in?

New York only. ElderONE serves Monroe, Ontario and Wayne counties in the Rochester area and describes itself as the only PACE program serving greater Rochester. It does not operate in California, Texas, Florida, Arizona, Tennessee or any other state.

PACE centers are Hudson, Emerson and North Park in Rochester and Silver Hill in Newark, open Monday to Friday, 8:30 am to 5:00 pm.

Is ElderONE the same as Independent Living for Seniors?

Yes. Independent Living for Seniors Inc is the nonprofit legal entity behind the ElderONE name, and New York Department of Health and CMS records still use it. The organization joined the PACE demonstration in 1992 and became a permanent PACE provider on November 3, 2003.

ElderONE is an affiliate of Rochester Regional Health, the nonprofit system formed in 2014 from Rochester General Health System and Unity Health System.

How do I find a rehab that takes ElderONE?

Start with the care team, since ElderONE must arrange and approve every service, then review the Provider Network Directory, organized by Monroe County and Ontario/Wayne County. Contracted chemical dependency sites are mainly Rochester Regional Health and Unity clinics in the Rochester area.

Enrollment questions go to (585) 922-2831 or toll free 855-457-4636, TTY 800-662-1220; free interpreters are reachable at 1-888-804-4414.

Outpatient Rehabhttps://rehabseekers.com/programs/outpatient/

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ElderONE is a Program of All-Inclusive Care for the Elderly, a PACE plan affiliated with Rochester Regional Health that serves adults 55 and older in Monroe, Ontario and Wayne counties, New York. It is not a conventional insurer: it pays for care and delivers much of it, and a participant agrees to receive all Medicare and Medicaid benefits through ElderONE alone.

That structure changes the question for anyone looking at addiction treatment. There is no benefit booklet listing days of residential care and no copay to budget for. Instead an interdisciplinary team of geriatricians, nurses, social workers, therapists and aides builds a care plan, meets daily, and authorizes each service. Care outside that plan and outside the contracted network is billable to the participant, except in an emergency.

This guide sets out what ElderONE covers across the levels of addiction care, how care team authorization works in place of insurer-style prior authorization, what a participant pays under each of the three payment groups, how Medicare drug coverage runs through the plan, and how to settle network status before anyone discusses an admission date.

Does ElderONE Cover Drug and Alcohol Rehab?

Yes, within the PACE rule that the plan covers all Medicare-covered services, all New York Medicaid state plan services, and anything further the interdisciplinary team finds necessary. The enrollment agreement does not itemize detox, residential treatment, PHP or IOP as separate benefits, so coverage rests on that rule and on the team’s authorization.

The ElderONE provider network directory carries categories for Addiction Medicine, Inpatient Chemical Dependency and Outpatient Chemical Dependency, which is the clearest published sign that substance use treatment sits inside the contracted network. Those sites are largely Rochester Regional Health programs, including Unity Chemical Dependency clinics on Long Pond Road and the Rochester Mental Health Center OASAS program on East Ridge Road. Federal PACE rules also state that Medicaid and Medicare limits on amount, duration and scope do not apply to a PACE participant, so length of care follows the care plan rather than a day count.

What Does ElderONE Pay For at Each Level of Care?

Level of care is set by the team rather than chosen in advance, written into the care plan, and reassessed at least every six months and whenever the participant’s condition changes. The three levels below are the ones most relevant to alcohol and drug treatment in later life.

Medical Detox

Inpatient hospital care is covered, including medical, surgical, intensive care and coronary care, and the network lists inpatient chemical dependency providers. A planned medical detox admission is arranged by the team in advance. Alcohol and benzodiazepine withdrawal can cause seizures, and acute withdrawal is an emergency department matter; emergency care needs no prior authorization, with notice to ElderONE as soon as possible and within 48 hours of a hospital admission.

