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eternal Health

Rehabs That Take eternal Health

Eternal Health is a health plan name listed by treatment centers in Massachusetts, and its plans can cover drug and alcohol treatment depending on plan, network and level of care.

Massachusetts centers on this page name Eternal Health on their own websites. Coverage for detox, residential care, outpatient programs and counseling can differ from one plan to another, and some services need prior authorization before they begin. The simplest step is to call ahead. Before admission, contact both the facility and Eternal Health with your member ID to check benefits, network status, any referral needed and what you may pay out of pocket.

Rehab Centers Near You

Drug and Alcohol Rehab Centers That Accept eternal Health

SSTAR – South Main Street, Fall River

1010 South Main Street, Fall River, Massachusetts, 2724

2.8★★★☆☆5

Joint Commission

OutpatientTelehealthAftercare

Accepts InsuranceAccepts MedicaidAccepts Medicare+6

MATMethadoneYoung adults+4

Spanish spokenDeaf and HoHPortuguese spoken

SSTAR is at 1010 South Main Street in Fall River. North Westport is 3.0 miles away and Tiverton 3.1. Tiverton, Somerset, Ocean Grove and Fall River all sit within 9 miles of the door. Bristol County is the relevant authority here, which matters for anyone using state-funded care. Treatment here covers intensive outpatient and outpatient care. SAMHSA holds the federal registration; the Massachusetts Bureau of Substance Addiction Services the state license. Medication for opioid dependence…

1.0 miQuiquechan River11 miNew Bedford Regional AirportServes29 towns

Substances treated

Adderall Rehab · Carfentanil Rehab · Codeine Rehab · Concerta Rehab · Dexedrine Rehab · Fentanyl Patch (Duragesic) Rehab · Fentanyl Rehab · Heroin Rehab · Hydrocodone Rehab · Hydromorphone (Dilaudid) Rehab · +27 more

Levels of care

Aftercare and Continuing Care · Continuing Care · Discharge Planning · Evening Treatment · Online Rehab and Telehealth · Outpatient MAT Clinic · Outpatient Rehab · Overdose Prevention Education · Post-Treatment Follow-Up · Recurrence Prevention · +1 more

Therapies

12 Step Rehab · Addiction Counseling · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Couples Counseling · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · +2 more

Mental health

Psychosocial Rehabilitation · Social Skills Training

Groups served

Adult Rehab · Couples Rehab · Hepatitis Support Services · HIV and Hepatitis Care · HIV Support Services · Men's Medicare Rehab · Men's Outpatient Rehab · Men's Rehab · Men's Telehealth · Men's TRICARE Rehab · +6 more

Support services

Case Management · Community Outreach · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Peer Support · Practical Support · Recovery Support Services · Suicide Prevention Services

Languages

Deaf and Hard of Hearing MAT · Deaf and Hard of Hearing Rehab · Portuguese Speaking Rehab · Spanish Speaking Rehab

Insurance accepted

Aetna · BCBS (Blue Cross Blue Shield) · Carelon Behavioral Health · Cigna Healthcare · eternal Health · Harvard Pilgrim Health Care · Health Plans Inc · Mashpee Wampanoag · Mass General Brigham Health Plan · Medicaid · +10 more

UMass Memorial Medical Center – Worcester

26 Queen Street, Worcester, Massachusetts, 1610

3.4★★★☆☆~~433~~

Federally certified

InpatientTelehealth

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersTrauma-informedSeniors+4

UMass Memorial Medical Center operates from 26 Queen Street in Worcester, close enough to Spencer and Northborough to serve both. The practical catchment runs to roughly 10 miles, covering Spencer, Northborough, Westborough and Oxford. Worcester is in Worcester County, which shapes which public funding routes apply. What is available here is residential treatment. The facility treats addiction and mental health together. Remote appointments are offered, useful for anyone without transport. SAMHSA holds the federal registration;…

1.8 miMiddle River3.2 miWorcester Regional AirportServes23 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

