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Sendero Health Plans

Rehabs That Take Sendero Health Plans

Sendero Health Plans is a nonprofit health plan in Central Texas, affiliated with Central Health, the hospital district for Travis County. Sendero has offered Texas Medicaid, CHIP and individual plans, and its coverage can include drug and alcohol treatment. Benefits depend on the specific plan, the provider network and the level of care, from outpatient counseling to residential treatment.Listed centers in New Jersey, Tennessee and Texas name Sendero on their own websites. Before admission, ask the center and Sendero about network status, prior authorization, referral needs and any deductible, copay or other cost you may owe.

Rehab Centers Near You

Drug and Alcohol Rehab Centers That Accept Sendero Health Plans

Recovery Unplugged Nashville – Brentwood

255 Wilson Pike Circle, Brentwood, Tennessee, 37027

4.9★★★★★~~386~~

Joint Commission

DetoxHospital detoxInpatient+6

Accepts InsuranceAccepts MedicaidSelf-Pay

Co-occurring DisordersMATTrauma-informed+9

Spanish spoken

The facility sits on Wilson Pike Circle, in the Maryland Farms area of Brentwood — an affluent Williamson County suburb immediately south of Nashville. The facility offers addiction detox, alcohol withdrawal management, drug withdrawal management and dual diagnosis treatment. Both residential and outpatient care are recorded at this location. Recorded credentials include The Joint Commission, DEA and State substance use agency licence.Treatment addresses substance use alongside co-occurring mental health conditions, including anxiety disorders, co-occurring disorders…

3.7 miWhitfield Park8.9 miNashville International AirportServes13 towns

Substances treated

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

Levels of care

14-Day Rehab · 21-Day Rehab · 30-Day Rehab · Addiction Retreat · Aftercare and Continuing Care · Alcohol Detox Program · Anxiety Retreat · Ativan (Lorazepam) Detox Program · Benzodiazepine Detox Program · Buprenorphine-Assisted Detox · +62 more

Therapies

12 Step Rehab · Activity Therapy · Addiction Counseling · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Couples Counseling · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Family Therapy · +5 more

Mental health

Co-Occurring Mental Health Conditions · Depression and Anxiety · Depression and PTSD · Depression and Trauma · Family Education Programs · Mental Health Conditions · Mental Health Treatment · Psychiatric Medication Management · Psychosocial Rehabilitation · Psychosocial Rehab Services · +4 more

Groups served

Active Duty Military Detox · Active Duty Military Dual Diagnosis 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 · Adult Rehab · Couples Rehab · +74 more

Support services

Case Management · Community Outreach · Education and Job Training · Employment Support · Health and Wellness Support · Health Education · Hepatitis C Treatment · HIV Treatment · Housing and Employment Support · Housing Assistance · +8 more

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · Ambetter (Centene) · BCBS (Blue Cross Blue Shield) · Cigna Healthcare · ComPsych · Humana · Magellan Health · Optum · Sendero Health Plans · UnitedHealthcare (UHC)

Recovery Unplugged Behavioral Health – Merchantville

1 West Park Avenue, Merchantville, NJ, 8109

5.0★★★★★66

Joint Commission

DetoxPHPIOP+4

Accepts InsuranceAccepts TRICARESelf-Pay

Co-occurring DisordersMATTrauma-informed+8

Spanish spoken

The provider's premises are at 1 West Park Avenue, Merchantville, New Jersey. The services listed are intensive outpatient and outpatient care. Provision spans substance use and mental health together. Treatment is delivered without an overnight stay, around existing commitments. Telehealth appointments are recorded as available, which widens what is reachable for anyone without transport. Family involvement is listed as part of the provision. The facility is federally registered and licensed by the New Jersey Division…

3.1 miNorth Branch Cooper River12 miPhiladelphia International AirportServes66 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 · Intensive Outpatient Program (IOP) · Online Rehab and Telehealth · Outpatient MAT Clinic · +7 more

Therapies

Mental health

Groups served

Active Duty Military Dual Diagnosis 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 · Couples Rehab · +56 more

Support services

Case Management · Community Outreach · Education and Job Training · Employment Support · Housing and Employment Support · Housing Assistance · Peer Support · Practical Support · Recovery Coaching · Recovery Support Services · +3 more

