Ambetter Health Insurance Coverage for Addiction Treatment
Discover Ambetter Health Insurance’s addiction treatment coverage, including rehab options and perks. Find the right plan for your needs.
Ambetter Health Insurance Coverage for Addiction Treatment
Discover Ambetter Health Insurance’s addiction treatment coverage, including rehab options and perks. Find the right plan for your needs.
Ambetter is a health insurance company that started offering ACA compliant insurance plans in 2014. They’re owned by Centene Corporation. Their geographical span is nearly nationwide with plans available in 29 states and they serve more than four million members.
The company primarily offers individual and family plans on the Insurance Marketplace of each state they operate in. They can also help employers set up an Individual Coverage Health Reimbursement Arrangement (ICHRA) to provide employees with health coverage.
Beyond regular health insurance plans Ambetter also offers dental and vision insurance in most states.
Does Ambetter Insurance Cover Addiction Treatment?
All of Ambetter’s health insurance plans are offered on the Insurance Marketplace so they all cover the 10 essential health benefits required by the Affordable Care Act (ACA). That list of essential benefits includes mental health and addiction treatment.
However, every plan is different in terms of how much coverage you have and what requirements you need to meet. For example you might need to get a referral or preauthorization before insurance coverage is approved.
The provider networks and level of coverage vary state by state but they make it easy for you to check their coverage for yourself even before you sign up. If you are considering an Ambetter plan you can get the details of the plan from the state Marketplace before you enroll. If you’re already a member you can review your insurance by visiting their website and logging into your account.
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This place is amazing. Amazing staff. Attractive facility. Very therapeutic. Attention to everyone's needs. Highly recommended. I wish I knew about this place 4 treatments ago.
Marco Hernandez
3 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
This is by far the most caring and attentive detox place I have ever been to ! The staff truly cares for the clients and goes above and beyond the basics to make my stay as comfortable as possible. I recommend this place to anyone struggling and needs help !
Robert Rowland
1 week ago
The summer house was very comfortable very welcoming and Homie. They take good care of the patients and all the staff. Here are wonderful and very caring. If I ever have to go back to detox I will come here, but hopefully I won’t.
Celebrities in recovery lol love this place so much. They helped me a lot with getting going in the right direction and what to pursue out of life. I was able to surrender my past and move on from my old ways through their programming.
Conan The Barbarian
3 weeks ago
Scottsdale Recovery has changed my life. If you or someone you know needs detox and/or treatment. This is the place. The staff is strategically handpicked by professionals; peers who have been through addiction and have come out the other end. The resources and services they provide are phenomenal, I would highly recommend SRC a million times over.
From day 1 to graduation, they guided me through, to a complete life changing transformation.
Zachary Adams
4 weeks ago
I just hit 3 years sober. This was the detox center that helped me. Just overall an amazing place with incredible staff. If I could give 10/ 5 stars I would. Absolutely PERFECT place to detox at.
A Transformative Path to Recovery: Runway and Treehouse Recovery
My journey to sustained sobriety began at Runway, a premier short-term stabilization facility in Santa Ana, California. Designed for individuals in crisis, Runway offers 24-hour monitoring in comfortable, well-appointed accommodations, including private bedrooms, an on-site cook, and a dedicated nursing staff. A compassionate team of five to six professionals provides individualized care, preparing patients for a seamless transition to long-term treatment. Runway’s structured yet nurturing environment makes it an exceptional choice for immediate, high-quality intervention.
After stabilization, I transitioned to Treehouse Recovery to address a complex history of alcohol addiction, combat-related injuries, and a rare psychotic episode triggered by marijuana use. The Treehouse staff’s expertise in treating combat veterans navigating reintegration and substance abuse was remarkable. Their swift, targeted response to my unique challenges laid a critical foundation for my recovery.
