Pathways
Does Pathways cover rehab?
Pathways is on our in-network list. Admissions verifies the member ID on your Pathways card before addiction or mental health treatment starts.
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Check your coverage
Send us three details and we’ll check what your plan covers, then call you back.
The name on the card
What does being in network with Pathways mean?
Pathways is on our in-network list, and admissions checks the benefits on your Pathways card. Anthem, Vivity, and Blue Shield of California each have their own page and are checked separately.
In network
Being in network means admissions can verify your Pathways benefits. It does not mean every Pathways card covers detox, PHP, or inpatient care.
Another name on the card
If your card also shows Anthem, Blue Shield, or another company, tell admissions. They still verify your benefits from the member ID instead of guessing which company runs the plan.
Levels of care
Levels of care your plan may cover
Enhance offers detox through Eden by Enhance, residential care at the Embrace Treatment Center location in Costa Mesa, and PHP, IOP, and outpatient care. Your plan may cover some of these levels, and verification tells you which ones.
Detox
- Where you sleep
- On site, during withdrawal
- How much of your week
- All of it
- What it is for
- Getting through withdrawal
- What usually comes next
- Inpatient or PHP
Inpatient
- Where you sleep
- On site, with clinical staff
- How much of your week
- All of it
- What it is for
- Structure away from use
- What usually comes next
- PHP
Partial hospitalization (PHP)
- Where you sleep
- At home
- How much of your week
- Most of each day
- What it is for
- A full day, home at night
- What usually comes next
- IOP
Intensive outpatient (IOP)
- Where you sleep
- At home
- How much of your week
- Part of the week
- What it is for
- Treatment around work
- What usually comes next
- Outpatient
Mental health treatment is checked the same way, and the logo on your card does not guarantee coverage for any level.
On the call
What to have ready for the call
The call goes faster when you have these details in front of you.
- Have the member ID and the name printed on the card.
- Know whether the card says PPO, HMO, or a marketplace plan.
- Tell admissions if you need detox, inpatient, PHP, IOP, or outpatient care.
- Give a phone number where admissions can reach you.
What we will not guess before verification
- Your copay, deductible, or daily rate.
- How many days your plan will pay for.
- Whether your plan will approve treatment.
If there is immediate danger, call 988 or go to the nearest emergency room first.
What we treat
Conditions your benefits may cover
Admissions checks your benefits for each of these conditions, and each one has its own page.
What happens when you call
Four steps, and you decide at each one whether to keep going.
You call or send the form
You share the member ID, the name on the card, and whether you need addiction treatment, mental health care, or both.
Admissions calls your plan
With your permission, admissions asks your plan what it covers for the level of care you need.
Admissions explains the results
Admissions tells you the deductible, any copay, and whether your plan requires prior authorization before treatment starts.
You decide
A verification is not an approval from your plan, and nothing starts until you decide to go ahead.
Benefits vary from plan to plan, and a verification is not a guarantee of coverage.
(714) 862-1907Cost and coverage
What your plan may cover
What you pay depends on your deductible, your copay and the level your insurer approves. Admissions checks your benefits with the insurer and tells you the figures before you decide anything.
Plans change, so admissions confirms coverage with your insurer before anything else happens.
Also in network with
- Cigna
- United Healthcare
- Ambetter
- MHN
- CalPERS
- Covered California
- Pathways
- Vivity
Common questions about Pathways
If your question is not answered here, call admissions at (714) 862-1907.
Does Pathways cover rehab?
Rehab may be covered, depending on your card, and admissions asks your plan what it includes. We do not publish copays, deductibles, or a number of days.
Is Pathways the same as Anthem?
Admissions treats them as separate names, and Anthem has its own page. If both names are printed on your card, bring the card to the call.
Is Pathways the same as Vivity?
No. Vivity is an Anthem Blue Cross HMO with its own page, and a Pathways card is checked separately, even if the names sound related.
What should I have ready?
Have your member ID, the name on the card, and the level of care you need. A screenshot of the Pathways name does not replace the member ID.
Have admissions check your Pathways card
Call with your member ID in hand. Admissions will tell you what your own card covers, not what every Pathways plan covers.
Enhance Health Group14742 Newport Ave STE 208, Tustin, CA 92780