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · Ambetter (Centene) · BCBS (Blue Cross Blue Shield) · Cigna Healthcare · ComPsych · Humana · Magellan Health · Optum · Sendero Health Plans · UnitedHealthcare (UHC)

Real Deal Outpatient Therapy – Richardson

1251 South Sherman Street, Richardson, TX, 75081

4.8★★★★★69

PHPOutpatient

Accepts InsuranceAccepts TRICARESelf-Pay

SeniorsYoung adultsCouples+1

Real Deal Outpatient Therapy occupies 1251 South Sherman Street in Richardson, Texas. On record, this provider offers partial hospitalization, intensive outpatient and outpatient care. What is recorded here is mental health provision. Provision is outpatient, so no overnight stay is involved. The record notes group sessions alongside individual work. SAMHSA holds the federal registration and the Texas Health and Human Services Commission the state license.

6.8 miMoody Coliseum - Southern Methodist University8.7 miDallas Love FieldServes15 towns

Levels of care

Evening Treatment · Outpatient Rehab · Partial Hospitalization Program (PHP) · Weekend Rehab

Therapies

Activity Therapy · Cognitive Behavioral Therapy (CBT) · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · EMDR Therapy · Evidence-Based Therapy · Family Therapy · Group Therapy · Individual Therapy · Specialized Therapy

Mental health

Co-Occurring Mental Health Conditions · Crisis Intervention · Depression and Anxiety · Mental Health Crisis Services · Mental Health Treatment

Groups served

Adult Rehab · Couples Rehab · Senior Outpatient Rehab · Senior PHP · Senior Rehab · Young Adult Rehab

Support services

Case Management · Education and Job Training · Housing and Employment Support · Recovery Support Services · Suicide Prevention Services

Insurance accepted

Aetna · Baylor Scott & White Health Plan · BCBS (Blue Cross Blue Shield) · Cigna Healthcare · Friday Health Plans · Humana · Kaiser Permanente · Magellan Health · Molina Healthcare · Optum · +5 more

Recovery Unplugged – Austin

5419 South Congress Avenue, Austin, TX, 78745

4.6★★★★★~~157~~

Joint Commission

DetoxPHPIOP+3

Accepts InsuranceAccepts MedicaidState Funded+1

Co-occurring DisordersMATTrauma-informed+11

Spanish spoken

Recovery Unplugged occupies 5419 South Congress Avenue in Austin, Texas. The record shows 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. Video appointments are recorded as an option here. Group and family work are both recorded. Registration is federal, through SAMHSA; licensing is held with the Texas Health and Human Services Commission.

7.9 miMount Bonnell6.7 miAustin Bergstrom International AirportServes8 towns

Substances treated

Levels of care

Aftercare and Continuing Care · Clonidine and Lofexidine Detox · Continuing Care · Detox by Substance · Detox Centers · Discharge Planning · Evening Treatment · Intensive Outpatient Program (IOP) · Non-12-Step Rehab · Online Rehab and Telehealth · +7 more

Therapies

Mental health

Groups served

Active Duty Military Dual Diagnosis 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 · Adult Rehab · Couples Rehab · Court Ordered Dual Diagnosis Rehab · +73 more

Support services

Case Management · Education and Job Training · Housing and Employment Support · Peer Support · Recovery Support Services

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · Ambetter (Centene) · BCBS (Blue Cross Blue Shield) · Cigna Healthcare · ComPsych · Humana · Magellan Health · Optum · Sendero Health Plans · TRICARE · +2 more

Transcendence Treatment Center – North Charleston

3900 Leeds Avenue, North Charleston, South Carolina, 29405

4.9★★★★★~~141~~

Joint Commission

DetoxPHPIOP+4

Accepts InsuranceAccepts TRICAREAccepts State Insurance+3

MATVeteransSeniors+7

Spanish spoken

Transcendence Treatment Center operates from 3900 Leeds Avenue in North Charleston, close enough to Charleston and Hanahan to serve both. Within around 10 miles that includes North Charleston, Hanahan, James Island and Mount Pleasant. The facility falls within Charleston County for the purposes of state and county-funded treatment. Transcendence Treatment Center offers partial hospitalization, intensive outpatient and outpatient care. Approved medication runs alongside counseling, which is what medication-assisted treatment means in practice. Addiction and mental…

14 miKiawah River3.8 miCharleston International AirportServes5 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 · Intensive Outpatient Program (IOP) · Non-12-Step Rehab · Online Rehab and Telehealth · +7 more