Inpatient Rehab · Non-12-Step Rehab · Online Rehab and Telehealth

Therapies

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

Mental health

Co-Occurring Mental Health Conditions · Crisis Intervention · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Illness Management and Recovery · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychosocial Rehabilitation · +3 more

Groups served

Adult Rehab · Court Ordered Rehab · Senior Rehab · Senior Telehealth · Trauma Informed Rehab · Trauma Survivor Programs · Young Adult Rehab

Support services

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

Insurance accepted

Aetna · BCBS (Blue Cross Blue Shield) · Cigna Healthcare · ConnectiCare · eternal Health · Harvard Pilgrim Health Care · Health New England · Mass Advantage · Mass General Brigham Health Plan · Medicaid · +10 more

SSTAR – Stanley Street, Fall River

386 Stanley Street, Fall River, Massachusetts, 2720

2.8★★★☆☆43

Joint Commission

DetoxHospital detoxInpatient+4

Accepts InsuranceAccepts MedicaidAccepts Medicare+4

Co-occurring DisordersMATTrauma-informed+6

Spanish spokenDeaf and HoHCreole spoken+1

SSTAR is at 386 Stanley Street in Fall River. Somerset is 2.2 miles away and North Westport 3.2. Within around 10 miles that includes North Westport, Ocean Grove, Tiverton and Smith Mills. Bristol County is the relevant authority here, which matters for anyone using state-funded care. Care offered spans detox, residential treatment and intensive outpatient. Approved medication runs alongside counseling, which is what medication-assisted treatment means in practice. Co-occurring conditions are handled concurrently rather than…

1.5 miQuiquechan River9.6 miNew Bedford Regional AirportServes28 towns

Substances treated

Adderall Rehab · Alcohol Detox · Alcohol MAT Friendly · Alcohol Medication Treatment · Alcohol Only Rehab · Alcohol Rehab · Ativan (Lorazepam) Rehab · Beer Addiction Treatment · Benzodiazepine Rehab · Binge Drinking Treatment · +50 more

Levels of care

Aftercare and Continuing Care · Alcohol Detox Program · Ativan (Lorazepam) Detox Program · Benzodiazepine Detox Program · Buprenorphine-Assisted Detox · Carfentanil Detox Program · Clonidine and Lofexidine Detox · Cocaine Detox Program · Codeine Detox Program · Continuing Care · +41 more

Therapies

12 Step Rehab · Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Contingency Management · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · +7 more

Mental health

Co-Occurring Mental Health Conditions · Crisis Intervention · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Crisis Services · Mental Health Treatment · Psychiatric Medication Management · +5 more

Groups served

Adult Rehab · Court Ordered Detox · Court Ordered Dual Diagnosis Rehab · Court Ordered MAT · Court Ordered Medicare Rehab · Court Ordered Outpatient Rehab · Court Ordered Rehab · Court Referral Accepted · DUI and DWI Programs · Early HIV Intervention · +33 more

Support services

Case Management · Community Outreach · Health and Wellness Support · Health Education · Hepatitis C Treatment · HIV Treatment · Housing and Employment Support · Housing Assistance · Intervention Services · Nutrition and Fitness Counseling · +9 more

Languages

Creole Speaking Rehab · 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 · Portuguese Speaking Rehab · Spanish Speaking Rehab

Insurance accepted

UMASS Harrington Hospital – Webster

340 Thompson Road, Webster, Massachusetts, 1570

2.5★★★☆☆~~166~~

Joint Commission

PHPIOPOutpatient+2

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersMATSeniors+7

Spanish spokenDeaf and HoH

UMASS Harrington Hospital is located at 340 Thompson Road in Webster, within 3.9 miles of North Grosvenor Dale and Quinebaug. North Grosvenor Dale, Quinebaug, Mechanicsville and Oxford all sit within 7 miles of the door. Worcester County is the relevant authority here, which matters for anyone using state-funded care. Services run to partial hospitalization, intensive outpatient and outpatient care. Buprenorphine, methadone or naltrexone can be prescribed alongside therapy. Co-occurring conditions are handled concurrently rather than…

