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Guide: Funding Options for Teen Residential Treatment

Rifling through paperwork and insurance forms at BlueRock

Why Funding Teen Residential Treatment Feels Overwhelming

When a teen needs residential treatment, most families are already stretched thin emotionally, logistically, and financially. It can feel like you have to learn a whole new language about levels of care, insurance rules, and state programs at the very moment you are worried most about your child.

At BlueRock Behavioral Health in Western North Carolina, residential treatment is designed to be accessible as a “public pay program with a private pay experience” for local teens and families. We accept North Carolina Medicaid and commercial insurance benefits, explains coverage, and offer self-pay options so you have a clearer picture of what care may cost before your teen arrives.

Understanding The Costs Of Teen Residential Care

Teen residential treatment is one of the more intensive levels of mental health care. Programs provide 24/7 supervision, daily therapy, psychiatric care, on-campus schooling, and structured activities that help teens practice real-world skills. In North Carolina, BlueRock operates as a Level II residential program, which means teens live on campus and receive structured mental health services in a home-like setting rather than a hospital.

Because care includes housing, therapy, school support, and around-the-clock staff, the total “sticker price” of residential treatment can look high compared with outpatient therapy or office-based services. What families actually pay depends on several factors, including:

  • Your insurance plan and whether the program is in network, out of network, or Medicaid-funded.
  • How long your teen stays in treatment, which is based on clinical needs and progress.
  • What services are included in the daily rate and which items may be billed separately.
  • Whether state or county programs help cover part of the cost.

You should not have to guess about any of this. A high-quality program will walk you through the financial side alongside the clinical plan so you can make informed decisions.

How Insurance Works For Teen Residential Treatment In North Carolina

Level II Residential Treatment And Medicaid Designations

North Carolina uses specific “levels of care” to describe different types of youth mental health treatment. Level II residential treatment is a 24-hour service in a structured program setting for youth who need more support than outpatient or in-home services, but who do not require a hospital or secure unit. At BlueRock, teens live on a 140-acre campus near Hendersonville and receive individual, group, and family therapy along with accredited on-campus academics.

Because Level II is a defined Medicaid service, coverage depends on clinical criteria and medical necessity. The state’s clinical coverage policies outline when residential services are covered for beneficiaries under age 21, and how programs document that care is needed and appropriate. Families do not have to memorize those policies, but it helps to know that your teen’s diagnosis, history, safety risks, and previous treatment attempts all play a role in funding decisions.

Commercial Insurance And Mental Health Parity

Many families use employer-sponsored or individual health plans to help pay for teen residential treatment. Federal mental health parity laws require most group health plans that offer mental health or substance use benefits to treat those benefits no more restrictively than medical or surgical benefits. In practical terms, that means a plan cannot place stricter visit limits, higher copays, or harsher review rules on residential mental health care than on comparable medical services, although plans can still review medical necessity and network status.

Parity does not guarantee that every residential program or every stay will be covered. Each plan has its own criteria, networks, and cost-sharing rules, so it is important to have the program’s admissions team review your benefits and help you understand how your plan applies to teen residential care.

North Carolina Medicaid Standard Plans, Tailored Plans, And EPSDT

North Carolina Medicaid now operates largely through managed care plans. Standard Plans began in 2021 and Behavioral Health and I/DD Tailored Plans launched in 2024, which shifted many members into plans that coordinate physical and behavioral health benefits. These plans must comply with mental health parity requirements for covered behavioral health services, including residential treatment when medically necessary.

For children and teens under 21, Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirement is especially important. EPSDT requires Medicaid to cover medically necessary services to correct or improve a physical or mental condition, even when the service might not be covered for adults. For some youth, EPSDT is the pathway that allows Medicaid to fund residential treatment when community services are not enough.

Funding Options Families Commonly Use

Option 1: North Carolina Medicaid

For many families in Western North Carolina, Medicaid is the primary funding source for teen residential treatment. BlueRock accepts North Carolina Medicaid, including managed care plans, for Level II residential services. Coverage typically involves a medical necessity review, and families must keep their Medicaid eligibility active throughout the stay. The BlueRock team works directly with your plan and care manager so you are not navigating this process on your own.

On the Admissions page and the Contact Us page, BlueRock explains that staff contact your Medicaid Standard or Tailored Plan to confirm residential Level II benefits, explain deductibles or other cost-sharing if applicable, and provide a clear summary of what coverage may look like. They also gather information about your home county, current providers, and any school plans, which helps route Medicaid questions to the correct managed care organization.

