Insurance

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EDCare believes in providing the most cost-effective treatment possible so you can afford to live a healthy life. We accept over 35 insurance contracts, including some state-funded programs. When necessary, our dedicated team negotiates special coverage agreements and single-case agreements with insurance providers. We also arrange individual payment plans when necessary. We are your advocates for good health and will work with your insurance company to obtain coverage.

Before Treatment

After completing your initial assessment with EDCare, our Utilization Management Clinician will contact the assigned case manager from your insurance company to obtain precertification coverage. This coverage typically authorizes several days in treatment to get you started.

During Treatment

After admitting, our Utilization Management Clinician will continue to act as a liaison between you and your insurance provider. Regular reviews between our treatment team and the assigned case manager from your insurance company are scheduled to obtain additional time in treatment.

Have questions? Check out our FAQs page.

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TRICARE® West

EDCare is in-network TRICARE® West for Residential (RTC), Partial Hospitalization (PHP), and Intensive Outpatient (IOP) levels of care. TRICARE® covers PHP and IOP services for active duty service members, their dependents, and retirees without age restrictions. Residential (RTC) benefits are available for family members and eligible dependents of retirees up to age 20.

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Single Case Agreement

A Single Case Agreement (SCA) is a special contract between a treatment provider, such as EDCare, and an insurance company that allows a patient to receive care from an out-of-network provider using their in-network benefits. The agreement is made on a case-by-case basis and typically requires documentation showing that the care is medically necessary and not available within the insurance network. At EDCare, we can help guide patients and families through the SCA request process if they qualify.