6.6 miSouth Fork Little River17 miWorcester Regional AirportServes21 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 · Evening Treatment · Intensive Outpatient Program (IOP) · Non-12-Step Rehab · Online Rehab and Telehealth · Outpatient MAT Clinic · Outpatient Rehab · Overdose Prevention Education · Partial Hospitalization Program (PHP) · Recurrence Prevention · +1 more

Therapies

Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Couples Counseling · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Family Therapy · Group Therapy · +3 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 · Serious Mental Illness Treatment

Groups served

Adult Rehab · Couples Rehab · Court Ordered Dual Diagnosis Rehab · Court Ordered MAT · Court Ordered Medicare Rehab · Court Ordered Outpatient Rehab · Court Ordered Rehab · Court Referral Accepted · DUI and DWI Programs · Hepatitis Support Services · +22 more

Support services

Case Management · Health and Wellness Support · Health Education · Recovery Support Services · Suicide Prevention Services

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

UMASS Memorial Medical Center Inc – Worcester

55 Lake Avenue North, Worcester, Massachusetts, 1655

2.7★★★☆☆~~508~~

Federally certified

InpatientTelehealth

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersTrauma-informedSeniors+4

55 Lake Avenue North in Worcester puts UMASS Memorial Medical Center Inc inside a short drive of Northborough, Westborough and the towns around them. Anyone within about 11 miles can reach it without a major journey, which takes in Northborough, Westborough, Upton and Clinton. Worcester County is the relevant authority here, which matters for anyone using state-funded care. UMASS Memorial Medical Center Inc delivers residential treatment. The facility treats addiction and mental health together. Some…

3.2 miMiddle River5.8 miWorcester Regional AirportServes23 towns

Substances treated

Levels of care

Inpatient Rehab · Non-12-Step Rehab · Online Rehab and Telehealth

Therapies

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

Mental health

Groups served

Adult Rehab · Court Ordered Rehab · Senior Rehab · Senior Telehealth · Trauma Informed Rehab · Trauma Survivor Programs · Young Adult Rehab

Support services

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

Insurance accepted

Umass Harrington Healthcare at Webster – Webster

340 Thompson Road, Webster, Massachusetts, 1570

2.5★★★☆☆~~166~~

Joint Commission

DetoxOutpatientTelehealth+1

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

MATTrauma-informedVeterans+8

Deaf and HoH

Umass Harrington Healthcare at Webster is located at 340 Thompson Road in Webster, within 4.0 miles of North Grosvenor Dale and Quinebaug. Within around 7 miles that includes North Grosvenor Dale, Quinebaug, Mechanicsville and Oxford. Webster is in Worcester County, which shapes which public funding routes apply. Umass Harrington Healthcare at Webster offers intensive outpatient and outpatient care. Medication for opioid dependence is available here alongside talking treatment. Co-occurring conditions are handled concurrently rather than…

6.6 miSouth Fork Little River17 miWorcester Regional AirportServes21 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

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 · +5 more

Therapies

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

Mental health

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

Groups served

Adult Rehab · Couples Rehab · Court Ordered Rehab · Early HIV Intervention · Hepatitis Support Services · HIV and Hepatitis Care · HIV Support Services · Men's Dual Diagnosis Rehab · Men's Medicare Rehab · Men's Outpatient Rehab · +18 more

Support services

Case Management · Community Outreach · Health and Wellness Support · Health Education · Housing and Employment Support · Housing Assistance · Intensive Case Management · Intervention Services · Practical Support · Recovery Support Services · +3 more

Languages

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

Insurance accepted

UMASS Harrington Hospital – Southbridge

29 Pine Street, Southbridge, Massachusetts, 1550

3.2★★★☆☆9

SAMHSA listed

PHPOutpatientTelehealth

Accepts InsuranceAccepts MedicaidAccepts Medicare+3

Co-occurring DisordersSeniorsYoung adults+4

Spanish spoken

UMASS Harrington Hospital operates from 29 Pine Street in Southbridge, close enough to Sturbridge and Fiskdale to serve both. Anyone within about 8 miles can reach it without a major journey, which takes in Fiskdale, Holland, Quinebaug and Lake Bungee. The facility falls within Worcester County for the purposes of state and county-funded treatment. What is available here is partial hospitalization, intensive outpatient and outpatient care. Licensing sits with the Massachusetts Bureau of Substance Addiction…

