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Ambetter from Sunshine Health: Detox & Rehab Centers in FL That Take Ambetter

Ambetter from Sunshine Health provides Florida residents comprehensive healthcare coverage, including coverage for substance use disorder (SUD) treatment.1 If you’re an Ambetter from Sunshine Health member struggling with drug or alcohol use, your insurance plan may be able to help cover the cost of detox, inpatient and outpatient rehab, and long-term residential treatment. This page will help you understand what your insurance plan may cover and how to check your coverage for rehab in Florida or out of state.

Florida is known for its white-sand beaches and year-round sunshine. But the state is also known for its culture of drug and alcohol use, with visitors flocking to cities like Daytona, Miami, and Panama Beach to party. Unfortunately, this doesn’t come without consequences. In 2020, more than 68,000 people were arrested for a drug-related offense in Florida. That same year there were 7,460 fatal overdoses throughout the state.2

If you’re a Florida resident struggling with drug or alcohol use, you’re not alone. Seeking treatment for addiction is a brave step, but you shouldn’t have to do it alone. The good news is that your Ambetter from Sunshine Health insurance may be able to help cover the cost of addiction treatment including detox, inpatient and outpatient rehab, and long-term residential treatment.

What Is Ambetter from Sunshine Health?

Ambetter offers affordable, high-quality health insurance throughout the U.S.3 In Florida, the insurance company is branded as Ambetter from Sunshine Health and provides healthcare coverage to residents throughout the state.

Ambetter from Sunshine Health is a subsidiary of Centene Corporation, which is a Fortune 500 company with over 30 years of experience in the Managed Care industry.4 Ambetter from Sunshine Health provides coverage for more than 1 million members and offers Medicare, Medicaid, and Individual plans.5

Does Ambetter from Sunshine Health Cover Rehab Treatment?

Yes, Ambetter from Sunshine Health may be able to provide full or partial coverage for rehab and other treatment in Florida and out of state, although coverage will vary.

The Affordable Care Act (ACA) mandates all marketplace providers to cover 10 essential health benefits for members.6 One of these essential health benefits is the treatment of substance use disorder (SUD).6 Keep in mind that coverage varies depending on the specific plan you have as well as factors like the type of addiction treatment you receive, where you receive it, and for long. It’s a good idea to check with your provider by calling the number on the back of your insurance card to verify your coverage. This way you’ll know exactly what will be covered and what you may be responsible for paying.

You can also get in touch with American Addiction Centers (AAC) by calling our helpline at AAC has treatment facilities across the U.S. that are in-network with Ambetter. Our team of admissions navigators can answer any questions you might have about addiction treatment options, verify your insurance over the phone, and help you with the admissions process once you’re ready.

What Substance Addiction Does Ambetter from Sunshine Health Cover?

Addiction can take many forms. If you’re struggling with drug or alcohol use, you can use your Ambetter from Sunshine Health insurance to provide full or partial coverage for addiction treatment for substances such as:

  • Alcohol.
  • Cocaine.
  • Crystal meth.
  • Heroin.
  • Marijuana.
  • Opioids.
  • Prescription drugs.

What Types of Addiction Treatment Does Ambetter from Sunshine Health Cover?

Ambetter from Sunshine Health may be able to cover at least some of the cost of addiction treatment, such as:7, 8

  • Detox programs: Although not always necessary, most treatment programs begin with detox. Detox is the process in which the body rids itself of substances (e.g., alcohol, drugs). Because detox can cause uncomfortable and even dangerous side effects, it’s often managed with medications administered by a physician.
  • Residential inpatient programs: With an inpatient program, patients live in a home-like setting at a facility full-time. While each program differs, patients can expect a variety of therapeutic approaches designed to help them examine destructive beliefs, patterns, and self-concepts.
  • Outpatient treatment programs: Outpatient treatment varies, but often involves a combination of group and individual therapy, as well as cognitive-behavioral therapy (CBT), motivational interviewing (MI), and other types of behavioral therapy.
  • Intensive outpatient programs (IOPs): For patients who need an outpatient treatment program with additional structure, an IOP can be a good fit. With an IOP, patients attend treatment for several hours each week and may transition to an outpatient program after.
  • Partial hospitalization programs (PHPs): In a PHP, patients live at home and attend treatment 5 or more days per week, for up to 6 hours per day.
  • Aftercare: Any ongoing treatment, such as 12-step meetings like A.A. is considered aftercare. Once a patient completes an inpatient or outpatient program, an aftercare program is designed to help them sustain their recovery and live a happier, healthier, more fulfilling life.

