AmeriHealth Insurance Coverage for Drug and Alcohol Rehab
If you have AmeriHealth insurance coverage and you are struggling with an addiction to drugs or alcohol, you may be wondering whether AmeriHealth covers detox or rehab treatments. With the introduction of the Affordable Care Act (ACA), which includes substance use disorders (SUDs) as 1 of the 10 elements of essential health benefits, AmeriHealth insurance plans are required to provide services for substance abuse treatment.1 However, your rehab coverage may vary depending on the type of AmeriHealth insurance plan you have and your place of residence.
American Addiction Centers (AAC) 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.
Does AmeriHealth Cover Drug and Alcohol Addiction Treatment?
Yes, most plans cover at least some of the costs of drug and alcohol rehab treatment. If you have an AmeriHealth insurance plan, the company will first determine if your treatment is medically necessary before covering any costs.
Depending on your insurance plan, limits may be placed on the number of days you have coverage for detox in a calendar year, the number of days you can be in an inpatient program in a calendar year, and how many days of outpatient rehab visits are covered in a calendar year.
Additionally, the services that are covered by your AmeriHealth plan may vary.
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 rehabilitation services received.
To see if your insurance covers treatment at an American Addiction Center (AAC) facility, reach out to AAC’s compassionate admissions navigators 24/7 at . Let us assist you on your journey to a healthier, happier life.
What Types of Substance Misuse Treatment Are Offered by AmeriHealth?
With most AmeriHealth plans covering at least some of the costs of addiction treatment, the type of rehab treatment process you undergo can vary in intensity and frequency. Types of substance abuse treatment may include:2,3
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.
Inpatient or Residential Rehab Treatment
With residential inpatient treatment, you receive treatment and live at the facility. Inpatient rehab typically involves group and/or individual therapy. It is often recommended for individuals with co-occurring mental health issues, limited outside support, home environments that don’t cater to sobriety, and poor treatment outcomes in the past.
Partial Hospitalization Program (PHP)
These programs allow you to live at home throughout treatment and spend your days at the treatment facility. Partial hospitalization is sometimes referred to as day treatment.
Intensive Outpatient Programs (IOP)
Intensive outpatient programs typically involve attending treatment programs approximately 3 evenings a week. Patients in these programs can live at home and go to work during the day.
Outpatient Rehab Treatment Programs
Outpatient rehab treatment programs provide treatment during the day or evening, but you return home at night. Treatment is similar to that of inpatient programs, and you typically receive individual and/or group therapy. Outpatient programs may allow patients to continue going to work or attending school while they receive treatment. It is often recommended for patients who have extensive social support and will not be in an environment that threatens their recovery.
When you decide to go to treatment for drug or alcohol addiction, you will work with your physician or addiction specialist regarding what type of rehab treatment, such as inpatient vs. outpatient, is best for you.
How to Check Your AmeriHealth Addiction Rehab Coverage
Before choosing the right drug and alcohol treatment center for you, check your AmeriHealth coverage and policy benefits to determine which costs will be covered by your insurance company and which will be out-of-pocket. Call the number on the back of your insurance card or log in to your account on AmeriHealth’s website to learn more about what your specific policy plan covers.
Knowing exactly what your AmeriHealth plan covers can give you peace of mind while you or your loved one is in rehab for drug or alcohol abuse. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles.
Drug and Alcohol Rehab Centers that Take Amerihealth Insurance
Finding the right rehab center which provides treatment for drug or alcohol abuse is an important step on your road to your recovery. You may be looking for an addiction treatment facility near you or one that is outside of the state you live in.
No matter what you are looking for, we have relationships with many insurance companies and may be able to get you or your loved one into one of our substance misuse facilities. Our rehab centers that take insurance in various states include:
- California: Laguna Treatment Hospital
- Florida: Recovery First Treatment Center
- Florida: River Oaks Treatment Center
- Nevada: Desert Hope Treatment Center
- Mississippi: Oxford Treatment Center
- Texas: Greenhouse Treatment Center
Do Treatment Centers Need to Be In-Network?
In most cases, you will need to seek treatment at a facility that is in-network with AmeriHealth to receive your full benefits. Even if you choose a rehab center 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 addiction treatment. You may be able to discuss financing options such as a payment plan or scholarships offered by the treatment center.
What Are AmeriHealth’s Coverage Levels and Plans?