8.4 miEast Brookfield River15 miWorcester Regional AirportServes14 towns

Substances treated

Levels of care

Evening Treatment · Non-12-Step Rehab · Online Rehab and Telehealth · Outpatient Rehab · Partial Hospitalization Program (PHP) · Weekend Rehab

Therapies

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

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Family Education Programs · Mental Health Conditions · Mental Health Treatment · Psychosocial Rehabilitation · Serious Mental Illness Treatment

Groups served

Adult Rehab · Couples Rehab · Court Ordered Dual Diagnosis Rehab · Court Ordered Medicare Rehab · Court Ordered Outpatient Rehab · Court Ordered Rehab · Court Referral Accepted · Senior Outpatient Rehab · Senior PHP · Senior Rehab · +2 more

Support services

Case Management · Recovery Support Services

Languages

Spanish Speaking Rehab

Insurance accepted

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Common questions

Answered from what is listed here.

What is eternalHealth?

eternalHealth is a small, independent Medicare Advantage insurer based in Boston that sells HMO, HMO-POS and PPO plans, all with $0 monthly premiums. It launched in December 2021 as the first new Medicare Advantage plan approved in Massachusetts since 2013 and now covers roughly 10,000 members.

Founded in 2019 by Pooja Ika and chaired by former Apple CEO John Sculley, it describes itself as women-owned and sells no employer, marketplace or Medicaid coverage.

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

What states does eternalHealth operate in?

Massachusetts and Arizona only. In Massachusetts the plans serve Bristol, Middlesex, Norfolk, Plymouth, Suffolk and Worcester counties. In Arizona they serve Maricopa, Pima, Pinal and Graham counties, with Pima County added for coverage starting January 1, 2025. No other states are served.

Massachusetts plans are Forever (HMO), Freedom (PPO) and Give Back (PPO). Arizona has Horizon, Harmony, Catalina and Valor Give Back for 2027.

Does eternalHealth cover rehab?

Yes, medically necessary substance use treatment is covered under Medicare rules. Inpatient psychiatric hospital care and Opioid Treatment Program services appear in every plan's Summary of Benefits, and Residential Substance Abuse Treatment Facility, Partial Hospitalization and Community Mental Health Center settings appear on the prior authorization list.

Cost sharing and authorization rules differ by plan, so call Member Services at 1-800-680-4568 (TTY 711) with your member ID before admission.

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

Does eternalHealth cover inpatient rehab?

Yes, inpatient psychiatric hospital stays are covered with prior authorization except in emergencies. On the 2027 plans a member pays $350 a day for days 1 to 6 on Forever (HMO) in Massachusetts and $225 a day for days 1 to 7 on Horizon (HMO) in Arizona, then $0 through day 90.

Freestanding psychiatric hospitals carry Medicare's 190-day lifetime limit. Valor Give Back instead uses Original Medicare cost sharing after the Part A deductible.

Medicare Inpatient Rehabhttps://rehabseekers.com/insurance-accepted/medicare/medicare-inpatient-rehab/

Does eternalHealth need prior authorization for rehab?

Yes, for facility-based care. Inpatient Psychiatric Facility, Residential Substance Abuse Treatment Facility, Psychiatric Residential Treatment Center, Partial Hospitalization and Community Mental Health Center settings all require prior authorization, except for emergency admissions. Decisions follow CMS Medicare coverage guidelines and medical necessity; no outside review criteria are named.

Requests go to eternalHealth's own utilization management team: standard fax 1-866-337-8686, expedited fax 1-866-215-4297, Provider Services 1-800-680-9255.

Residential Rehabhttps://rehabseekers.com/programs/residential/

Does eternalHealth cover therapy?

Yes, individual and group outpatient mental health therapy is covered on every plan, and the 2027 Summaries of Benefits state no visit limits. In-network copays run $15 to $30 per visit, and brief medication-monitoring visits are $0 on the Forever, Catalina and Harmony HMOs.

