Rehab Centers That Accept Ambetter Health Insurance

When it comes to getting treatment for substance abuse, many people are overwhelmed and discouraged by how many options there are, what treatment will look like, and the cost of a rehab program. Many options may help you cover the cost of your treatment, including insurance coverage.

Though your insurance company probably won’t cover the entire cost of your treatment, most major health insurance plans, like Ambetter Health Insurance, will help cover the cost at least partially. This can make it easier to get the treatment you need.

Offering health insurance plans in Alabama, Arizona, Arkansas, California, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, and Washington, Ambetter Health is a major insurance provider in the U.S.

Keep reading to learn about getting your addiction treatment covered through your Ambetter Health Insurance plan, including what kind of treatment is covered, factors that affect coverage, and more.

Yes, Ambetter Health Insurance plans do help cover the cost of drug and alcohol rehab, but it’s important to understand the details of this coverage. Coverage varies between Ambetter Health plans and may be contingent on certain prerequisites such as meeting your deductible, getting an official diagnosis, and more.

To fully understand the coverage your Ambetter plan offers, it’s best to call a representative for more details about your plan and what kind of treatment you may be eligible for.

The Federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) plays an important role in addiction treatment for health insurance plans across the country. The law prevents insurance providers from offering better coverage for medical/surgical treatments than for mental health and substance abuse treatments.

In other words, this prevents your insurance company from making it harder to get substance abuse treatment compared to other medical treatments. Later on, the Affordable Care Act (ACA) was passed, which now requires all health insurance companies to cover mental health treatment at least partially, which includes addiction rehab.

There are many types of addiction treatment that Ambetter Health may offer coverage for. Depending on the type of substance use disorder (SUD) you have, the severity of it, and your treatment history, you may find certain types of treatment to be more well-suited for your needs.

Ambetter Health Insurance may help cover the cost of several evidence-based treatment methods such as detoxification, inpatient treatment, outpatient treatment, medication-assisted treatment, therapy and counseling, and aftercare.

Medical detox is a very common treatment service typically offered at the start of rehab. A detox happens when your body processes and metabolizes any remaining addictive substances. It can be a very difficult part of your recovery journey due to withdrawal symptoms and can even be dangerous without medical supervision.

During a medical detox, you’ll have continual medical supervision while you detox from addictive substances. The idea is to make the process as safe and comfortable as possible. You can expect your care team to monitor your vitals, administer necessary treatments and medications, and help you manage withdrawal symptoms and cravings.

Inpatient rehab, or residential treatment, is one of two kinds of treatment. Inpatient treatment can be a great option for individuals who have previously tried outpatient treatment or have more severe addictions. That being said, it can be very beneficial for anyone dealing with addiction.

Inpatient rehab programs are extended treatment programs usually spanning 30, 60, or 90 days. During the course of treatment, individuals live in the rehab facility. This helps reduce outside stress, triggers, and temptations. It also provides a supportive and safe environment for recovery.

You’ll follow a strict schedule during inpatient treatment, likely including therapy, counseling, and other types of treatment each day.

Outpatient rehab is the other major category of addiction rehab. Outpatient rehab can be a great follow-up to inpatient treatment, good for those who cannot leave their home for an extended period, or those with less severe addictions.

Rather than living in a treatment center during treatment, outpatient programs provide treatment several times a week at a care facility that individuals travel to. Because outpatient treatment is less intensive, it often lasts longer than inpatient treatments. Some programs can last several weeks or months.

There are also intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs). Think of these as steps between inpatient and outpatient treatment. These may be good options for those who are not quite ready to step down to outpatient treatment but don’t need full inpatient treatment.

Medication-assisted treatment (MAT) is an evidence-based treatment method that uses FDA-approved medications to treat and manage addiction.

It can sound counterintuitive to take a medication to treat substance addiction, but the medications used in MAT are indicated to help manage withdrawal symptoms, curb cravings, and reduce the effects of addictive substances.

MAT is often used in conjunction with other addiction treatment services and can greatly increase patient success. Over time, patients can be weaned off medication.

Therapy and counseling are two integral parts of addiction recovery. They are both offered in several formats.

Therapy is typically offered as individual therapy or group therapy. Some treatment centers may offer other kinds of therapy, like family therapy or couples therapy. Behavioral therapy, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT), is often used in addiction treatment.

As for counseling, individual and group settings are typically offered in rehab programs. Individual counseling can be a great opportunity to discuss your goals, fears, and progress. As for group counseling, you’ll have an opportunity to connect with peers and hear their experiences with addiction.

Dual diagnosis programs are a specialty type of treatment program that some recovery centers offer.

Many people who struggle with substance addiction have co-occurring disorders, also called dual diagnoses. Co-occurring disorders are mental health conditions like anxiety, depression, or post-traumatic stress disorder.

Dual diagnosis programs are designed to address both substance addiction and mental illness simultaneously, as they often impact one another. Many people with mental health conditions find their illness exacerbates their addiction and vice versa.

Aftercare, also called continuing care, is the next step after a treatment program. Aftercare is a highly individualized part of recovery, so you and your healthcare provider will discuss what aftercare options may be best for you.

The idea behind continuing care is to help ease the transition between treatment and day-to-day life as well as reduce the risk of relapse. Aftercare services can include regular therapy or counseling sessions, 12-step groups, sober living, or outpatient treatment.