Does Ambetter from Sunshine Health Cover Mental Health & Dual Diagnosis Treatment?

Yes, Ambetter from Sunshine Health should cover some, if not all, mental health and dual diagnosis treatment as mandated by the Affordable Care Act (ACA).6

Co-occurring disorders exist when someone has a mental health disorder along with substance use disorder (SUD). Some common mental health disorders that occur alongside SUD include:9

  • Anxiety.
  • Attention-deficit hyperactivity disorder (ADHD).
  • Bipolar disorder.
  • Depression.
  • Personality disorder.
  • Schizophrenia.

Approximately half of the people who experience SUD also experience a co-occurring mental health disorder and vice versa.9 Research strongly suggests that patients who receive dual diagnosis treatment (e.g., treating both disorders at the same time), experience better outcomes.9

In-Network vs. Out-of-Network Drug Rehab Centers

Ambetter from Sunshine Health has a network of providers that offer a wide range of medical and mental health services. Ambetter from Sunshine Health contracts with these providers to get better pricing, making them in-network.10 If you go to an out-of-network provider, the costs may not be covered, or you may need prior authorization.10 Whenever possible, it’s best to seek treatment at a facility that is in-network. Although in-network facilities can help you save money, it’s important to not let the cost of rehab deter you from getting the help you need. If you can’t find in-network treatment, you still have several options to help pay for the cost of rehab, including grants, loans, scholarships, and sliding scales.

How to Check Your Ambetter from Sunshine Health Coverage for Rehab

Finding a treatment facility can feel overwhelming, but knowing in advance what your Ambetter from Sunshine Health insurance will cover can give you peace of mind. The good news is you can check your coverage at an American Addiction Centers (AAC) rehab in Florida or out of state in 2 easy ways:

  1. Contact an AAC admissions navigator at if you aren’t ready to talk. You’ll be able to share your story and get helpful information regarding treatment.
  2. Fill out the form below to check your insurance coverage.

Rehab Centers That Accept Ambetter from Sunshine Health

American Addiction Centers (AAC) is an in-network provider with Ambetter, which means that your Ambetter from Sunshine Health plan may provide partial or full coverage for treatment at an AAC facility in Florida or out of state. AAC has treatment centers across the U.S., including the following that accept Ambetter:

  • Desert Hope Treatment Center: Located near Las Vegas, Nevada, this facility caters to patients from all walks of life. Desert Hope offers specialty programs for drug and alcohol use, including programs specifically designed with first responders and veterans in mind.
  • Greenhouse Treatment Center: This rehab facility has locations in Arlington and Dallas and allows you or your loved one to receive individualized drug and alcohol treatment in a calm setting. Greenhouse offers a variety of treatment options including co-occurring disorder treatment and a specialized LGBTQ program.
  • Oxford Treatment Center: Nestled in Etta and Oxford, Mississippi, this treatment center offers high-quality addiction treatment in a natural, serene environment. Patients can enjoy amenities including an equestrian center, fitness center, walking trails, and more.
  • Recovery First Treatment Center: Located in Hollywood, Florida, you can find superb treatment at Recovery First with several options for care and amenities.
  • River Oaks Treatment Center: Located outside of Tampa, Florida, River Oaks offers personalized treatment for addiction and co-occurring mental health issues.

Deciding to seek treatment for addiction is courageous and you deserve all the help you can get. American Addiction Centers is committed to helping break the cycle of addiction and can help you find the right treatment program for your unique needs. Contact us at to speak to one of our compassionate admissions navigators.

 

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