An annual depression screening in a primary care setting carries no cost sharing, and Valor Give Back members pay 20 percent coinsurance instead of a flat copay.

Counseling and Therapyhttps://rehabseekers.com/therapies/counseling-and-therapy/

How much does therapy cost with eternalHealth?

$15 to $30 per in-network visit on the 2027 plans: Horizon and Catalina $15, Forever $25, Harmony $30, and the Freedom and Give Back PPOs $30 in-network or $50 out-of-network. Valor Give Back charges 20 percent in-network and 50 percent out-of-network.

Annual medical out-of-pocket maximums range from $3,100 on Catalina to $6,500 in-network on the Massachusetts PPOs, which caps what you pay in a year.

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

Does eternalHealth cover online therapy?

Yes, telehealth visits are $0 per service on the HMO plans, though not every provider offers them. On the Massachusetts PPOs a telehealth visit with a primary care provider is $0 and a specialist visit is $10 in-network or $40 out-of-network.

Valor Give Back does not cover telehealth out-of-network, so check that the clinician is in the plan's network before booking a virtual visit.

Medicare Telehealthhttps://rehabseekers.com/insurance-accepted/medicare/medicare-telehealth/

Does eternalHealth cover methadone?

Yes, Opioid Treatment Program services are a listed benefit on every plan. The 2027 copays per service are $20 on Horizon and Catalina, $25 on Forever, $30 on Harmony and the two Massachusetts PPOs, and 20 percent coinsurance on Valor Give Back.

Methadone tablets sit on Tier 2 and solutions on Tier 3 of the Part D formulary, though Valor Give Back carries no Part D drug coverage.

Methadone Medication Clinichttps://rehabseekers.com/medications/mat/methadone/

Does eternalHealth cover Suboxone?

Yes, in generic form. On the formulary effective October 1, 2026, buprenorphine and buprenorphine/naloxone sublingual tablets are Tier 2 and buprenorphine/naloxone film is Tier 3, with no prior authorization listed. Brand Suboxone, Zubsolv, Sublocade and Brixadi are not on that list.

On the Forever (HMO) for 2027, Tier 2 costs $5 for a 30-day supply and Tier 3 is 23 percent coinsurance.

Medicare Suboxonehttps://rehabseekers.com/insurance-accepted/medicare/medicare-suboxone/

Does eternalHealth cover Vivitrol?

Yes, the Vivitrol 380 mg injection sits on Tier 5, the specialty tier, of the formulary effective October 1, 2026, with no prior authorization listed. Naltrexone 50 mg tablets are Tier 2, disulfiram is Tier 3 and acamprosate is Tier 4.

Tier 5 drugs cost 30 percent coinsurance on the Forever (HMO) for 2027, and the Valor Give Back plan has no Part D drug coverage at all.

Vivitrol Shothttps://rehabseekers.com/medications/mat/naltrexone/vivitrol-shot/

Does eternalHealth cover out-of-network rehab?

No, not on the HMO plans. HMO members must use network providers and a network primary care provider who gives referrals, and care outside the network is paid only for emergencies, urgent care out of the area, out-of-area dialysis, and services unavailable in network with prior authorization.

The Massachusetts PPOs do pay out-of-network at higher cost sharing: inpatient psychiatric care is 30 percent on Freedom and 45 percent on Give Back.

Medicare Residential Rehabhttps://rehabseekers.com/insurance-accepted/medicare/medicare-residential-rehab/

Does eternalHealth have a Medicaid plan?

No. eternalHealth sells Medicare Advantage plans only, most with Part D drug coverage and one without. There is no MassHealth plan in Massachusetts, no AHCCCS plan in Arizona, no dual eligible special needs plan, and no employer or ACA marketplace product.

If you have Medicaid instead, treatment is billed through the state program and its managed care plans rather than through eternalHealth, which contracts only with Medicare.

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

How do I find a rehab that takes eternalHealth?