You must discuss your coverage details with an Ambetter Health Insurance representative to ensure that your plan covers specific treatment services. Coverage varies between plans.

As mentioned above, coverage for addiction treatment varies between insurance plans. This is because several factors can affect your coverage.

Factors that may affect your rehab coverage include:

• The state you live in
• The type of plan you have
• Whether you choose an in-network or out-of-network provider
• Your copays and deductibles
• Preauthorization and medical necessity requirements
• The type of treatment you choose

No, Ambetter Health does not cover out-of-network non-emergency services such as alcohol and drug rehab programs. For more specific details on your out-of-network coverage, contact Ambetter Health.

It’s important to understand the difference between in-network and out-of-network providers when starting your treatment journey. In-network providers are those who are contracted with Ambetter Health to offer lower treatment costs. Out-of-network providers are not contracted with Ambetter Health, and thus, do not offer contracted rates, which often leaves you to cover the entire bill.

If your preferred provider is out-of-network, you can of course choose to see them, but keep in mind your cost of treatment will likely be much higher. If you’re adamant about choosing an out-of-network provider, you may be able to set up a payment plan with the treatment center. Others may offer sliding-scale fees.

Ambetter Health offers a range of health insurance plans to choose from. This allows you to choose a plan that will best meet your needs.

It’s important to review the details of each plan as they offer different amounts of coverage, have different deductibles, and may provide access to a different list of providers.

Ambetter Health offers the following types of insurance plans:

• Individuals plans
• Family plans

Ambetter Health offers three tiers of insurance on HealthCare.gov:

• Ambetter Essential Care (bronze plans) – These plans have lower monthly premium payments but can result in higher out-of-pocket costs.
• Ambetter Balanced Care (silver plans) – These plans balance monthly premium payments and out-of-pocket costs. Ambetter Balanced Care plans also offer out-of-pocket payment reductions for copays, deductibles, and coinsurance.
• Ambetter Essential Care (bronze plans) – These plans have lower monthly premium payments but can result in higher out-of-pocket costs.
• Ambetter Balanced Care (silver plans) – These plans balance monthly premium payments and out-of-pocket costs. Ambetter Balanced Care plans also offer out-of-pocket payment reductions for copays, deductibles, and coinsurance. 
• Ambetter Secure Care (gold plans) – These plans have higher monthly premium payments, which reduce your out-of-pocket costs in the long run.

Ambetter Health also offers the following types of plans in select states:

• Ambetter Health Premier: Grouped by bronze, silver, and gold, these plans offer the broadest network of providers, cover essential health services, and don’t require referrals.
• Ambetter Health Select: Offered exclusively in Georgia, these plans offer affordable premiums and are offered in bronze, silver, and gold tiers.
• Ambetter Health Value: Value plans offer access to a network of providers, and members are assigned a primary care physician (PCP). Speciality services require referrals. These plans are offered in Texas and Florida and are grouped by bronze, silver, and gold.
• Ambetter Health Solutions: Available in bronze, silver, and gold, these plans are meant for individuals purchasing health insurance through defined contributions or health reimbursement arrangements, such as an individual coverage health reimbursement arrangement (ICHRA) or qualified small employer health reimbursement arrangement (QSHERA). These plans are offered in Georgia, Indiana, Mississippi, Missouri, Ohio, and South Carolina.

For more information on specific plan types and coverages, contact an Ambetter Health Insurance representative. For additional guidance on insurance coverage for addiction treatment, call our helpline today.

Now that we’ve covered the types of treatment covered through Ambetter Health Insurance and what factors may affect your coverage, you may be wondering what types of addiction are covered by your plan.

Substance addiction treatment covers a variety of addiction types. That being said, treatment plans typically cover a wide variety of addictions.

Ambetter Health Insurance plans may offer coverage for the treatment of:

• Alcohol addiction
• Cocaine addiction
• Stimulant addiction
• Opioid addiction
• Heroin addiction
• Benzodiazepine addiction
• Marijuana addiction
• Methamphetamine addiction
• Prescription drug addiction

If you’re unsure whether your addiction treatment may be covered, don’t hesitate to contact Ambetter Health for more information about your substance abuse treatment coverage.

It may be daunting to think about finding a treatment center that not only accepts your insurance but also offers the treatments and amenities required for your unique needs. However, there are several easy ways you can find a rehab center that accepts Ambetter Health.

Use the following methods to find a treatment center that accepts your plan:

• Use Ambetter’s provider directory. In your Ambetter Health account, you can utilize the provider directory to search for addiction treatment centers that are in-network for your plan.
• Call rehab facilities. If you find a treatment center that you like but are not sure if they accept your insurance, you can always call to confirm if they’re in-network with your provider.
• Check out our lists of treatment centers by state. Each list contains some of the top-rated treatment centers in the state as well as information about accepted insurance plans and treatment offerings.

Keep in mind, you may need to meet certain requirements before your Ambetter plan covers your substance abuse treatment. Talk with a representative to confirm whether you need prior authorization, a referral, or an official diagnosis before enrolling in a program.

If you or your loved one needs addiction treatment, you may be worried about the cost of treatment. Thankfully, if you have health insurance, you may be able to get your treatment partially covered.

Ambetter Health Insurance plans offer coverage for addiction rehab, though the amount of coverage depends on several factors.

For more help with verifying insurance coverage and finding the right treatment center for you, call our helpline today.