NYSHIP Empire Plan Coverage for Residential Treatment
Empire Plan members may be able to use their non-network mental health and substance use benefits for treatment on Maui.
If you’re covered by The Empire Plan through NYSHIP, your non-network mental health and substance use benefits may help cover part of residential treatment at Maui Recovery. Carelon Behavioral Health manages these benefits, and your stay must be approved before admission. Send us your plan details or call (877) 317-8260, and we’ll check what your plan covers.
Who has The Empire Plan
NYSHIP, the New York State Health Insurance Program, covers about 1.2 million people. The Empire Plan is its main plan. Members include:
- New York State employees and retirees, including CSEA, PEF and UUP members
- Employees of more than 800 local government employers: school districts, fire districts, counties, cities, towns, villages and library systems
- Their enrolled spouses, partners and dependents
How Empire Plan mental health and substance use benefits work
- The Empire Plan’s Mental Health and Substance Use Program is administered by Carelon Behavioral Health.
- Maui Recovery is not in the Carelon network. Care here is non-network.
- Non-network care is subject to a deductible and coinsurance, up to an annual maximum. The amounts depend on your group, and they’re listed in your Empire Plan At a Glance.
- The stay must be approved by the program before treatment. If Carelon doesn’t certify it as medically necessary, the plan won’t pay for it. Our team handles this process with Carelon.
Key facts
| Licensed | Residential treatment center |
| Accredited | The Joint Commission |
| Location | Lahaina, Maui, Hawaii |
| Setting | 20 acres overlooking the Pacific |
| Size | 8 beds, plus private villas |
| Care | Medical detox and residential treatment |
| Treats | Substance use and mental health |
| Typical stay | 30 to 90 days |
| Insurance | Out-of-network with all plans |
| Admissions | (877) 317-8260 |
Using your Empire Plan at Maui Recovery
Benefits check
Send your Empire Plan card or call us. We check your non-network benefits and explain them.
Carelon approval
With your permission, our team works with Carelon on approval and provides the clinical information it needs.
Arrival
Once approved, our admissions team helps coordinate your arrival on Maui.
Claims
Our billing team submits claims and works with your plan directly, so you don’t have to.
Why New York public employees choose treatment on Maui
Teachers, firefighters and state workers often know many people in their community. Treatment far from home offers privacy away from colleagues, students and neighbors, and real distance from the routines and stress tied to substance use.
Maui Recovery is a licensed luxury residential treatment center with only 8 beds, set on 20 acres overlooking the Pacific in Lahaina. Clients receive medical detox and residential treatment for substance use and mental health, with a typical stay of 30 to 90 days.
Empire Plan FAQ
Does The Empire Plan cover rehab outside New York?
The Empire Plan includes non-network benefits for mental health and substance use care, and those benefits aren’t limited to New York. Whether a stay is covered depends on approval and your group’s terms. A benefits check confirms yours.
Is Maui Recovery in the Carelon network?
No. Maui Recovery is a non-network provider for The Empire Plan.
Do I need approval before I go?
Yes. The Mental Health and Substance Use Program must approve the stay before treatment, and care that isn’t certified as medically necessary isn’t covered. Our team handles this with Carelon.
What will I pay?
That depends on your group’s non-network deductible and coinsurance and on any amount above what the plan allows. We’ll go over this with you after your benefits check.
Will my employer find out?
Your health information is protected by federal privacy law, and we don’t contact your employer.
Does The Empire Plan cover detox?
Medically necessary detox is part of the mental health and substance use benefit. Approval rules apply in the same way.
More about how insurance works at Maui Recovery: Using your insurance.
Find out what your plan covers
Send us your insurance details and our admissions team will contact your plan, then walk you through what we find. Our billing team works directly with your insurance company, so you don’t have to handle claims or paperwork.
Prefer to talk? Call (877) 317-8260.
Maui Recovery is not affiliated with or endorsed by NYSHIP, the New York State Department of Civil Service or Carelon Behavioral Health. Plan details come from published NYSHIP documents and vary by group and year; your plan documents control. We cannot guarantee coverage or payment. Updated October 27, 2026.