Start with the plan's Find a Doctor search, which keeps separate Massachusetts HMO and PPO directories and one Arizona directory, or call Member Services at 1-800-680-4568 (TTY 711). A paper directory can be mailed on request, and the local member line is 617-693-7391.

Ask the program to confirm it is in-network for your exact plan name and contract number, then have it start prior authorization before the admission date.

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

Can I still enroll in eternalHealth in Massachusetts?

No, not at the moment. CMS suspended enrollment of new beneficiaries into the Massachusetts contracts H1280 and H2694 from 11:59 p.m. on August 27, 2026, after the state's Division of Insurance placed the insurer under administrative supervision and required it to stop writing new business.

The letter addresses new enrollment only and stands until the Massachusetts order is lifted. The Arizona contract H3551 was not named in the suspension.

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eternalHealth is a Boston-based Medicare Advantage insurer selling HMO, HMO-POS and PPO plans in six Massachusetts counties and four Arizona counties. A member holding one of its cards is covered under Medicare Advantage rules, so addiction treatment is a covered benefit where it is medically necessary, delivered by a network provider and authorized in advance where the plan asks for it.

The company is independent and small. Founded in 2019 by Pooja Ika and launched on December 30, 2021 as the first new Medicare Advantage plan approved in Massachusetts since 2013, it carries around 10,000 members across the two states, with John Sculley as chairman of the board. It writes no employer, marketplace or Medicaid business. On August 12, 2026 the Massachusetts Division of Insurance placed eternalHealth under administrative supervision and required it to suspend writing new business until state financial requirements are met, and CMS suspended new enrollment into Massachusetts contracts H1280 and H2694 from 11:59 p.m. EDT on August 27, 2026. Those orders address new enrollment only.

This guide sets out which levels of addiction care the plans pay for, where prior authorization applies and who handles it, what a stay and a therapy visit cost on each 2027 plan, how medication is covered under the shared formulary, and how to work out whether a program is in the right network.

Does eternalHealth Cover Drug and Alcohol Rehab?

Yes. Every eternalHealth plan is a Medicare Advantage plan, so medically necessary substance use treatment is covered under Medicare rules. Inpatient psychiatric hospital care and Opioid Treatment Program services are itemised in each Summary of Benefits, and residential substance use, partial hospitalization and community mental health center settings sit on the plan’s prior authorization list.

What the published Summaries of Benefits do not itemise is partial hospitalization, intensive outpatient and outpatient substance use services as separate lines, so the dollar figures for those come from the Evidence of Coverage rather than the short benefit summary. Ask Member Services on 1-800-680-4568 for the benefit chart entry that applies to the level of care being arranged before anyone sets a start date.

What Does eternalHealth Pay for at Each Level of Care?

The ladder follows Medicare: hospital-based withdrawal management, inpatient psychiatric care, residential treatment, partial hospitalization, outpatient therapy and medication. The level is matched to clinical need at assessment, and the plan reviews the request against CMS Medicare coverage guidelines and medical necessity.

Medical Detox

Withdrawal management delivered in a hospital falls under the inpatient benefit, and an emergency admission does not wait for authorization. eternalHealth does not publish a separate detox line, so a planned medical detox admission is worth confirming with the plan’s utilization management team first: ask which place of service the admitting program will bill and whether that setting is on the authorization list.

Residential and Inpatient

Inpatient psychiatric stays are covered with prior authorization except in emergencies, and freestanding psychiatric hospitals carry the Medicare 190-day lifetime limit. On the 2027 plans the member share is $350 a day for days 1–6 and $0 for days 7–90 on Forever (HMO) and Freedom (PPO), $335 a day for days 1–7 on Give Back (PPO), $225 a day for days 1–7 on Horizon and Harmony, and $175 a day for days 1–5 on Catalina. Residential Substance Abuse Treatment Facility and Psychiatric Residential Treatment Center settings also require authorization, which is how Medicare residential rehab is handled.

