Sentara Health Plans Behavioral Health Treatment Coverage and Benefits
If you have health insurance through Sentara Health Plans (formerly Optima Health), your insurance may provide out-of-network coverage for behavioral health treatment at NuView Treatment Center.
Our admissions team can confidentially verify your insurance benefits, clarify available coverage, estimate your potential out-of-pocket costs, and explain your payment options. Verifying your benefits is an information-gathering step with no obligation to begin treatment.
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Verify My Sentara Health Plans Benefits Does Sentara Health Plans Cover Behavioral Health Treatment?
Sentara Health Plans is a health insurance company that operates in Virginia and Florida. Its out-of-network (outside of your plan’s contracted provider network) coverage in California is limited.
Your coverage may depend on factors such as:
- Your specific Sentara Health Plans policy
- Whether your plan provides out-of-network benefits
- Whether the treatment is medically necessary
- The recommended level of care
- Whether prior authorization is required
- Your deductible, copayment, coinsurance, and out-of-pocket maximum
If you are seeking care in California, contact Sentara Health Plans before treatment begins to request out-of-network authorization. Without this advance approval, an out-of-network claim may be denied. Our admissions team can help you understand what to ask for.
Our admissions team can also verify your benefits and enable you to understand what your Sentara Health Plans policy may cover.
What May Be Covered Under Sentara Health Plans?
Depending on your specific plan and needs, Sentara Health Plans may cover medically necessary substance use disorder and mental health disorder treatment services:
- Clinical assessments and psychiatric evaluations
- Partial hospitalization program (PHP)
- Intensive outpatient program (IOP)
- Dual diagnosis care services
- Medication management.
The services available to you and your level of coverage depend on your specific plan and medical circumstances.
Sentara Health Plans We Can Help You Verify
Sentara Health Plans, formerly known as Optima Health, offers a range of individual, family, and employer-sponsored insurance policies for behavioral health treatment.
Some of the plans we can help verify:
- Individual plans
- Marketplace plans
- Employer-sponsored group plans
- Legacy Optima Health plans
Coverage varies based on your plan, program, or employer. Benefits are verified before treatment begins.
Once We Know What Your Plan Covers, Here's What Treatment Looks Like
NuView provides behavioral healthcare for those seeking outpatient care for substance use and mental health concerns.
When you reach out to us, our admissions team can confidentially verify your Sentara Health Plans benefits, explain your coverage, and discuss potential out-of-pocket costs with you.
Partial Hospitalization Program
A structured, full-day program for people who need intensive support but not 24-hour residential care.
Intensive Outpatient Program
Fewer weekly hours than PHP, designed to fit around work, school or family obligations.
Evening Track
Structured evening care that supports recovery while allowing you to maintain your daily routine.
Telehealth Services
Virtual sessions for eligible California residents, for added flexibility and access.
Individual Therapy
One-on-one sessions with a licensed therapist.
Group Therapy
Peer support facilitated by a clinician.
Case Management
Coordinated support connecting you with the right resources throughout treatment.
Medical Services
Oversight from a psychiatric provider and clinical team as part of your care.
How Can You Verify Your Sentara Health Plans Behavioral Health Benefits?
If you want to verify your Sentara Health Plans coverage and benefits for behavioral health treatment, the following are the simple, straightforward steps.
Please note that verifying your insurance coverage and benefits is simply an information-gathering step. You are not obligated to commit to a treatment program after verifying your insurance. It is an opportunity to understand your available benefits, potential costs, and treatment options so you can make your recovery decisions on your own time.
Let Us Begin With a Confidential Conversation
If you or a loved one is considering behavioral health treatment, you do not need to have everything figured out before reaching out.
You do not even need to understand all the details of your Sentara Health Plans policy.
Our admissions team can answer your questions, verify your behavioral health benefits, explain potential out-of-pocket costs, and enable you to understand your payment options so that you can make informed decisions about the cost of your care.
Do You Have Questions About Your Coverage?
NuView's admissions team can help verify your Sentara Health Plans coverage and benefits, explain your options, and enable you to take the next step toward treatment with greater confidence.
Frequently Asked Questions About Sentara Health Plans Behavioral Health Treatment Coverage and Benefits
Sentara Health Plans is a health insurance company that offers health plans in Virginia and Florida. It previously operated under the Optima Health name. Its plans include behavioral health benefits; however, coverage varies by specific plan.
Many Sentara Health Plans provide benefits for substance use and mental health disorder treatment when services are medically necessary and meet the requirements of the member's plan.
Out-of-network coverage depends on your specific plan. Some Sentara Health Plans may include out-of-network options, while other plans may require you to receive behavioral health services from participating providers.
Optima Health is a former name associated with Sentara Health Plans. If your insurance card or policy identifies Optima Health, our admissions team can verify your current benefits and determine what behavioral health coverage may be available under your specific plan.
Prior authorization means your insurance plan may require approval before certain behavioral health services can be covered.
- Deductible: The amount you may need to pay for covered behavioral healthcare services before your insurance begins paying, as per your plan's terms and conditions.
- Coinsurance: The percentage of covered behavioral healthcare costs you may be responsible for after meeting your deductible.
- Out-of-Pocket Maximum: The maximum amount you pay toward covered behavioral healthcare services during a year before the plan pays 100% of covered costs.