Residential and Inpatient

Hospital inpatient care and nursing home care are both covered when needed, and ElderONE’s network hospitals are Rochester General, The Unity Hospital of Rochester, Clifton Springs Hospital & Clinic and Newark-Wayne Community Hospital. Terms for freestanding residential rehab are not published, so the question for the team is which inpatient chemical dependency site it contracts with and what the expected length of stay looks like.

PHP, IOP and Outpatient

Outpatient health services under the enrollment agreement include general medical, psychiatric and specialist care, and ElderONE social workers provide individual and family counseling alongside the clinical plan. Outpatient chemical dependency clinics and addiction medicine clinicians sit in the network, so step-down from a hospital stay to an intensive outpatient program or a weekly clinic visit is arranged through the team rather than booked directly.

Does ElderONE Need Prior Authorization for Rehab?

In effect, yes. Every non-emergency service has to be authorized by the interdisciplinary care team, which must jointly agree to add, change or stop anything in the care plan. There is no separate utilization review department and no outside behavioral health manager; the team that treats the participant is the team that authorizes the treatment.

No named medical necessity criteria such as ASAM, InterQual, MCG or LOCUS are published. Federal PACE rules require the team to weigh the participant’s medical, physical, emotional and social needs against current clinical practice guidelines. Urgent and post-stabilization care runs through the 24-hour on-call provider on (585) 922-2800, and federal rules treat such care as authorized if the organization does not respond within one hour.

Going outside the network. ElderONE has no out-of-network benefit apart from emergency care, and a participant may be fully and personally liable for unauthorized or out-of-network services. Out-of-area emergency costs are reimbursed against a written receipt, so keep the paperwork and call the on-call line.

Who Can Enroll in ElderONE?

Enrollment is limited to adults 55 and older living in Monroe, Wayne or Ontario County who are assessed as needing nursing home level care, need at least one community-based long-term service for more than 120 days, and can live safely at home. Anyone Medicare-eligible needs Parts A and B, and applicants are asked to hold New York Medicaid or be Medicaid eligible unless paying privately. Assessment is either a direct evaluation by ElderONE or one by the New York Independent Assessor, operated by Maximus Health Services, which reviews every direct assessment. Enrollment in another HMO, Managed Long Term Care plan or Home and Community Based waiver has to end first, and joining a separate Medicare drug plan later ends PACE enrollment.

How Much Does Rehab Cost With ElderONE?

Nothing at the point of care. The enrollment agreement states there are no hidden costs and no co-payments, and PACE rules exclude deductibles, copayments, coinsurance and other cost sharing for authorized services. The cost question is therefore about monthly premiums, which depend on which of three payment groups the participant falls into.

With both Medicare and Medicaid there is no premium and no Part D premium, though the local department of social services determines any cost share and a Medicaid spend-down may apply. With Medicare only, a monthly premium based on the Medicaid capitation amount and average share of cost is charged, plus a Part D premium. Private pay carries a monthly premium plus a prescription drug premium. No dollar figures are published for either premium, so ask enrollment on (585) 922-2831. Non-payment after a 30-day grace period can lead to involuntary disenrollment.

Typical US market rates before insurance
Level of care	Monthly	Daily
Medical detox (7–14 days)	$1,500 – $5,200 per week	$215 – $745
Residential inpatient	$6,200 – $26,000	$205 – $865
PHP	$7,200 – $14,000	$240 – $465
IOP	$2,700 – $9,200	$90 – $305
Outpatient	$1,300 – $5,200	$45 – $175

Those are the sums a program bills without coverage. For a PACE participant the figure that matters is not the sticker price but whether the service sits in the care plan and the network, because care arranged outside both can land on the participant in full.

Does ElderONE Cover Suboxone, Methadone and Other Addiction Medication?

Prescription and over-the-counter medications are covered when ordered by a network provider and obtained through a network pharmacy, and ElderONE supplies the participant’s creditable Medicare Part D coverage. No public formulary or drug-specific policy for medication-assisted treatment was found, so the specific drug question belongs to the care team and the prescribing clinician.

