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If your insurance plan includes out-of-network benefits, you may be able to use it to help cover the cost of residential treatment.
Our admissions team walks you through what to expect financially before you commit to anything.
Every insurance plan has a network, a group of providers, hospitals, and treatment facilities that have a direct billing agreement with your carrier.
When you receive care outside that network, your plan may still cover a portion of the cost. That’s your out-of-network benefit.
For mental health and addiction treatment specifically, out-of-network benefits matter because the best-fit program for your situation may not be the closest one or the one your insurer defaults to.
PPO plans, in particular, are designed with this flexibility in mind; they allow you to seek specialized care wherever it’s available, not just within a defined local network.
Not every plan does. The most important distinction is your plan type:
PPO (Preferred Provider Organization): Most PPO plans include out-of-network benefits, meaning Maple Mountain can bill your insurer directly, or you can seek reimbursement after treatment. This is the most common plan type among our clients.
EPO (Exclusive Provider Organization): EPO plans typically do not cover out-of-network care except in emergencies. If you have an EPO, our admissions team will review your specific plan, there are sometimes exceptions for specialized behavioral health care.
HMO (Health Maintenance Organization): HMO plans generally require care to be provided within a defined network and do not include reimbursement for out-of-network care. Coverage at Maple Mountain under an HMO plan is unlikely, though we’ll verify before drawing any conclusions.
Not sure what type of plan you have? Your insurance card or benefits summary will typically list the plan type. Our team can also identify it during verification.
Before you arrive, our admissions team contacts your insurer to confirm whether your plan includes out-of-network mental health benefits, what your reimbursement rate is, and what your estimated out-of-pocket costs will be.
Most plans require prior approval before residential treatment begins. We submit all required clinical documentation to your insurer and follow up until authorization is confirmed — that process never falls on you.
Maple Mountain handles billing directly with your insurance carrier throughout your stay. You are not responsible for navigating the claims process.
Your plan pays its share based on your specific out-of-network benefit. Your remaining responsibility — after your deductible and coinsurance — is what you pay out of pocket. We walk you through those numbers clearly before treatment begins.
You pay a set amount before your insurer begins sharing costs. If you’ve already met your deductible for the year, coverage may begin immediately.
After your deductible is met, your insurer covers a percentage of costs, commonly 60–80% for out-of-network care, and you cover the remainder.
Once you reach this annual limit, your insurer covers 100% of covered services for the rest of the plan year. For clients who enter treatment later in the year, this can significantly reduce total costs.
Out-of-network benefits are typically paid based on a percentage of the “usual and customary” rate for the service. Our admissions team will explain what this means for your specific plan in plain terms.
Under the Mental Health Parity and Addiction Equity Act, insurance carriers are required to cover mental health and addiction treatment on terms that are comparable to medical and surgical benefits.
This means your insurer cannot apply more restrictive out-of-network rules to residential mental health treatment than it does to other types of medical care.
If your plan covers out-of-network care for medical procedures, it is generally required to cover out-of-network residential mental health treatment under the same terms. Our admissions team is familiar with parity laws and will flag any coverage discrepancies on your behalf.
Yes. Because Maple Mountain accepts PPO plans with out-of-network benefits, clients from any state can access residential treatment here. Out-of-network coverage is not geographically restricted — it applies regardless of where you live or where your insurer is based.
In most cases, no. Maple Mountain bills your insurer directly, so you are not typically required to pay the full cost upfront and wait for reimbursement. Your out-of-pocket responsibility — your deductible and coinsurance share — is what you pay directly. Our admissions team will outline what that looks like before treatment begins.
Denials are not always final. Insurance carriers must provide a reason for any denial, and most denials can be appealed. Maple Mountain’s billing team is experienced with the appeals process and will work on your behalf if a claim is disputed or denied.
The fastest way is to call us. Our admissions team contacts your insurer directly and gets the answers in plain language — usually the same day. You can also look at your Summary of Benefits and Coverage document, which your employer or insurer is required to provide, and look for a section on out-of-network behavioral health benefits.
Yes. Prior authorization is required by most plans before residential treatment begins. Our admissions team initiates and manages the entire process — submitting clinical documentation, following up with your insurer, and confirming approval before your arrival.
