Substance Use Disorder

PrimeWest Health is committed to ensuring that members have access to substance use disorder (SUD) treatment. We cover appropriate SUD treatment services for members age 12 and over. Covered services may include the following:

• Inpatient treatment
• Residential treatment
• Outpatient treatment
• Peer recovery support
• Treatment coordination
• Medication assisted therapy
• Chemical use assessments
• Residential withdrawal management

You must have either a Rule 25 assessment or a Comprehensive assessment before you can be admitted to treatment. Both assessments look at the effects of substance use on your life during the past 12 months. Results are used to recommend the right level of care. The assessment usually takes 1 to 2 hours. It may take longer depending on your needs.

You can have either type of assessment.

• A Rule 25 assessment must be completed by a Rule 25 assessor at your county or tribal nation of responsibility. Call your county or tribal nation to schedule a Rule 25 assessment. The numbers are in the table below.
• A Compressive assessment must be completed by a licensed alcohol and drug counselor (LADC) or other qualified provider. Call PrimeWest Health at the number below. We will help you find an SUD treatment center you can contact to schedule a Comprehensive assessment.

Call PrimeWest Health at 1-866-431-0801 (toll free) if you have questions or need help finding a qualified assessor. TTY users call 1-800-627-3529 or 711 (toll free). Ask to speak to our Behavioral Health Care Coordinator.

More information about SUD services can be found in your Member Handbook or Evidence of Coverage (EOC).

Revised 7/21/2020

PW_07-17_241
DHS_Approved_07/29/2020
Updated_07/29/2020