Where the Prescription Is Filled

Network pharmacies named in the directory are Buffalo Pharmacies Institutional in Williamsville, Healthdirect Institutional Pharmacy Services, Lifetime Pharmacy and Saint Ann’s Home Pharmacy. Because all drug coverage runs through the plan, signing up for a standalone Medicare drug plan ends PACE enrollment altogether. Ask whether buprenorphine or naltrexone is on the plan’s drug list before a hospital discharge rather than at the pharmacy counter.

What to Ask the Care Team

Ask which addiction medicine clinician in the network would prescribe, how a daily methadone clinic visit would be arranged and transported, and whether Rochester Regional Health’s integrated medication-assisted treatment service is the route the team would use. That service belongs to the health system’s own list rather than being a published ElderONE benefit, which is exactly why the question is worth asking in writing.

Which Rehab Centers in New York Are In-Network With ElderONE?

A program is in-network when it holds a contract with ElderONE and appears in the Provider Network Directory, which is organized by Monroe County and by Ontario and Wayne counties and lists chemical dependency and behavioral health categories. Network status is settled by that directory and by the care team, since the plan has no out-of-network benefit beyond emergencies.

New York has 1,100+ listed treatment programs, 1,061 of which accept Medicaid, concentrated in New York, NY, Bronx, NY, Brooklyn, NY and Buffalo, NY. Programs that accept ElderONE are gathered on the ElderONE page, alongside the wider list of rehabs in New York. Each listing shows the payments the program says it accepts, its licensing and accreditation, and how far it sits from the nearest airport, which is enough to shortlist before the call that settles contract status. Counts updated October 2026.

How Do I Find a Rehab That Takes ElderONE?

Start with the care team, not the admissions line. For an enrolled participant, the team arranges the referral to a contracted chemical dependency provider; for an applicant, enrollment comes first on (585) 922-2831, toll free 855-457-4636, TTY 800-662-1220, with the 24-hour on-call line at (585) 922-2800 and free interpreters on 1-888-804-4414.

Enrollment runs from referral to evaluation, an in-home assessment by a nurse, social worker and primary care provider, then an enrollment meeting and a signed agreement. Anyone under 55, or living outside Monroe, Ontario and Wayne counties, is not eligible and would use standard Medicare or Medicaid coverage instead. Day services run at four PACE centers: Hudson and Emerson and North Park in Rochester, and Silver Hill in Newark, open Monday to Friday, 8:30 am to 5:00 pm.

Is ElderONE the Same as Independent Living for Seniors or Rochester Regional Health?

ElderONE is the brand; Independent Living for Seniors Inc is the nonprofit legal entity behind it, and New York Department of Health and federal records still use that older name. The organization joined the PACE demonstration in 1992 and was designated a permanent PACE provider by CMS and the state on November 3, 2003, and it is an affiliate of Rochester Regional Health, the nonprofit system formed in 2014 from Rochester General Health System and Unity Health System. It is not a Medicare Advantage plan, and it is unrelated to similarly named plans elsewhere in New York.

Before calling a program: know whether the participant is already enrolled, ask the care team to name the contracted chemical dependency provider it would use, and get the authorization in the care plan before any admission date is set. Those three answers settle both the route and the bill.

References and Citations

ElderONE — participant enrollment agreement (09.2023v2), Provider Network Directory and program service pages.
New York State Department of Health — Managed Long Term Care Plan Directory, PACE model entries and PACE eligibility guidance.
Centers for Medicare & Medicaid Services — PACE program rules on covered services, cost sharing, care planning and urgent care response.
Rochester Regional Health — ElderONE affiliate information and behavioral health and chemical dependency service listings.
RehabSeekers directory listings and market rate research, United States, 2026. Ranges are indicative and vary by program, length of stay and coverage.