Coverage
NYSHIP addiction treatment on Long Island
Long Island members can use Empire Plan benefits for detox, inpatient or residential rehab, PHP and IOP in Nassau and Suffolk counties. You are not limited to network programs: out-of-network benefits can help pay for a private or higher-end treatment center, once the care is certified as medically necessary. Knowing how those benefits work before admission is the key to keeping costs predictable.
Published by the NYSHIP.rehab editorial resource · Updated
Can I use out-of-network benefits for a private treatment center?
Yes, The Empire Plan pays benefits for certified non-network substance use care, so a private program on Long Island or elsewhere is not automatically off the table (PE and C-82 At A Glance, printed pp. 11–12). Many members choose a private center for smaller groups, more individual therapy, faster admission or a quieter setting.
For a non-network inpatient or residential stay, the guides describe your share as 10% coinsurance of billed charges, limited by the combined annual coinsurance maximum — $3,750 for the enrollee under the PE guide (printed p. 3). That means covered clinical charges for a certified stay can be largely paid by the plan. See how out-of-network rehab is paid for the full math.
Call our treatment helpline at 516-219-1975 to talk through your benefits and private and network treatment options in New York and New Jersey. The helpline is not NYSHIP or your plan, and it can't guarantee coverage or admission.
What does the plan pay for at a higher-end program?
| Usually clinical (can be covered if certified) | Usually optional (plan likely won't pay) |
|---|---|
| Medically supervised detox and nursing care | Private suites or upgraded rooms |
| Individual, group and family therapy | Spa, fitness or recreational outings |
| Psychiatric evaluation and medication management | Chef-prepared or specialty meals |
| Residential treatment days approved by the plan | Transportation and family lodging |
Which levels of care are available on Long Island?
Nassau and Suffolk have hospital-based and freestanding programs at most levels of care. New York's OASAS certifies addiction programs; certification is a state license, not network membership. Compare coverage by level:
- Detox and withdrawal management — often the first step for alcohol, opioid or benzodiazepine dependence.
- Inpatient and residential rehab — approved network stays are described as paid in full.
- PHP, IOP and virtual IOP — lets you live at home, useful for commuters and working parents.
Substance-specific guides: alcohol, opioids, cocaine and stimulants and benzodiazepines.
What should you do before admission?
Before you choose a Long Island program
- Call our helpline to review your benefits and compare private and network options.
- Ask the program whether it is in network or will bill as a non-network provider.
- Make sure the program requests certification before admission, and keep the reference number.
- Get an itemized estimate separating clinical care from optional charges.
- Plan time away from work — see medical leave for rehab.
Certification is required in or out of network; without it, the guides say you may receive no benefits (printed p. 11). Learn more about prior authorization and which rehabs are in network.
Frequently asked questions
Can NYSHIP cover a private rehab on Long Island?
It can. The Empire Plan pays non-network benefits for certified substance use care. For inpatient stays, the guides describe 10% coinsurance on billed charges up to the annual coinsurance maximum. Optional amenities are usually not covered.
Do I have to use an in-network Long Island program?
No. Network programs usually cost less, but out-of-network benefits let you choose a non-network program. Certification is still required before admission.
Who can help me check my benefits for Long Island treatment?
Our treatment helpline at 516-219-1975 can review private and network options in New York and New Jersey. It is not NYSHIP or your plan and cannot guarantee coverage.
Related guides
- CostsOut-of-network rehab with NYSHIP in 2026How the Empire Plan pays out-of-network substance abuse treatment in 2026: allowed amounts, billed-charge coinsurance, balance bills and luxury rehab.
- CoverageDrug Rehabs That Take NYSHIP: Finding In-Network Addiction TreatmentLearn how to find drug and alcohol rehab centers that accept NYSHIP and The Empire Plan. Verify Carelon network status, detox, inpatient, and IOP coverage.
- CoverageNYSHIP inpatient and residential rehab coverageHow Empire Plan inpatient and residential rehab coverage works: certification, network stays paid in full, non-network 10% of billed charges and what to ask.
- CoverageDoes NYSHIP cover detox and withdrawal management?Does NYSHIP cover detox? How Empire Plan MHSU rules apply to medically supervised withdrawal management, emergencies, network status and certification.
- CostsHow much does rehab cost with NYSHIP?Estimate your Empire Plan rehab cost in five steps: network copays, the non-network deductible, coinsurance and balance billing.
- CoveragePrior authorization for NYSHIP rehab: who calls, and whenWhen Empire Plan substance use care needs certification, who requests it, what happens in emergencies and a call checklist for the MHSU Program.
Sources and source dates
- The Empire Plan At A Glance — Participating Employers (PE), January 2026 (opens in a new tab) — January 2026 (AAG-PE-1/26). Printed page(s) 3, 11, 12. New York State Department of Civil Service.
- The Empire Plan At A Glance — Council 82 (C-82), January 2026 (opens in a new tab) — January 2026 (AAG-C-82-1/26). Printed page(s) 3, 11, 12. New York State Department of Civil Service.
- New York State Office of Addiction Services and Supports (OASAS) (opens in a new tab) — Reference listed October 17, 2026
- NYSHIP — Employees of Participating Employers (official site) (opens in a new tab) — Accessed October 17, 2026. The former cs.ny.gov group benefits page now redirects here.
Plan guides are summaries and can change. Your Empire Plan Certificate and Certificate amendments control. This page is general education, not medical, legal or benefits advice. Read our editorial standards.