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Welcome to the helpline at RehabNet.com, we are open around the clock, ensuring you can discuss treatment options for yourself or someone close to you at any time. This line is managed by Lumina, an esteemed addiction recovery institution with facilities nationwide.
Upon reaching out to our helpline, you’ll engage with a dedicated treatment specialist ready to guide you through the various mental health and addiction recovery services available at any Lumina facility.
Neither you nor the individual in need are bound to enroll in any program with Lumina when utilizing our assistance line.
In instances where our facilities might not align with your specific requirements, our team can suggest alternative detox or rehabilitation centers, including the possibility of connecting with the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline for a more tailored recommendation. It’s important to note that we do not gain financially or in any other form from referrals to different treatment centers.
Our assistance line is a complimentary service, with no charges incurred by the caller. Our primary goal is to facilitate the discovery of a Lumina Healing Center that matches your recovery aspirations.
For an extensive list of recovery programs, we encourage you to explore our main website’s top-ranked rehab facilities or utilize the SAMHSA Treatment Services Directory.
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Published: November 5, 2023
Centene Insurance was founded by an orphan who spent her career as a hospital’s bookkeeper. The company is now one of the country’s biggest carriers of Medicaid plans.
It offers coverage through the Healthcare Insurance Marketplace, contracts with the American Department of Defense, and coverage available through its subsidiaries. Centene policyholders can use their health care coverage to access substance use disorder treatment.
Learn more about what substance abuse treatment options Centene Insurance offers, where you can get coverage, and what factors affect your health insurance coverage.
Answer: Possibly. If you’ve purchased Centene Insurance through the Healthcare Insurance Marketplace, rehab coverage is required under the Affordable Care Act (ACA).
If it’s offered through a different subsidy of Centene Corporation, it will depend on the state and county you live in, your insurance plan, and the treatment program.
You’ll need to check that the treatment center or rehab facility for your drug abuse or alcohol addiction is considered a network provider.
Answer: Centene covers all types of substance use disorder treatment. However, your specific insurance plan may not cover all of your addiction treatment.
It may cover a lower percentage of the total cost of inpatient treatment plans but a higher percentage of outpatient programs, as those can cost significantly less. It may not cover detox unless your healthcare providers submit a referral.
If your plan was purchased by March 23, 2010, and has not changed significantly, offering the same coverage as later insurance plans isn’t required.
Centene may cover medical detox, but you must check your specific plan. Even if it’s generally covered, you may negate that coverage if you’re treated at an out-of-network facility or fail to gain pre-approval.
Your insurance plan may cover medication-assisted treatment (MAT), but there may be restrictions on that coverage. Sometimes, health insurance will only cover a portion of a prescription, so you may have out-of-pocket costs even if your medication is covered.
MAT can refer to medication used to help you through initial withdrawal symptoms in drug addiction treatment. It can also apply to medication that you take to maintain your sobriety.
Centene’s Medicare Part A covers inpatient rehab. Before the ACA, Medicaid did not cover substance abuse treatment for minors or childless adults. However, some states now offer coverage for those individuals.
This type of treatment falls under the Mental Health Parity and Addiction Equity Act (MHPAEA), which requires insurance coverage for substance use disorder (SUD) treatment to be equivalent to any other medical and surgical benefits.
Additionally, any plan purchased from Centene health insurance companies through the Health Insurance Marketplace will include some coverage for inpatient rehab.
A dual diagnosis is given when a patient has co-occurring disorders of substance abuse and mental health. You’ll need to check your specific Centene health plan or contact your insurance provider to determine what benefits might apply to your dual diagnosis.
Medicare, Medicaid Part B, and any ACA plans through Centene will cover some outpatient treatment programs.
Your explanation of benefits (EOB) will tell you what percentage of treatment will be paid through insurance and what portion will be your responsibility.
You may have copays and a remaining balance if you haven’t met your deductibles.
Behavioral health services are considered Essential Benefits under the Affordable Care Act and, therefore, are covered by Centene plans. Medicare and Medicaid also cover mental health services.
Even if your insurance plan was grandfathered in before the ACA took effect, you may have some sort of Employee Assistance Program (EAP) benefits that offer a few behavioral health counseling sessions for free.
Behavioral health treatment is evidence-based and shown to heavily contribute to your overall wellness and relapse prevention.
Check with the Centene provider in your area to find out what types of continuing care are covered under your plan.
Coverage may apply to additional inpatient or outpatient treatment, residential treatment, or sober living communities.
Verify that these treatment services are in-network and whether you need a referral. It’s important that you (or your loved one) receive the right type of treatment for substance use disorder.
Centene Corporation has an extensive network of health plans through its subsidiaries. However, each plan is shaped by factors that affect which network providers are covered and the total cost of your monthly premiums.
Factors that affect coverage levels and pricing include:
*While insurance companies must offer coverage regardless of pre-existing conditions, your insurance plan may pre-date this law.
Answer: Whether Centene will cover out-of-network rehab centers depends on your plan and location. To find out if your insurance covers healthcare providers, you’ll need to contact your local insurance office.
If your policy has you listed as a Georgia resident, for example, it may be hard to get treatment covered if you decide to seek help in Florida.
There are a variety of options through Centene Corporation, depending on your location, income, and military service.
Centene provides healthcare plans through:
However, the coverage for each of these will vary by state, county, and plan type.
For example, a search for plans in Texas resulted in the following options:
Centene also takes a whole health approach by including:
Addiction is a chronic disease, and treatment is ongoing for the rest of your life.
Depending on your plan, you may be eligible for coverage for addiction to:
Centene Insurance offers Medicaid plans in 30 states, with coverage to be extended to Oklahoma residents starting in 2024.
Medicare Prescription Drug Plans (PDPs) are offered in all 50 states and Washington, D.C., and Wellcare has Medicare Advantage Plans in 36 states. Illinois, Michigan, Texas, South Carolina, and Ohio are all part of the Medicare-Medicaid Demonstration Plan through Centene.
Here are the top ways to find Centene-approved rehab facilities near you:
If you’re struggling to make sense of your insurance company’s coverage even with the information they provide, don’t worry.
RehabNet.com can help with locating drug and alcohol rehab programs that are covered by your Centene insurance plan. Simply call our helpline today, and we’ll walk you through it.
Ambetter HEALTH. “Sign up for high-quality, affordable health insurance.”
Centene Corporation. “Ethics & Integrity.”
Centene Corporation. “Medicaid.”
Centene Corporation. “Medicare from Wellcare.”
Centene Corporation. “Our History.”
Centene Corporation. “Products & Services.”
Centene Corporation. “Texas Solutions.”
Centene Corporation. “Whole Health Solutions.”
Centene Corporation. “Why We’re Different.”
Center for Medicare Advocacy. “Medicare Coverage of Mental Health and Substance Abuse Services.”
Centers for Medicare and Medicaid Services. “Coverage and Delivery of Adult Substance Abuse Services in Medicaid Managed Care.”
Children in an Urban America Project. “History of the Betty Brinn Children’s Museum.”
Healthcare.gov. “Grandfathered health plan.”
Healthcare.gov. “Health benefits & coverage: Mental health & substance abuse coverage.”
Healthcare.gov. “Health benefits & coverage: What Marketplace health insurance plans cover.”
U.S. Department of Health and Human Services. “About the Affordable Care Act.”
U.S. Department of Health and Human Services. “Pre-Existing Conditions.”
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