Therapies

Activity Therapy · Addiction Counseling · Anger Management · Brief Intervention · Cognitive Behavioral Therapy (CBT) · Contingency Management · Counseling and Therapy · Dialectical Behavior Therapy (DBT) · Evidence-Based Therapy · Family Therapy · +5 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 · Psychosocial Rehab Services

Groups served

Adult Rehab · Couples Rehab · Court Ordered Rehab · Legal Advocacy Support · Men's Dual Diagnosis Rehab · Men's Outpatient Rehab · Men's Rehab · Men's Sober Living · Men's Telehealth · Men's TRICARE Rehab · +16 more

Support services

Case Management · Community Outreach · Housing and Employment Support · Housing Assistance · Peer Support · Practical Support · Recovery Support Services · Self Help Groups · Suicide Prevention Services · Supported Housing

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · Ambetter (Centene) · BCBS (Blue Cross Blue Shield) · Cigna Healthcare · ComPsych · Humana · Magellan Health · Mines and Associates · Optum · Sendero Health Plans · +2 more

Recovery Unplugged Austin – Austin

14109 FM 969, Austin, TX, 78724

4.7★★★★★~~161~~

Joint Commission

DetoxHospital detoxInpatient+6

Accepts InsuranceAccepts MedicaidAccepts TRICARE+2

Co-occurring DisordersMATTrauma-informed+10

Spanish spoken

The listing gives 14109 FM 969, Austin, Texas as the location. What is recorded here is detox, residential treatment and intensive outpatient. Medication-assisted treatment is recorded, combining prescribing with regular clinical contact. People stay on site for the duration, which is what inpatient care means here. Video appointments are recorded as an option here. Veterans and military families are recorded as a served group. Federal listing is via SAMHSA, and the Texas Health and Human…

12 miMount Bonnell5.8 miAustin Bergstrom International AirportServes8 towns

Substances treated

Levels of care

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 · +1 more

Mental health

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

Groups served

Active Duty Military Detox · Active Duty Military Dual Diagnosis Rehab · Active Duty Military Outpatient 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 · Couples Rehab · +94 more

Support services

Case Management · Community Outreach · Employment Support · Health and Wellness Support · Health Education · Hepatitis C Treatment · HIV Treatment · Housing and Employment Support · Housing Assistance · Peer Support · +7 more

Languages

Spanish Speaking Rehab

Insurance accepted

Aetna · Ambetter (Centene) · BCBS (Blue Cross Blue Shield) · Cigna Healthcare · ComPsych · Humana · Magellan Health · Optum · Sendero Health Plans · TRICARE · +2 more

Burning Tree Lodge – Elgin

122 Fisher Street, Elgin, TX, 78621

4.6★★★★★~~210~~

Joint Commission

DetoxInpatientResidential+2

Accepts InsuranceAccepts TRICAREState Funded+1

Co-occurring DisordersMATTrauma-informed+10

Burning Tree Lodge operates from 122 Fisher Street in Elgin, Texas. The services listed are residential treatment. Medication-assisted treatment forms part of the provision listed here. Treatment happens in-house, with residents on site day and night. Remote appointments appear on the record, useful where travel is difficult. Veterans and military families are recorded as a served group. Registration is federal, through SAMHSA; licensing is held with the Texas Health and Human Services Commission.

16 miBastrop State Park Lake13 miAustin Executive AirportServes6 towns

Substances treated

Levels of care

14-Day Rehab · 21-Day Rehab · 30-Day Rehab · 45-Day Rehab · 60-Day Rehab · 90-Day Rehab · Addiction Retreat · Aftercare and Continuing Care · Anxiety Retreat · Clonidine and Lofexidine Detox · +22 more

Therapies

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

Mental health

Groups served

Active Duty Military Dual Diagnosis 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 · Couples Rehab · Court Ordered Dual Diagnosis Rehab · Court Ordered MAT · +56 more

Support services

Insurance accepted

Aetna · Ambetter (Centene) · Baylor Scott & White Health Plan · BCBS (Blue Cross Blue Shield) · Carelon Behavioral Health · Christus Health Plan · Cigna Healthcare · ComPsych · Curative Health Plan · First Health · +11 more

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Common questions

Answered from what is listed here.

Does Sendero Health Plans cover rehab?