Families whose teens are enrolled with North Carolina Medicaid managed care organizations such as Vaya Health, Healthy Blue, WellCare of NC, UnitedHealthcare Community Plan, AmeriHealth Caritas North Carolina, or Carolina Complete Health may have residential benefits managed through those plans. Plan participation can change over time, so it is important to confirm the most current information with admissions and your Medicaid plan.

If your teen has Medicaid and their provider recommends residential treatment, you can:

  • Call your Medicaid plan to ask whether Level II residential treatment is a covered service for youth your child’s age.
  • Ask your care manager what documentation is needed to support medical necessity.
  • Contact BlueRock to start a benefits check, share your child’s history, and see whether Level II residential care at BlueRock fits your teen’s needs.

Because of EPSDT, Medicaid may approve services for youth under 21 when they are medically necessary to help correct or improve mental health conditions, even if similar services would not be covered for adults. Your Medicaid plan and the program’s admissions staff can explain how EPSDT may apply in your situation.

Option 2: Employer And Individual Commercial Insurance

Some families use employer-sponsored or marketplace plans to help pay for residential treatment. BlueRock notes that they work with most major commercial insurance plans, verify eligibility, and confirm whether they are in network or out of network for a particular plan. The admissions and billing teams then explain deductibles, copays, coinsurance, and any out-of-pocket maximums in plain language so you know what portion of the cost you might be responsible for.

Commercial plans typically review medical necessity using their own criteria. BlueRock’s clinicians share clinical information with your insurer, coordinate any required reviews, and submit documentation that supports Level II residential care for your teen. If your plan offers out-of-network benefits, BlueRock may request a single-case agreement when appropriate. This is a negotiated arrangement between the program and your insurer for a specific episode of care. It is not guaranteed, but it can sometimes reduce your out-of-pocket responsibility.

For families with commercial insurance, helpful steps include:

  • Calling the number on your insurance card to ask about benefits for “residential mental health treatment” for adolescents.
  • Requesting information on any limits related to length of stay, step-down expectations, or concurrent reviews.
  • Documenting the name of anyone you speak with and any reference numbers for your records.
  • Sharing this information with the BlueRock admissions team so they can align your teen’s treatment plan with funding rules whenever possible.

Option 3: Self-Pay And Payment Arrangements

In some situations, families pay part or all of the cost of residential treatment directly. This may happen when insurance coverage is limited, when a plan does not cover a specific program, or when a family chooses to move quickly while insurance reviews are still in progress.

BlueRock offers self-pay options and provides a written Good Faith Estimate for uninsured or self-pay patients as required by federal law. Before your teen admits, the team outlines the expected daily rate, what is included, and what additional costs might arise. Some families use savings, help from relatives, or accounts like Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) to pay for eligible medical expenses.

If you are considering self-pay:

  • Ask for a detailed, written estimate and a clear explanation of what is included.
  • Clarify whether the program offers payment plans or staged deposits.
  • Talk with your tax advisor about whether any costs might qualify as deductible medical expenses.

Option 4: State And County Assistance And Grants

North Carolina funds a range of behavioral health services through state and federal dollars that are administered by Local Management Entity–Managed Care Organizations (LME–MCOs) and other Medicaid managed care plans. These agencies may not always pay directly for residential treatment at a specific program, but they can help coordinate assessments, crisis services, step-down care, and other supports like intensive in-home services, outpatient therapy, or respite.

If your teen is involved with child welfare, juvenile justice, or disability services, your caseworker or care coordinator may know about additional state or county funding streams or grant programs that can help support treatment or aftercare. It is always appropriate to ask whether there are resources for youth who need residential care or intensive wraparound services.

Families can also connect with North Carolina resource hubs such as NC 211 or NCCARE360 to explore local supports related to housing, transportation, food assistance, and care coordination. These services do not replace residential funding, but they can reduce other stressors while your teen is in treatment.

Option 5: School District And Education Supports

When a teen has an Individualized Education Program (IEP) or 504 plan, school funding focuses primarily on educational services rather than medical care. In some complex cases, school districts may continue to provide or coordinate educational support while a student receives treatment in a residential setting, especially if that placement is related to the student’s educational needs.

At BlueRock, teens attend an accredited on-campus school with licensed teachers. The team coordinates credit transfer with home districts and supports existing IEP or 504 plans when possible so academic progress continues during treatment. It is helpful to involve your IEP team early, share information about residential treatment, and clarify how your teen’s educational goals will be supported while they are at BlueRock and after they return home.

