Start with the truth.

Shift Support Network is out-of-network with every commercial insurance carrier as of right now. Credentialing is in process with the major California payers. Single case agreements are available now. This article will not tell you that we are in-network with anyone we are not. Anything you read here about a specific carrier is about how that carrier's out-of-network behavioral health benefit tends to work, not about a contract Shift does not have. The only number that matters for your specific case is the number that comes back when we verify your specific plan.

What follows is a walk-through of the major California-relevant commercial carriers, the patterns we see in their out-of-network behavioral health benefits, the questions worth asking each one, and the situations in which we have seen each carrier approve a single case agreement.

This is not a quote. No article can quote a specific cost-share or out-of-pocket number for a specific plan you have not shared. The same carrier writes hundreds of plan designs, including the self-funded employer plans they administer. The only way to get a real number is to verify your specific policy. We do that for free, in writing, in two minutes. See the benefit check form or how OON benefits work in plain English.

UnitedHealthcare and Optum.

UnitedHealthcare commercial PPO

In-network status with Shift: credentialing in process. OON-billable now.

Optum is the behavioral health arm of UnitedHealthcare. Most UnitedHealthcare commercial PPO plans route SUD outpatient authorization through Optum, even when the medical plan stays with United. That matters because the prior authorization conversation for a virtual IOP usually happens with an Optum reviewer, not a United generalist. Out-of-network behavioral health coverage on United commercial PPO plans varies widely by the employer that bought the plan; most large-employer self-funded plans on the United network include an out-of-network behavioral health benefit, often with an OON deductible separate from the in-network deductible.

What to ask on the verification call: whether Optum is the behavioral health administrator, the OON deductible for the plan year and remaining balance, the OON coinsurance for outpatient behavioral health, the OON out-of-pocket maximum, and whether the plan accepts single case agreement requests submitted through Optum's OON intake channel.

Cigna and Evernorth.

Cigna commercial PPO and Open Access Plus

In-network status with Shift: credentialing in process. OON-billable now.

Evernorth is Cigna's behavioral health arm. The pattern is similar to United and Optum: most Cigna commercial PPO and Open Access Plus plans include an out-of-network behavioral health benefit, with the OON cost-share tier separate from in-network and typically with a higher deductible. Cigna's behavioral health authorization tends to flow through Evernorth utilization review. Cigna-administered self-funded plans (where Cigna is the network and an employer self-insures the claims) sometimes have generous OON benefits and sometimes have very narrow ones, depending on the employer plan design.

What to ask: same as above, with the addition of confirming the behavioral health vendor (Evernorth vs an external carve-out) and the specific authorization pathway for IOP. The Cigna page walks through the practical detail.

Aetna.

Aetna PPO, Aetna Choice POS II, Aetna-administered self-funded plans

In-network status with Shift: credentialing in process. OON-billable now.

Aetna's commercial PPO and Choice POS II plans usually include an out-of-network behavioral health benefit. Aetna-administered self-funded plans (a large share of Aetna's commercial book, especially for mid-size and large employers) write their own benefit designs and the OON terms vary substantially. Aetna's behavioral health utilization review is in-house for most plan types. Some Aetna plans route mental health and SUD through a separate carve-out vendor; verify on the call.

What to ask: OON deductible, OON coinsurance for outpatient behavioral health, OON out-of-pocket maximum, prior authorization requirement for IOP (revenue code 905, H0015), and whether the plan accepts single case agreement requests. The Aetna page has the specifics.

Anthem Blue Cross of California (and Elevance).

Anthem Blue Cross CA, Anthem PPO, Anthem-administered self-funded

In-network status with Shift: credentialing in process. OON-billable now.

Anthem Blue Cross of California is one of the two largest commercial PPO networks in the state. Most Anthem commercial PPO plans include an out-of-network behavioral health benefit. Anthem moved several large carve-out books to its in-house Anthem Behavioral Health unit; some employer plans still route behavioral health through a third party (Carelon for some books). Self-funded employer plans on the Anthem network write their own behavioral health benefit; verify the specific plan.

Anthem-administered plans for entertainment industry populations (the SAG-AFTRA Health Plan moved its behavioral health carve-out to Anthem effective 2026-01-01) are a specific subgroup worth verifying carefully because the carve-out terms differ from standard Anthem commercial plans. The Anthem page walks through the major patterns.

Blue Shield of California.

Blue Shield of California (BSCA)

In-network status with Shift: credentialing in process. OON-billable now.

Blue Shield of California is a separate company from Anthem Blue Cross and a separate company from BCBS plans in other states (the BCBS Association is a national federation, not a single insurer). BSCA commercial PPO plans usually include an out-of-network behavioral health benefit. BSCA HMO plans typically do not include an out-of-network benefit; HMO members usually have to go in-network or out-of-pocket. BSCA's behavioral health utilization review is in-house for most commercial PPO products.

Verify the plan type (PPO vs HMO vs EPO) before assuming OON benefits exist. If the plan is HMO, the SCA pathway is the most likely route, and we will say so on the verification call.

Kaiser Permanente commercial.

Kaiser Permanente commercial HMO

In-network status with Shift: not a contracted provider. OON benefit usually not available.