PHP, IOP and Outpatient

Partial hospitalization and community mental health center care are listed as settings needing authorization, which indicates coverage when medically necessary. Individual or group outpatient therapy in 2027 costs $25 on Forever, $30 in-network on Freedom and Give Back, $15 on Horizon and Catalina, $30 on Harmony, and 20% coinsurance on Valor Give Back. Brief medication-monitoring visits are $0 on Forever, Catalina and Harmony, and no visit limit is stated. Whether an intensive outpatient program needs authorization is not published, so ask before the first session of PHP or IOP.

Which eternalHealth plan is on the card? Massachusetts has Forever (HMO, contract H1280), Freedom (PPO) and Give Back (PPO, both H2694) across Bristol, Middlesex, Norfolk, Plymouth, Suffolk and Worcester counties. Arizona has Horizon (HMO), Harmony (HMO, renamed from eternalHealth + Fry’s on January 1, 2027), Catalina (HMO, Pima County only) and Valor Give Back (HMO-POS) under contract H3551, across Maricopa, Pima, Pinal and Graham counties. Copays, networks and drug coverage differ by plan.

Does eternalHealth Need Prior Authorization for Rehab?

Yes for facility-based care. Prior authorization is required for inpatient psychiatric stays except emergencies, and the authorization list names Inpatient Psychiatric Facility, Partial Hospitalization, Community Mental Health Center, Residential Substance Abuse Treatment Facility and Psychiatric Residential Treatment Center as settings that must be authorized in advance.

Requests are handled in-house rather than through a behavioral health carve-out vendor. The admissions team files with eternalHealth utilization management through Provider Services on 1-800-680-9255, with a standard fax line of 1-866-337-8686 and an expedited line of 1-866-215-4297. Part D requests go through CoverMyMeds for OptumRx. The published list points to CMS Medicare coverage guidelines and medical necessity without naming a commercial criteria set.

Do I Need a Referral From My Primary Care Doctor?

On the HMO plans, yes in practice. HMO members choose a network primary care physician who issues referrals, and out-of-network care is generally not covered apart from emergencies, out-of-area urgent care, out-of-area dialysis and services unavailable in network with prior authorization. The Massachusetts PPOs pay out of network at higher cost sharing, and Valor Give Back, an HMO-POS, pays most out-of-network services at 50%.

Three questions the published documents do not answer. Whether detox, IOP and office-based outpatient substance use treatment require authorization, which medical necessity criteria the reviewers apply, and how a continued stay is reviewed. Put all three to Member Services on 1-800-680-4568 or Care Management on 1-800-787-5076 and note the reference number.

How Much Does Rehab Cost With eternalHealth?

Every plan carries a $0 monthly premium on top of the Part B premium and none has a medical deductible, so the number that governs a long admission is the annual out-of-pocket maximum. For 2027 that cap is $6,000 on Forever, $6,500 in-network and $9,500 combined on Freedom, $6,500 in-network and $10,000 combined on Give Back, $4,000 on Horizon and Harmony, $3,100 on Catalina, and $5,500 in-network and $9,000 out-of-network on Valor Give Back.

Give Back (PPO) reduces the Part B premium by up to $48 a month and Valor Give Back by up to $100 a month. Valor Give Back also uses Original-Medicare-style inpatient psychiatric cost sharing, $0 after the Part A deductible for days 1–60 and $434 a day for days 61–90 at 2026 amounts, which makes the daily copay plans cheaper for a short stay and the coinsurance plan cheaper for a long one.

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 billed without coverage. With an eternalHealth plan the member share is the daily copay or coinsurance above, capped by the plan’s out-of-pocket maximum, which is why an authorization in place before admission matters more than the sticker price. Telehealth is $0 per service on the HMO plans, though not every provider offers it, and PPO specialist telehealth is $10 in-network; Medicare telehealth is often the cheapest route to continuing counseling after a stay.

Does eternalHealth Cover Suboxone, Methadone and Other Addiction Medication?

Yes, through two separate routes. Medication given inside an Opioid Treatment Program is paid as a program service with a per-service copay, and a prescription filled at a pharmacy runs through the Part D formulary, ID 26208, a five-tier comprehensive list shared by the Massachusetts and Arizona plans and effective October 1, 2026.