Yes, Sendero Health Plans covers substance use treatment as an essential health benefit, with no annual or lifetime dollar limits. Its 2026 marketplace HMO plans take in detox, residential treatment, partial hospitalization, intensive outpatient and outpatient counseling, in network only, with preauthorization required for the higher levels of care.

In-network treatment organizations named by Sendero include Recovery Unplugged, The Right Step and Cenikor; its behavioral health and crisis line is 855-765-9696.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

Does Sendero cover detox?

Yes, detox is covered. Acute and sub-acute detoxification, including residential addiction program admissions, sits on the 2026 preauthorization list, and Sendero names Recovery Unplugged (512-562-0608), The Right Step (844-529-2358) and Cenikor (888-236-4567) as in-network withdrawal management options.

Only in-network detox is covered, since these HMO plans pay nothing out of network except emergency care and emergency transportation. Authorization requests go to 1-855-297-9191.

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

Does Sendero cover residential rehab?

Yes, residential and inpatient substance use treatment is covered once preauthorization is granted. On the 2026 Original Silver plan an inpatient stay costs $500 after the $4,250 individual deductible; Real Gold charges 30% per stay and Central Platinum charges $250 per stay with no deductible.

Sendero defines a residential treatment center as a facility licensed as a 24-hour intensive inpatient setting that is not licensed as a hospital.

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

Does Sendero cover IOP?

Yes, intensive outpatient treatment for substance use is covered with preauthorization. Sendero defines an intensive outpatient program as at least three hours a day, three or more days a week, and psychiatric intensive outpatient care was added to the preauthorization list on 5/1/2026.

No visit cap appears in the 2026 plan documents, which state that behavioral health treatment limits cannot be more restrictive than medical and surgical limits.

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

Does Sendero cover partial hospitalization?

Yes, partial hospitalization for mental health, substance use and eating disorders is covered with preauthorization. Sendero's plan documents treat licensed drug and alcohol rehabilitation programs as partial hospitalization services, and the program must hold Joint Commission accreditation or the equivalent. Custodial care and day care are excluded.

Preauthorization runs through utilization management at 1-855-297-9191, open weekdays 6am to 6pm and weekends and holidays 9am to noon.

Partial Hospitalization Program (PHP)https://rehabseekers.com/programs/outpatient/php/

Does Sendero need prior authorization for rehab?

Yes. Inpatient mental health and substance use stays, acute and sub-acute detox, short-term residential care, partial hospitalization, intensive outpatient care, 23-hour crisis stabilization and alcohol and drug rehabilitation services all require preauthorization, and the provider requests it. Some outpatient behavioral health services need approval too.

Reviewers apply InterQual criteria plus internal criteria, and facilities must notify the plan of every urgent inpatient admission, including behavioral health.

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

Does Sendero cover out-of-network rehab?

No. These HMO plans include no out-of-network benefits, so treatment at a program outside the network is yours to pay, and those payments do not count toward the deductible or out-of-pocket maximum. Emergency care and emergency transportation are covered anywhere, in or out of network.

Sendero's behavioral health provider search lists in-network programs, and the 855-765-9696 line connects you to social workers who help find one.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

Does Sendero cover therapy?

Yes, outpatient therapy and psychiatry are covered, and behavioral health can be self-referred to an in-network provider with no referral needed. That includes individual therapy with an LCSW, LPC, LMFT, PhD or PsyD, and medication management with a psychiatrist or psychiatric nurse practitioner.

Member cost in 2026 ranges from a $10 copay per visit on Central Platinum to 20% coinsurance on Original Silver and 30% on Real Gold.

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

Does Sendero cover online therapy?

Yes, in-network telehealth is covered on the same terms as an in-person visit, counseling and medication management included. Sendero names Televero as a telehealth-only therapy and medication management provider, with Three Oaks Counseling and Vida Clinic offering both in-person and virtual appointments.

NormanMD virtual urgent care, staffed by Austin Regional Clinic doctors, runs 24/7 at $0 with no copay and no deductible.

Online Rehab and Telehealthhttps://rehabseekers.com/programs/online-rehab-and-telehealth/

How much does rehab cost with Sendero?

On the 2026 Original Silver plan an inpatient substance use stay costs $500 after a $4,250 individual deductible, with outpatient care at 20% coinsurance. Real Gold charges 30% per inpatient stay after a $350 deductible, and Central Platinum charges $250 per stay with no deductible.