Option 6: Short-Term Financial Strategies For Families

Even with insurance or Medicaid, families often face deductibles, copays, coinsurance, or other out-of-pocket costs. Short-term strategies may include:

  • Using HSA or FSA funds for eligible medical expenses associated with treatment.
  • Adjusting tax withholding or planning ahead with your tax preparer if you expect high medical expenses in a given year.
  • Speaking with trusted family members about temporary support or loans that align with your family’s values and comfort level.

While community fundraising platforms can sometimes help, it is important to protect your teen’s privacy and dignity. Before sharing details online, talk as a family about what feels appropriate and how information may persist long term.

Questions To Ask About Costs And Coverage

Whether you are speaking with an insurance company, Medicaid plan, or residential program, clear questions can help you understand what is covered and what remains your responsibility. Consider asking:

  • How does my plan cover teen residential mental health treatment, and what criteria are used to decide whether it is medically necessary?
  • Is BlueRock Behavioral Health considered in network or out of network for my plan?
  • What deductibles, copays, or coinsurance will apply, and what is my out-of-pocket maximum?
  • Are there any limits on length of stay, and how are extensions reviewed if my teen still needs care?
  • How will coverage change if my teen steps down to outpatient therapy, intensive in-home services, or partial hospitalization?
  • Are there any services, assessments, or supplies related to residential treatment that my plan does not cover?

With a program, it is also appropriate to ask how they communicate about balances, what happens if insurance pays less than expected, and whether they can help you appeal coverage decisions when appropriate.

How BlueRock Helps Families Navigate Funding

BlueRock’s mission is to provide competent, quality mental health services “for everyone regardless of socioeconomic status.” The program describes itself as a locally owned residential adolescent treatment center on a 140-acre campus in Bat Cave, North Carolina, serving families across Asheville and Western North Carolina. The intent is to pair strong clinical care with practical support so that funding does not become the only barrier to treatment.

To make funding easier to navigate, BlueRock:

  • Verifies North Carolina Medicaid (Standard and Tailored Plans) and commercial insurance benefits at no cost to the family.
  • Reviews clinical information to determine medical necessity for Level II residential treatment and coordinates with insurers and care managers.
  • Explains deductibles, coinsurance, and out-of-pocket maximums in everyday language rather than insurance jargon.
  • Provides written financial estimates before admission, including Good Faith Estimates when required, so families can plan ahead.
  • Offers self-pay options if insurance does not cover some or all services and discusses payment arrangements transparently.

Admissions staff are available 24/7 to answer questions about funding, walk families through the steps to admit a teen, and coordinate with existing providers and schools. You do not have to know exactly which plan your teen qualifies for to reach out. The team will help you sort through the details.

Note On Location For North Carolina Families

BlueRock Behavioral Health is located on a 140-acre campus in Bat Cave, near Hendersonville, about 30 minutes south of Asheville. The residential setting gives teens space to step away from daily stressors, focus on recovery, and build new skills in a calm, nature-based environment. At the same time, the location is close enough for many families across Western North Carolina to visit for family therapy, seminars, and campus events.

Because BlueRock works with North Carolina Medicaid and many commercial plans, families from different counties and school districts come to the program when a higher level of care is needed. The admissions team helps coordinate with local providers and schools so that treatment, funding, and aftercare are all aligned with your home community.

How To Start A Benefits Check With BlueRock

If you are considering teen residential treatment and want to understand your funding options, you can start with a simple phone call. BlueRock’s admissions staff will listen to your teen’s story, gather basic information, and begin verifying benefits with your Medicaid plan or commercial insurer.

To get started, you can:

  • Visit the Admissions page to learn more about who BlueRock serves and what the intake process looks like.
  • Use the form on the Contact Us page to request a call back or ask specific questions about funding.
  • Call the main number listed on the website and select the option for admissions to begin a benefits check by phone.

Reaching out does not obligate you to admit your teen. It is a way to understand your options, learn how Medicaid or commercial insurance might apply, and see whether BlueRock’s Level II residential program is a good fit for your child.

If your teen is in immediate danger or you are concerned about a life-threatening emergency, call 911 right away. For urgent mental health, substance use, or suicide concerns, you can call or text 988 to reach the Suicide and Crisis Lifeline. These services are available 24 hours a day and can help you stay safe while you explore longer term treatment options such as residential care.

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