On that formulary, buprenorphine sublingual tablets and buprenorphine/naloxone tablets sit on Tier 2 and the film on Tier 3, with no prior authorization listed; brand Suboxone, Zubsolv, Sublocade and Brixadi are not listed. Naltrexone 50 mg is Tier 2 and the Vivitrol shot is Tier 5 specialty. Acamprosate is Tier 4, disulfiram Tier 3 and naloxone products Tier 2 to 4. Methadone tablets are Tier 2 and solutions Tier 3, while methadone for opioid use disorder is dispensed through a licensed opioid treatment program rather than a retail counter.

Opioid Treatment Program Copays

For 2027 the per-service share is $25 on Forever, $30 in-network and $50 out-of-network on Freedom and Give Back, $20 on Horizon and Catalina, $30 on Harmony, and 20% in-network or 50% out-of-network on Valor Give Back.

Where the Prescription Is Filled

Pharmacy benefits run through OptumRx on 1-800-891-6989, available around the clock. The 2027 Part D deductible is $0 on Tiers 1 and 2 and $250 on Tiers 3 to 5 for Forever, $275 for Freedom and Catalina, $400 for Give Back, $200 for Horizon and $250 for Harmony. Valor Give Back has no Part D coverage at all, as it was designed for veterans holding TRICARE For Life, so that pharmacy question belongs with the other coverage.

Which Rehab Centers Are In-Network With eternalHealth?

A program is in-network when it holds a contract covering the specific plan on the member card, and eternalHealth keeps separate directories for the Massachusetts HMO, the Massachusetts PPOs and Arizona. Network status is settled in the plan’s Find a Doctor search or by calling Member Services, and it shifts as contracts are signed and renewed.

Programs that accept eternal Health are gathered on the eternal Health page, with wider lists for Medicare rehab, Medicare IOP and Medicare MAT. Each listing shows the payments the program says it accepts, its licensing and accreditation, and how far it sits from the nearest airport, so a shortlist can be drawn up before the call that settles network status and authorization.

How Do I Find a Rehab That Takes eternalHealth?

Start with the Find a Doctor search on the plan’s member site, choosing the Massachusetts HMO, Massachusetts PPO or Arizona directory that matches the card, or call Member Services on 1-800-680-4568 (TTY 711) and ask for a network behavioral health provider or opioid treatment program. A paper directory is available on request, and the 24/7 nurse hotline on 1-800-892-1361 is open outside Member Services hours.

No outside behavioral health vendor and no dedicated behavioral health phone line are published, so the general member and care management numbers are the route in. Search geography matters too: coverage runs only in six Massachusetts counties and four Arizona counties, so a program further afield in Massachusetts or Arizona may still be in network even when it sits outside the service area.

Is eternalHealth the Same as Eternal or EternalHealth, Inc.?

No to the first and yes to the second. Eternal was a performance-health and longevity clinic company in San Francisco and New York that announced on July 14, 2026 that it would cease operations, and it has no stated connection to the insurer. EternalHealth, Inc. is the legal sponsoring organization named in the 2026 CMS letter; the 2025 notice named Eternal Health of Delaware, Inc. for the same Massachusetts contracts.

Can I Still Join eternalHealth?

Not in Massachusetts while the suspension stands. CMS stopped new enrollment into contracts H1280 and H2694 from August 27, 2026 until the state order is lifted, repeating a suspension imposed on March 19, 2025 and released on September 10, 2025. The Arizona contract H3551 was not named. Current coverage and claims are a separate matter from new enrollment, and Member Services is the place to confirm how an in-progress authorization is affected.

References and Citations

Centers for Medicare & Medicaid Services — enrollment suspension letter for contracts H1280 and H2694, August 27, 2026, and sanction release notice, September 2025.
Massachusetts Division of Insurance — order placing eternalHealth under administrative supervision, August 12, 2026.
eternalHealth — 2026 and 2027 Summaries of Benefits for the Massachusetts and Arizona plans, prior authorization list, provider directory pages and comprehensive formulary ID 26208.
RehabSeekers directory listings and market rate research, United States, 2026. Ranges are indicative and vary by facility, length of stay and coverage.