Annual out-of-pocket maximums cap the total: $7,750 individual on Original Silver, $8,750 on Real Gold and $4,900 on Central Platinum.

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

Does Sendero cover MAT?

Yes, medication-assisted treatment is available in network. Sendero names CARMAhealth (512-212-4670) for outpatient substance use and mental health care including MAT. Pharmacy benefits run through Navitus Health Solutions, so check the 2026 formulary for a specific medication's tier and any prior authorization rules.

The Navitus pharmacy help line is 1-866-333-2757. Coverage of methadone through an opioid treatment program is not described in Sendero's published 2026 plan materials.

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

Does Sendero cover medication for alcohol use disorder?

Yes. Acamprosate delayed-release tablets sit on Tier 3 of the 2026 formulary and Antabuse (disulfiram) tablets on Tier 4, neither with prior authorization, quantity limits or step therapy. What you pay depends on your plan's pharmacy tier cost sharing.

Tier placement sets the copay, and no more than one step applies in step therapy for serious mental illness medications. The Navitus pharmacy line is 1-866-333-2757.

Alcohol Addiction Medicationhttps://rehabseekers.com/medications/alcohol-addiction-medication/

Does Sendero accept Medicaid?

No. Sendero left Texas STAR Medicaid and CHIP effective May 1, 2018, when about 18,000 members moved to other plans, and it now sells only individual ACA marketplace HMO plans. There is no Sendero Medicare Advantage product either.

If you now have Texas Medicaid, look for a treatment program that bills your current STAR managed care plan rather than Sendero.

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

What counties does Sendero cover?

Sendero Health Plans sells coverage in eight Central Texas counties: Travis, Hays, Bastrop, Burnet, Lee, Caldwell, Fayette and Williamson. It operates only in Texas and offers no plans in any other state; roughly 60% of members lived in Travis County as of 2019.

Membership reached 38,387 in May 2026, up 35% over the prior year. Central Health, the Travis County hospital district, created, funds and owns the plan.

How do I find a rehab that takes Sendero?

Start with Sendero's in-network behavioral health provider search, or call the Behavioral Health and Crisis Line at 855-765-9696, where social workers help match you with an in-network program. Member services at 1-844-800-4693 can also tell you whether a facility is in network.

Then have the program request preauthorization, since inpatient care, detox, residential treatment, partial hospitalization and intensive outpatient care all need approval before admission.

Private Insurance Acceptedhttps://rehabseekers.com/insurance-accepted/private-insurance-accepted/

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Sendero Health Plans is a nonprofit Texas HMO owned by Central Health, the Travis County hospital district, and it sells individual ACA marketplace plans across eight Central Texas counties. For anyone looking at addiction treatment, that means a commercial HMO benefit: substance use care is covered as an essential health benefit, delivered through Sendero’s own Central Texas network.

Two facts shape every answer below. Sendero plans carry no out-of-network benefits apart from emergency care and emergency transportation, so a program outside the network is paid privately and those payments do not count toward the deductible or the out-of-pocket maximum. And a Sendero card in 2026 is a marketplace card: the plan withdrew from Texas STAR Medicaid and CHIP on May 1, 2018 and sells no Medicare Advantage product.

This guide covers which levels of addiction treatment Sendero pays for, what the 2026 preauthorization list requires before admission, what a stay costs under the Original Silver, Real Gold and Central Platinum plans, how medication is handled through the pharmacy benefit, and how to work out whether a Central Texas program holds a Sendero contract.

Does Sendero Health Plans Cover Drug and Alcohol Rehab?

Yes. Mental health and substance use disorder services are essential health benefits on every Sendero plan, with no annual or lifetime dollar limits. Inpatient substance use treatment, acute and sub-acute detoxification, short-term residential care, partial hospitalization, intensive outpatient treatment and outpatient counseling are all covered in network, with preauthorization for the higher levels.

Sendero’s behavioral health pages set out the same ladder: help with withdrawal, residential care in a licensed facility, and outpatient treatment, alongside partial hospitalization, intensive outpatient and inpatient psychiatric care on the mental health side. Plan documents state that treatment limits for mental health and substance use care cannot be more restrictive than those applied to medical and surgical benefits.

What Does Sendero Cover at Each Level of Care?

The level is set by clinical assessment and then reviewed against Sendero’s criteria, not chosen in advance. Each step down the ladder has its own definition in the Evidence of Coverage, and the definitions matter because they decide which benefit line a stay is billed under.