Google Reviews
Maple Mountain Mental Health and Wellness has changed my life. The staff is loving, kind, and they make the environment safe for everyone. Unlike other treatment centers, they individualize your treatment according to your needs. This place is a second home to me and I consider the staff and clients my second family. I’m going to miss this place so much. ❤️
I would give Maple Mountain health and wellness 10+ stars if I could! Going there was the best thing I have ever done for myself in my whole life. I highly recommend this facility for anyone dealing with trauma. The modalities of therapy offered were life-changing. I learned many new life skills, and have tools to bring home as I continue my healing and recovery journey. I felt like I was in a safe, beautiful home with the most loving, caring, and kind staff you could ever ask for. The best part is that I made lifelong friends that I will cherish forever. The entire program is incredibly well structured, the staff and therapists are very knowledgeable and kudos to the chefs, as the food was not only nutritious, but phenomenal! Aside from the educational groups that range from group processing, yoga Nidra, sound bath, nutrition and wellness, equine and music therapy (my personal favorites) DBT, CBT, and stress management were incredibly valuable, and I learned so much from these programs. Jen was the first person I spoke with, and I knew in our conversation that this was the right place for me. I was warmly welcomed right from the beginning, and knew this journey would be healing and memorable. We also were able to have a lot of fun with the experiential activities they carefully planned for us. Special kudos to Vikki, who went out of her way to give me the care and tools for me to maintain my recovery. I am forever grateful to every single person at Maple Mountain recovery. I researched the entire country for two weeks to find this place, and it was worth that time because they deserve every rave review they get! Super highly recommended and feel free to reach out if you have any questions! Thank you so much to everyone at MMR! I will never forget you and love you all💜
Maple Mountain Mental Health and Wellness in Utah completely exceeded my expectations. From day one, their team created a highly personalized treatment plan tailored just for me—every session felt tailored to my needs.
The Staff are so friendly and helpful, I am able to work on a lot of the traumas and life events that have happened to me that have caused turmoil for many years. They also have helped me find a new way of viewing myself and how to move on with my life and find new chapters for me to write for myself. I am so thankful for Maple Mountain Mental Health and Wellness.
I’ve been to several treatment centers and this place is by far the best place I’ve ever been! The staff has been wonderful and attentive to all my needs. Maple Mountain Mental Health and Wellness has literally saved my life and I’m a better person today because of them! I have a lot of love and respect for this place and the people there!
Maple Mountain Mental Health and Wellness has changed my life. The staff is loving, kind, and they make the environment safe for everyone. Unlike other treatment centers, they individualize your treatment according to your needs. This place is a second home to me and I consider the staff and clients my second family. I’m going to miss this place so much. ❤️
Coming to a place like MMR can be stressful and scary, especially when already emotionally all over the place, but I will forever be grateful for finding this place. I don’t have enough positive words to describe just how thankful I am. Every single person on the staff is so incredible that they easily helped me get through my anxiety about being in residential treatment. They are all so caring and compassionate that it was easier than I ever thought possible. The group and individual sessions were thorough and enlightening, too. I’ve also never had such delicious and healthy meals. I’m going to be disappointed in my own cooking now 🙃
My journey at MMR has been life changing. I honestly don’t know where to begin!
This is my 5th treatment center in 2 years for alcoholism but this is the first place that has targeted the trauma linked to it. I’m so impressed with the differences in MMR from previous centers.
The best way I can describe it is “family style treatment”. The staff becomes like family, it’s a tight community of folks who honestly care about your recovery. The therapists and case managers are out of this world amazing! Very rarely do you get to know your case manager on a personal level. Here, they become a major part of your recovery and help look at every aspect of your life and how they can help.
I could go on and on about the incredible benefits of MMR but would just highly recommend giving it a try!
I arrived at Maple Mountain Mental Health and Wellness feeling lost and overwhelmed, but from the moment I stepped through the doors, I was greeted with warmth and understanding. The personalized approach to treatment made all the difference for me. Each staff member truly took the time to listen to my story and tailored their support around my needs. The diverse range of activities—from mindfulness meditation to equine therapy—helped me explore new avenues of healing. I formed deep connections with fellow residents and staff, creating a supportive network that I will cherish forever. Maple Mountain Mental Health and Wellness isn’t just a treatment center; it’s a place of healing and hope. I’m so grateful for the journey I embarked on here, and I am leaving with not just tools for recovery, but lasting friendships. Thank you, MMR!
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Our admissions team verifies benefits same-day, at no cost, with no obligation to commit to treatment.
We are committed to ensuring that our services are accessible to everyone, regardless of their insurance status. We understand that insurance can be a complex and confusing process, but we are here to help you every step of the way.