Kaiser Permanente is a closed-network HMO. Most commercial Kaiser plans do not include an out-of-network behavioral health benefit. Kaiser members are usually expected to use Kaiser's in-system behavioral health services, including Kaiser's own SUD outpatient programs. There are exceptions, most often when Kaiser's in-system option does not meet medical necessity for a specific patient (waitlists too long given clinical acuity, no available clinician with required specialty), in which case Kaiser can authorize an out-of-network provider under a single case agreement.

The practical reality: if you are Kaiser, the first step is to engage Kaiser's behavioral health line through your member portal or the number on the back of the card and ask what their in-system options are. If those options do not fit, the SCA conversation with Kaiser is the next step. We can help structure the SCA request if it makes sense to pursue.

Health Net.

Health Net California commercial

In-network status with Shift: not currently contracted. OON-billable on PPO plans with OON benefits.

Health Net is a regional California carrier (part of Centene). Its commercial PPO plans usually include an out-of-network behavioral health benefit. Health Net administers some Medi-Cal managed care plans and some Medi-Cal MOUs, but the Medi-Cal benefit does not generally include an out-of-network outpatient SUD benefit for commercial purposes. Verify whether the policy is the commercial PPO or one of the Medi-Cal lines before any OON conversation.

Common employer plans.

The phrase "employer plan" usually means one of two things. Either the employer fully insures through a carrier (Anthem, Aetna, Cigna, United, BSCA) and the carrier's standard plan design applies, or the employer self-funds and contracts the carrier as the network and claims administrator. Most large employers in California (tech, finance, healthcare systems, large public employers like the UC system) are self-funded. Self-funded plans write their own benefit rules within the carrier's network. The behavioral health benefit on a self-funded plan can be more generous than the carrier's standard commercial product or less generous.

What this means in practice: do not assume your employer plan has the same benefits as another employee at another company on the same carrier. Verify the specific plan. The Summary of Benefits and Coverage (SBC) document is required to be furnished by the employer for each plan and is the cleanest place to read the in-network vs out-of-network cost-share tier and the out-of-pocket maximums. The medical necessity criteria and authorization rules are usually in the Summary Plan Description (SPD), which is a longer document the employer's benefits team can provide.

Union health funds and Taft-Hartley trusts.

Union members in California are usually covered through one of three structures: a single-employer union benefit (the union has a contract with one employer), a Taft-Hartley multiemployer trust (a separate legal entity that pools contributions from many employers to fund benefits for a defined craft or trade), or a public-sector benefit (CalPERS, county or municipal employee benefits).

Taft-Hartley multiemployer trusts run the gamut for behavioral health benefits. Some have purpose-built SUD benefits with generous out-of-network coverage because the membership skews toward populations (skilled trades, transportation, construction) where SUD treatment access is a known priority. Some have very narrow benefits. Most have separate prior authorization rules from the underlying carrier or third-party administrator. The Milwaukee Drivers' Trust is one of several trusts whose plan design pays high out-of-network rates for outpatient SUD treatment; it is not a California-located fund but its members can be in California. Other trust populations vary widely.

The practical move with a union health fund or Taft-Hartley trust: read the Summary Plan Description (the trust is required to furnish it on request), call the fund's member services line, and verify the specific behavioral health benefit and the OON terms. We do this verification for you when we run benefits. The union and Taft-Hartley page walks through the patterns we see most often.

Skip the speculation. Run your specific plan. Two minutes to share the card. We come back with what your specific plan covers and what you would owe, in writing, before you commit to anything.

Check your benefits Or call (805) 815-6777

Entertainment industry plans.

SAG-AFTRA Health Plan, the Motion Picture Industry Health Plan, the Directors Guild plan, the Writers Guild plan, Actors' Equity, IATSE National Health and Welfare Fund, and the AFM-local plans serve a working population for whom thirty-day disappearances are essentially incompatible with the work. Most of these plans include an out-of-network behavioral health benefit. Some run their behavioral health through a carve-out vendor (Optum, Anthem, etc.); some run it in-house. The SAG-AFTRA Health Plan moved its behavioral health carve-out to Anthem effective 2026-01-01, which changed the authorization pathway for that plan's members. The entertainment industry plans page goes through each one.

Medi-Cal and Medicare.

Shift does not accept Medicare. Medi-Cal is pending county MOU. If you are on Medi-Cal managed care or Medicare, we will tell you on the first call that we are not the right fit for your current coverage and we will help you find a provider whose network status fits your plan. We do not admit patients on benefits that do not pay.

TRICARE.

Shift does not accept TRICARE. Active duty service members, retirees, and military dependents on TRICARE benefits are best served by TRICARE-network providers and the military health system's behavioral health resources, including the VA for veterans and the Defense Health Agency's purchased-care network for active duty.

The one paragraph to come back to.

Shift is out-of-network with every commercial carrier as of right now. The only number that matters for your specific case is the number that comes back when we verify your specific plan. Most commercial PPO plans on the major California carriers include an out-of-network behavioral health benefit. Most HMO plans do not, though single case agreements are a path when the in-network option does not fit. The verification call is free, two minutes, and the answer comes back in writing the same day. If the math does not work on your plan, we will say so on the call.

Related reading