Medical Detox

Acute and sub-acute detoxification, listed as a residential addiction program inpatient service, sits on the 2026 preauthorization list effective August 1, 2026, so it is a covered service that needs authorization first. Medical detox for alcohol or benzodiazepines carries seizure risk, and where withdrawal is already acute an emergency department is the right destination, since emergency care is covered anywhere, in or out of network, around the clock.

Residential and Inpatient

The Evidence of Coverage defines a residential treatment center as a 24-hour licensed, intensive, inpatient facility that is not licensed as a hospital, and short-term residential behavioral health appears on the preauthorization list. Inpatient substance use admissions need authorization too, and the admitting program must notify Sendero of urgent inpatient admissions, including behavioral health. Residential rehab runs on continued-stay review rather than a fixed benefit of nights.

PHP, IOP and Outpatient

Licensed drug and alcohol rehabilitation programs are treated as partial hospitalization services under the plan, which must hold Joint Commission accreditation or the equivalent; custodial care and day care are excluded. An intensive outpatient program is defined as at least three hours a day, three or more days a week. Outpatient counseling with an LCSW, LPC, LMFT, LCDC, PsyD or PhD clinician and psychiatric medication management are covered on the standard office visit terms.

Which Sendero plan is on the card? The 2026 lineup is Original Silver, Real Gold, Central Platinum, Preferred Bronze, Capital Silver, Hill Country Gold, Quality Care Bronze High Deductible and Austin512 Silver, each an HMO with on-exchange and off-exchange variants. Bronze, Silver and Gold plans use a Consumer Choice Evidence of Coverage, which does not offer some or all Texas state-mandated health benefits; Platinum has its own document. The service area is Travis, Hays, Bastrop, Burnet, Lee, Caldwell, Fayette and Williamson counties.

Does Sendero Need Prior Authorization for Rehab?

Yes. Every behavioral health item on the 2026 preauthorization list needs authorization before the service starts: inpatient mental health and inpatient substance use care, 23-hour crisis stabilization beds, partial hospitalization, intensive outpatient treatment, alcohol and drug rehabilitation therapeutic services, short-term residential care and acute or sub-acute detox. The treating provider files the request with Sendero.

Reviews use InterQual criteria supplemented by Sendero’s internal criteria. Utilization management is reached on 1-855-297-9191, Monday to Friday 6am to 6pm and weekends and holidays 9am to noon; the 2026 provider newsletter lists 1-855-895-0475 for the same hours, so an admissions team should ask which line the plan is routing authorizations through. Sendero also publishes a preauthorization code lookup tool, and the plan summaries note that some outpatient mental health and substance use services need authorization as well as all inpatient stays.

Do I Need a Referral for Therapy With Sendero?

No. Behavioral health services are self-referred, so a primary care visit is not a prerequisite for counseling or a psychiatric assessment, provided the clinician is in network. In-network telehealth and online treatment is covered on the same terms as an in-person visit, which keeps counseling workable from the rural edges of the service area.

There is no out-of-network benefit. Sendero plans pay for in-network care only, apart from emergency care and emergency transportation, and anything paid to a non-contracted program does not count toward the deductible or the out-of-pocket maximum. A program in Houston, Dallas or out of state is a self-pay arrangement unless the admission began as an emergency.

How Much Does Rehab Cost With Sendero Health Plans?

It turns on the metal tier. On the 2026 Original Silver Off Exchange-100 plan the deductible is $4,250 individual and $8,500 family, with a $7,750 and $15,500 out-of-pocket maximum; outpatient mental health and substance use care runs at 20% coinsurance after the deductible, an inpatient stay is $500 per admission after the deductible, and behavioral health office visits show a $20 copay.

Real Gold On Exchange-201 carries a $350 individual and $700 family deductible with an $8,750 and $17,500 out-of-pocket maximum, outpatient care at 30% coinsurance, inpatient behavioral health at 35% per stay and inpatient substance use care at 30% per stay. Central Platinum Off Exchange-600 has no deductible, a $4,900 and $9,800 out-of-pocket maximum, a $10 outpatient copay and $250 per inpatient stay. Coinsurance applies after the deductible unless the plan summary says otherwise.

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. With an in-network Sendero admission the ceiling is the out-of-pocket maximum on the plan, so knowing how much of the deductible has already been met this year is worth doing before any date is agreed.