AmeriHealth provides health care to more than 265,000 people in New Jersey and Pennsylvania with a range of services for both individuals and employers.4 Its plans include HMO, EPO, Medicaid, and Medicare.5
AmeriHealth insurance offers a variety of plan options for healthcare needs, including substance abuse treatment. Because many of their affiliates use the AmeriHealth name, the plan structure may vary by location; it’s always best to check the details of your specific drug and alcohol treatment coverage before entering your local rehab center.
AmeriHealth plans include:6
- Health maintenance organization (HMO): Your primary care doctor will manage your care for you, referring you to specialists, as needed, who are within the network. HMO plans only cover in-network doctors.
- HMO (plus): This is similar to a standard HMO except you can choose the doctor or hospital without a referral. However, you must choose one within the network.
- Point-of-service (POS): With a POS plan, your physician will coordinate all your care for you. You can choose where you go, and it can be with an in- or out-of-network provider.
- POS (plus): With a POS plus plan, you’ll get all the benefits of the POS plan, but you won’t need a referral for care.
- Preferred provider organization: You’ll have an extensive network of doctors and specialists from which to choose. They can be in- or out-of-network, and you don’t need a referral.
- Exclusive provider organization: This plan allows you to see any doctor or specialist you want without a referral, but you’ll need to stay within the network.
AmeriHealth Rehab Treatment Cost Coverage Levels
Within the major plans are different rehab treatment cost coverage levels by which the plans are categorized.6
The different categories help to define the costs you are responsible for. They are not a reference to the quality of rehab services or the type of medical access you have.6 If you have the “lower-level” Bronze plan, you will pay less monthly but pay more when you need care. You also will have a higher co-pay.
If you opt for the Gold plan, you will pay more every month but less when you receive addiction rehab services.
The Silver plan is in the middle, with moderate costs both monthly and at the time of service.6 For someone who will need frequent or costly services, it may make sense to purchase a plan with less out-of-pocket costs at the time of service, like the Gold or Platinum plans.
What Treatment Length Will AmeriHealth Cover?
The length of the treatment plan may be something that your insurer considers when it is determining whether or not it will cover your substance abuse treatment. In some cases, it may cover a treatment plan with a short duration, but it may resist covering a longer treatment plan.
While treatment length varies depending on various factors, including the substance that has been misused, how long the substance has been misused, and if there are co-occurring disorders, any length of treatment is important and helps patients work toward their recovery. However, research has shown that adequate treatment length makes patients more likely to find success with their addiction treatment.3 So, make sure to work with AmeriHealth to receive the length of treatment that will best help you.
If you have your insurance through your employer, there is no need to worry about your privacy. When you use your coverage for drug and alcohol abuse treatment, it is always confidential and discreet.
What Should I Do if AmeriHealth Won't Cover the Total Cost of Addiction Rehab?
If your AmeriHealth insurance policy does not cover all your rehab expenses, it’s important not to let that stop you from getting treatment. Some rehab facilities offer payment plans so you can gradually pay your costs back over time. Others offer grants and scholarships to those with financial need. You should contact the substance abuse facility you are interested in to find out about their financing and scholarship options.
Here are additional resources that provide more information about other ways to pay for rehab with or beyond what AmeriHealth covers:
If you need addiction treatment that your insurance won’t cover, there are other options available. Your insurance provider may be willing to pay for certain services and to give you a discount on services that it does not cover. Even with no insurance coverage, you can still get treatment for drug or alcohol abuse. Many facilities offer payment plans and other financing options to help you get the care you need.
Choosing to attend rehab for an SUD is one of the most important steps on your path to recovery. There is help available and your AmeriHealth policy and benefits can help you pay for rehab treatment so you can focus on what matters: your sobriety and long-term recovery.
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- Abraham, A.J., Andrews, C.M., Grogan, C.M., D’Aunno, T., Humphreys, K.N., Pollack, H.A., Friedmann, P.D. (2017). The Affordable Care Act Transformation of Substance Use Disorder Treatment. Am J Public Health, 107(1): 31-32.
- Kaiser Permanente. (2020). Inpatient and Outpatient Treatment for Substance Use Disorder.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): How long does drug addiction treatment usually last?
- AmeriHealth. (n.d.). About AmeriHealth.
- AmeriHealth. (n.d.). Individual and family health plans.
- AmeriHealth New Jersey. (2023). 2023 Benefits at a Glance.