Does GHI Cover Rehab? Understanding Your EmblemHealth / GHI Benefits

GHI, now part of EmblemHealth, covers many public and private employees in New York — including some enrolled through NYSHIP. If you have a GHI plan, it likely includes benefits for addiction treatment. We help members understand their GHI coverage, verify what their plan may cover, and start treatment without judgment. Reaching out is private, and there is no obligation.

Does GHI Cover Addiction Treatment?

Under the federal Mental Health Parity and Addiction Equity Act (MHPAEA), plans that cover behavioral health generally must do so on terms comparable to medical care. That means substance use disorder benefits are typically available across multiple levels of care, with the specifics depending on your plan and what is medically necessary. GHI / EmblemHealth plans generally include substance use disorder benefits across detox, inpatient, and outpatient care. The exact copays, deductibles, and network rules depend on your specific GHI plan. For NYSHIP members, GHI may be offered as a plan option alongside the Empire Plan — our does NYSHIP cover rehab and EmblemHealth rehab coverage pages have more detail.

GHI, EmblemHealth, and NYSHIP — How They Fit Together

It can be confusing that one plan goes by several names. GHI (Group Health Incorporated) is one of the companies that make up EmblemHealth. Some New York public employees have GHI through NYSHIP, while others have it through a city or private employer. Whichever applies to you, the treatment benefits work in a similar way, and verifying your plan is the surest way to know what you have.

Levels of Care GHI Plans Typically Cover

A clinical assessment determines what is medically necessary. GHI plans commonly cover:

In-Network Care and Costs

Using an in-network provider generally keeps your out-of-pocket costs lower. Some GHI plans also offer out-of-network benefits at a higher cost share. Our cost guide and copay and deductible pages can help you estimate what to expect, and we can confirm your exact benefits confidentially.

Verify Your GHI Benefits

Here is how we typically help GHI and EmblemHealth members:

• Collect your NYSHIP or Empire Plan member ID information
• Confirm your behavioral health and substance use benefits on your behalf
• Review the levels of care your plan may cover and what to expect
• Talk through next steps at your own pace, with no pressure

When you are ready, call 631-800-4691 or email support@alumniaidservices.com, and we will help you understand your options and verify your benefits confidentially. If you or a loved one is in immediate crisis, call or text 988. The free, confidential SAMHSA National Helpline is also available at 1-800-662-4357.