Does Sendero Cover Suboxone, Methadone and Other Addiction Medication?

Pharmacy benefits run through Navitus Health Solutions on 1-866-333-2757. On the 2026 exchange formulary, acamprosate delayed-release tablets sit at Tier 3 and Antabuse at Tier 4, neither carrying prior authorization, a quantity limit or step therapy. Sendero’s behavioral health pages name an in-network outpatient clinic offering medication-assisted treatment.

Where the Prescription Is Filled

Medication given during an inpatient or residential stay is billed as part of that authorized service, while a retail fill goes through the Navitus benefit with its own tier and any prior authorization form. Formulary placement for Suboxone, Sublocade and Vivitrol is not stated on the plan’s published pages, so ask Navitus for the tier and whether the long-acting injections are billed to the pharmacy or the medical benefit. Belbuca, a buprenorphine product for pain rather than opioid use disorder, is listed as not covered. Sendero also states that it does not require more than one step of step therapy for serious mental illness.

Methadone and Opioid Treatment Programs

Methadone dispensed through a licensed opioid treatment program is not addressed on Sendero’s published documents, so a patient starting at a methadone clinic should call member services on 1-844-800-4693 and ask whether the clinic holds a Sendero contract and how daily dosing is billed. Put the question before the first dose rather than after the first statement arrives.

Which Rehab Centers in Texas Are In-Network With Sendero Health Plans?

A program is in network when it holds a contract with the Sendero HMO network covering the specific plan named on the card and is licensed in Texas for the level of care it delivers. Because these plans pay nothing outside the network except emergencies, network status settles the bill. Sendero’s Find a Provider tool and its behavioral health directory are where that status is settled.

Texas has 650+ listed treatment programs, 464 of which accept Medicaid, concentrated in Houston, TX, Dallas, TX, San Antonio, TX and Austin, TX. Programs that accept Sendero Health Plans are gathered on the Sendero Health Plans page, within the wider list of rehabs in Texas, with separate pages for detox centers and outpatient rehab. 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 contract status. Counts updated October 2026.

How Do I Find a Rehab That Takes Sendero Health Plans?

Call the Sendero Behavioral Health and Crisis Line on 855-765-9696, which is staffed to help locate an in-network behavioral health provider and has social workers available, or search the plan’s behavioral health directory directly. Member services is 1-844-800-4693, Monday to Friday 8am to 5pm in English and Spanish, with TTY on 711 and 988 for the Suicide and Crisis Lifeline.

Then ask the admissions team three things: whether the program contracts with Sendero for the plan named on the card, who files the preauthorization and when, and what level of care the InterQual review is expected to support. Case management is available through 1-855-297-9191 or the online request form, which is useful where a step down from residential to continuing care has to be arranged inside one network.

Is Sendero the Same as IdealCare, Central Health or Texas Medicaid?

IdealCare was the earlier name of the same marketplace product, used from 2013 to around 2021, with Ideal Bronze still on the 2024 plan list. Central Health, the Travis County Hospital District, created Sendero in 2011 and owns it as a subsidiary, alongside CommUnityCare Health Centers; Sendero Health Solutions is a separate credentialing and third-party administration entity announced in 2026. Sendero is not a Blue Cross licensee, and it is not Texas Medicaid: STAR and CHIP coverage ended on May 1, 2018, and enrollment since then is through the marketplace.

Before you call a program: have the plan name and metal tier from the card, the deductible balance for the year, and the county of residence ready. Then confirm with the plan that the program is contracted and that the authorization has been filed, because with no out-of-network benefit those two answers decide the entire cost of the admission.

References and Citations

Sendero Health Plans — 2026 Summary of Benefits and Coverage documents, Evidence of Coverage, preauthorization list effective August 1, 2026, behavioral health pages and provider directories.
Sendero Health Plans — 2026 Exchange Formulary and Navitus Health Solutions pharmacy benefit information.
Central Health (Travis County Hospital District) — Sendero ownership and service area statements, Q3 FY2026 membership update and board funding decisions of 2018 and 2019.
Sendero Health Plans and Central Health — announcements on the withdrawal from Texas STAR Medicaid and CHIP effective May 1, 2018.
RehabSeekers directory listings and market rate research, United States, 2026. Ranges are indicative and vary by facility, length of stay and coverage.