Ambetter is an insurance company that provides health insurance to over 2 million people in the United States. As part of the Affordable Care Act (ACA), Ambetter provides marketplace insurance plans that cover some or all the costs of drug and alcohol rehab programs.

If you have Ambetter health insurance and are searching for a substance abuse treatment facility that is covered by your plan, American Addiction Centers (AAC) is here to help.


Does Ambetter Cover Addiction Treatment?

You may be wondering if your Ambetter insurance plan covers drug and alcohol addiction treatment. The short answer is yes. Ambetter will cover at least some of your substance abuse treatment. Based on the plan you have, your treatment may be partially or fully covered.

The Affordable Care Act (ACA) requires all insurance companies to provide some type of coverage for addiction treatment. The ACA requires all health insurance plans to cover behavioral health treatment (e.g., psychotherapy and counseling), mental health inpatient services, and substance use disorder (SUD) treatment.4

The financial responsibility you have for your treatment will depend on the state you live in, the healthcare plan you have, the treatment you need, and if you choose an in-network or out-of-network facility. No matter what rehab facility you choose and what insurance policy you have, you will likely be responsible for paying some out-of-pocket costs.

The amount of coverage you have can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.

How to Check Your Ambetter Rehab Coverage 

Before choosing the right substance abuse rehab center for you, check your Ambetter policy benefits to determine which costs will be covered by your insurance company and which will be out-of-pocket for you. Call the number on the back of your insurance card or log in to your account on Ambetter’s website to learn more about what your specific policy plan covers.

Knowing exactly what your Ambetter insurance plan covers can give you peace of mind while you or your loved one is in rehab for addiction. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles.


What Rehab Centers Take Ambetter Insurance?

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Ambetter insurance plan, the following AAC facilities accept Ambetter for drug and alcohol addiction rehab.

  • Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth, all in a luxurious setting with high-end amenities.
  • Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and telehealth, all with individualized treatment programs.
  • Recovery First Treatment Center: Located in Hollywood, Florida, Recovery First treats substance use disorders by combining evidence-based therapeutic modalities with top-level care. Recovery First provides a personalized continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth.
  • River Oaks Treatment Center: Located in Riverview, Florida, River Oaks treats substance use disorders through combining evidence-based therapies with world-class amenities. Provided care includes detox, residential treatment, behavioral disorder treatment, dual-diagnosis treatment, outpatient services, and telehealth, all with individualized treatment programs.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Ambetter insurance.


Different Types of Ambetter Substance Abuse Treatment

If Ambetter is your insurance provider, your policy may cover the following for drug and alcohol addiction treatment:

Detox Services

Medical detox helps you withdraw safely from drugs and alcohol. Under 24/7 medical supervision, staff will work closely with you—and may prescribe medications to help ensure that you withdraw safely and that your symptoms are addressed as needed. Learn more about Medical Detox Centers Near Me.

Inpatient or Residential Care

Inpatient/residential live-in treatment centers provide substance abuse rehab onsite. You will live at the facility for 15, 30, 60 or 90 days, depending on your needs and the program you’re in. Learn more about Residential Inpatient Programs.

Partial Hospitalization Program (PHP)

These programs allow you to live at home throughout treatment and spend your days at the treatment facility. This is sometimes referred to as day treatment. Learn more about Partial Hospitalization Programs (PHP).

Intensive Outpatient Program (IOP)

These programs typically involve attending treatment programs approximately 3 evenings a week. People in these programs can live at home and go to work during the day. Learn more about Intensive Outpatient Care.

Outpatient Treatment

This is typically for those who have completed inpatient treatment. Patients live at home but attend the treatment center for 10–12 hours a week to complete the drug and alcohol rehab program. Learn more about Outpatient Programs.

Your Ambetter health insurance plan impacts your total cost of substance abuse treatment in terms of monthly premiums, copays, deductibles, and potential out-of-network costs. Some parts of rehab treatment may or may not be covered, but you can expect at least partial coverage under Ambetter, regardless of the plan you have.


Do Rehab Centers Need to Be In-Network to Accept Ambetter insurance?

In most cases, you will need to seek treatment at a rehab facility that is in-network with Ambetter to receive your full benefits. Even if you choose a center or program that is in-network, you may still be responsible for some of the treatment costs.

If you choose a facility that is out-of-network, you may be responsible for all the costs of your drug and alcohol addiction treatment. You may be able to discuss financing options such as a payment plan or scholarships offered by the treatment center.


What are Ambetter’s Coverage Levels and Plans?

Mental health and substance abuse treatment are considered essential health benefits. As a result, all marketplace plans—including Ambetter—must cover some of these costs for those who are seeking treatment. According to the ACA, all health plans in the marketplace must cover behavioral health treatment (e.g. psychotherapy and counseling), mental health inpatient services, and substance use disorder (SUD) treatment.1

Before choosing your Ambetter plan, it is important to take your medical needs and finances into consideration. You want to ensure that you’re selecting the right plan for you, especially if your healthcare needs include addiction treatments and medical care costs associated with drug and alcohol abuse.

Ambetter plans include:2

  • Bronze plans: Known as Ambetter Essential Care, these plans cover essential healthcare needs. They have lower monthly premiums but higher out-of-pocket costs if you need a lot of care. Bronze plans are best for those who do not need frequent medical care.
  • Silver plans: Known as Ambetter Balanced Care, these plans provide a balance between monthly premiums and out-of-pocket costs, particularly if you qualify for financial assistance. Silver plans offer the best value and are ideal for those who use their plan occasionally and prefer lower deductibles.
  • Gold plans: Known as Ambetter Secure, these plans offer high monthly premiums to help reduce your out-of-pocket costs. These plans are best for those who have frequent and/or ongoing healthcare needs.

Ambetter currently provides coverage in the following 20 states:3

  • Arizona
  • Arkansas
  • Florida
  • Georgia
  • Illinois
  • Indiana
  • Kansas
  • Michigan
  • Mississippi
  • Missouri
  • New Hampshire
  • New Mexico
  • Nevada
  • North Carolina
  • Ohio
  • Pennsylvania
  • South Carolina
  • Tennessee
  • Texas
  • Washington

Rehabs.com strives to provide you with the most updated information on each carrier’s addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.


 

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