Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
If you see a First Health logo on your insurance card, you might assume First Health is your insurance company. In most cases, it isn’t. First Health Network is a preferred provider organization (PPO) network owned by Aetna. Employers, third-party administrators and other plans rent access to it so their members can see contracted providers at negotiated rates.
Promises Dallas-Fort Worth is in network with Aetna, and our contract includes First Health Network. Here’s how that works and what it can mean for addiction and mental health treatment.
A Network, Not an Insurer
It helps to separate two roles. Your plan decides what’s covered, how much you pay, and whether a service is medically necessary. The network is the group of providers who have agreed to set rates. First Health supplies the network. The company that processes your claims is usually a different name on your card, often a third-party administrator or an insurer.
This is why two people with First Health logos can have very different benefits. One might have a generous employer plan, while another might have a limited plan with narrower coverage for behavioral health care.
You may see First Health on cards from self-funded employer plans, plans run by third-party administrators, and other benefit programs that don’t build their own networks. The plan’s name, not the network’s, is usually printed near your member ID. That’s the name to keep in mind when you read your benefit documents or call about coverage.
How First Health Relates to Our Aetna Contract
Our in-network agreement with Aetna names First Health Network. When your plan accesses First Health for behavioral health services, our Lewisville facility may be treated as in network for your plan. Some plans use one network for medical care and another for behavioral health, so confirming both is worthwhile.
What Your Plan May Cover
Your plan, not the network, sets coverage. Subject to plan terms, medical necessity and prior authorization, benefits may include:
- Medical detox, which is essential for alcohol and benzodiazepine withdrawal because it can be life-threatening
- Residential treatment for addiction, mental health conditions or both
- Partial hospitalization (PHP) in person at our Lewisville campus
- A virtual intensive outpatient program (IOP) available online to adults across Texas
These benefits can apply whether your primary concern is substance use, a mental health condition such as depression or anxiety, or both at once.
How to Verify Benefits With a First Health Card
Look for the claims address or customer service number on your card. That number belongs to the company administering your plan, and it’s the right place to ask about benefits. When you call, ask:
- Does my plan use First Health for behavioral health providers?
- Is Promises Dallas-Fort Worth in Lewisville in network under my plan?
- Which levels of care need prior authorization, and who handles those reviews?
- What are my deductible, coinsurance and out-of-pocket maximum?
Our admissions team can also make these calls for you as part of a free, confidential insurance verification. That can be especially helpful with rented-network plans, where it isn’t always obvious who to call.
Frequently Asked Questions
Should I call First Health about my benefits?
Usually not. First Health manages the provider network, not your benefits. Call the plan administrator or insurer listed on your card instead.
Is First Health part of Aetna?
Yes. First Health Network is owned by Aetna, and it’s included in our Aetna in-network contract.
Do I need a referral for treatment?
Many PPO-based plans don’t require referrals, but prior authorization for detox and residential care is common. Ask your plan to be sure.
What if my card shows more than one network logo?
Some plans use different networks for different services or regions. Ask your plan administrator which network applies to behavioral health care in Texas.
Let Us Help You Check
See every plan we’re in network with on our insurance options page, contact our team, or call (469) 546-9303 any time, day or night.