Find out how we can help you on your road to recovery.

Insurance Verification

Let’s verify your coverage for treatment at a Vogue Recovery Center location. Your information is always confidential.
Have your health insurance card ready

How to fill out our verification form

Identify Your Insurance Provider
We’ll be able to tell you if your provider is in-network.

Provide Contact Information
You will receive a call from us with treatment options.

Enter Your Policy Information
We’ll need information located on your insurance card.

Your Name(Required)
Who is seeking treatment?
Loved One’s Information (Only Complete if You Are Seeking Treatment for A Loved One)

Loved One's Name
MM slash DD slash YYYY
MM slash DD slash YYYY

Insurance Information

Would you like us to verify your insurance benefits? (or a loved one's insurance benefits?)
Policy Holders Name
MM slash DD slash YYYY
Policy Holders Address*

Private Insurance or Self-pay, We’ll Work with You.

vogue insurance

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