Home / Coverage / Musicians and AFM Local Health Plans
Musicians and AFM Local Health PlansUsing your musicians local health plan for virtual outpatient treatment.
There is no single national health fund for working musicians. Health coverage for American Federation of Musicians members runs through local funds, employer plans, and individual coverage, which varies a lot from one player to the next. Your plan is unique. We verify yours specifically before you commit to anything.
The honest version.
We are out of network with commercial carriers. In-network credentialing is in progress. We verify your out-of-network benefits and tell you the real out-of-pocket number before you start.
What we will and will not tell you about cost.
We do not waive cost-shares. We do not tell you treatment is free. We verify your OON benefits, give you the real number, and if cost is a genuine barrier we will talk about it case by case.
The honest version: it is fragmented, and the national pension fund is not a health fund.
The American Federation of Musicians and Employers Pension Fund (AFM-EPF) is a pension fund, not a health plan. It does not provide medical or behavioral health coverage. Health coverage for working musicians runs at the local level and through other sources: the Local 802 funds in New York and the Local 47 funds in Los Angeles administer health benefits for eligible members in those areas, and many players carry employer coverage, a spouse's plan, or individual marketplace coverage. Because there is no single national AFM health fund, the first step is identifying which plan actually covers you. We read whatever you have, then pull your out-of-network behavioral benefit.
The pieces of the plan
- An allowed amount for each kind of visit or day of behavioral care.
- A deductible you meet before the plan starts splitting the cost.
- A coinsurance split after the deductible.
- An out-of-pocket maximum for the year, after which the plan covers more or all.
- An authorization step for intensive outpatient and PHP-intensity hour expansion, which we handle.
What we do for you on the benefits side
- Identify which plan actually covers you, then call it on your behalf to pull the actual out-of-network behavioral numbers for the level of care you need.
- Translate them into the dollar cost of a week of treatment, so there are no surprises.
- Submit the authorization and stay on the case through review and renewal.
- Bill what the plan considers reasonable, so there is no balance-bill surprise later.
Where musician coverage actually lives, and who to call.
Because there is no single national AFM health fund, your coverage depends on where you work and which local you belong to. Two of the largest local health funds are in the major recording and performing centers, and there is a well-known independent recovery resource for the music community that is not part of Shift.
The largest local health funds
The Local 802 funds in New York and the Local 47 funds in Los Angeles administer health benefits for eligible members in those areas. If you qualify through one of these locals, that fund's plan document controls your out-of-network behavioral benefit. Send us the front of your card and any fund materials and we will read them together.
Start the benefit check MusiCares (independent resource)A recovery resource for the music community
MusiCares is an independent charitable organization that supports the health and recovery needs of people who work in music. It is not part of Shift Support Network and not a health insurance plan. It can be a resource for navigating recovery and may help with referrals. If virtual intensive outpatient or PHP-intensity care is the right level of care, you can come to us and we verify your out-of-network behavioral benefit.
Start the benefit checkTreatment that does not pause your gigs.
Cohorts run morning, afternoon, or evening, all virtual. We can hold the schedule around a session, a run of shows, or a tour rehearsal block, and we keep documentation tight within 42 CFR Part 2 limits and your signed authorization. Nothing about your treatment goes to a label, a contractor, a bandleader, or a fund office without your written consent.
Plain-English answers.
Are you in network with my musicians local health plan?
No. We are out of network with commercial carriers and with the local musician health funds. In-network credentialing is in progress. Many local fund plans include an out-of-network behavioral health benefit, and we bill out-of-network. We verify your specific terms before you commit.
Is there a national AFM health plan I can use?
No. The American Federation of Musicians and Employers Pension Fund (AFM-EPF) is a pension fund, not a health plan, and it does not provide medical or behavioral health coverage. Health coverage for musicians runs through local funds such as Local 802 in New York and Local 47 in Los Angeles, employer plans, a spouse's plan, or individual coverage. We help you identify which plan covers you.
What is MusiCares and are you part of it?
MusiCares is an independent charitable organization that supports the health and recovery needs of people who work in music. It is not part of Shift Support Network and not an insurance plan. It can be a resource for navigating recovery and referrals. If virtual intensive outpatient is the right level of care, you can come to us and we verify your out-of-network behavioral benefit.
How do I find out what my plan really covers?
Send us the member ID and group number on the front of your card. We identify the plan, call it, pull the actual out-of-network behavioral numbers for the level of care you need, and translate them into what a typical week of treatment would cost you, before you start.
What about confidentiality? My contractor and bandleader cannot find out.
Substance use treatment records are protected by 42 CFR Part 2, the federal confidentiality rule that is stricter than HIPAA. We do not share with a label, contractor, bandleader, or fund office unless you sign a specific written authorization. Co-occurring mental health records are protected by HIPAA. Both rules combined are designed for exactly this situation.
How fast can you verify my benefits?
Same day in most cases if you send us the member ID and group number on the front of your card during business hours. The benefit check itself is no-cost and no commitment.
Verify your benefits in two minutes.
Send us the member ID and group number on the front of your card. We identify your plan, come back with your specific out-of-network deductible, coinsurance, out-of-pocket maximum, and what a typical week of intensive outpatient or partial hospitalization-intensity care would cost you. No commitment until you decide.
If you or someone you are with is in immediate danger, call or text 988 (the Suicide & Crisis Lifeline) or call 911. Shift Support Network is an outpatient program and is not an emergency service. Substance use treatment records are protected by 42 CFR Part 2.