Treehouse’s program distinguishes itself through a robust team-based approach, which fosters accountability, camaraderie, and personal growth. Patients are organized into small, cohesive units that collaborate on daily tasks, from meal preparation and facility maintenance to group sports and weightlifting. This model mirrors the discipline and interdependence of military teams, which was particularly resonant for me as a veteran. For example, morning team raft exercises in the surf required synchronized paddling, teaching us to trust one another and communicate effectively under pressure. These activities were more than physical; they instilled a sense of shared purpose and mutual reliance, reinforcing the skills needed for long-term sobriety. By working closely with peers, I rebuilt self-esteem, learned to embrace responsibility, and developed a support network that extended beyond the program. This team dynamic was a cornerstone of my recovery, providing a safe space to confront vulnerabilities and celebrate collective achievements.
Beyond its team-based framework, Treehouse emphasizes the physiological and biological aspects of addiction, moving beyond traditional talk therapy. Physical training restored my strength and confidence, while the program’s focus on leadership in its latter half prepared me for a successful return to everyday life.
Over a year later, I remain sober, with strengthened family ties and renewed self-confidence. The ongoing support from Runway and Treehouse, through regular check-ins, reflects their commitment to clients’ long-term success. Their tailored, family-like approach creates a global network of support that empowers individuals to thrive post-treatment.
I wholeheartedly recommend Runway and Treehouse Recovery to anyone seeking a path to lasting recovery. These facilities not only saved my life but also provided the tools and community to build a brighter, more fulfilling future.
Sincerely,
Charlie
CB
1 week ago
I showed up to Treehouse ready to change but i didn't know how to make these changes. Anything i tried alone always seemed to fail until i was accepted into the treehouse family. They showed me how to handle simple to complex tasks with a rational clear thinking mind. They gave me the tools and confidence to stay in a state of gratitude day in and day out. They solidified my hard working ethics and gave me a place to call home. We worked hard and we had a lot of fun. I particularly love the ocean (surfing, diving, skimboarding) so being on the boats with the team was my favorite part of the physical modalities. I owe it big time to the clinical staff for listening intently, caring and asking the right questions at the right time to help me work through a lifetime of baggage.
Cruz Bokolas
3 months ago
Treehouse has made a huge impact on my life. The values, connections and education have given me an entire different perspective on life. They have given me the tools and knowledge on how to live a life in sobriety. The staff are all super cool and very supporting of whatever you are going through and will do the best they can to help you get where you need to be. Thank you treehouse !
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The people @ Recovery unplugged are saving life's everyday. If you know anyone struggling with addiction., Austin,Teagan, Becca, Ian, Patrick, Andy, Jessica, Camille, Jason , the entire nursing staff are all phenomenal and great at what they do. I can't forget the chef Dillon, Ricky, Kyle in the kitchen are the best.
Corey Ludin
2 weeks ago
Absolutely hands down the most caring staff you will find from the techs, to the nurses, to the providers. If you or a loved one is looking for help this is the place. You aren't a number at any point of the process. Full size beds and TV's in every room. Chef prepared meals and they even do your laundry so you can completely focus on your recovery-don't hesitate to change your life! Best first step you can take
Dan Craze (CrazeDanConfuzd)
2 weeks ago
This place is unlike any other rehab I’ve ever been to. The staff and music theme were so healing. This is what I needed. When I say it saved my life I mean it whole heartedly. If you want to get clean and change your life please come here!
AlcoholismOpioid AddictionDrug AddictionDual DiagnosisSubstance AbuseMental Health
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program
Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceFinancial Aid
Brittnay was so helpful with placing my son in a perfect environment for him to heal!
Marian S Moore
2 weeks ago
I had come and make a review. I was in distress and full of Anxiety (that I diagnosed myself with lol) trying to find my son an appointment in order for him to be discharged. I googled several places who did not accept his insurance. I felt defeated and said a prayer than I googled some more and found Provive Wellness. Not only was Tommy very knowledgeable, patient, and reached out to the social worker right away. My son was scheduled in no time. This is what I call superb customer service. And the best part of all I have no out of pocket cost, everything is covered by the insurance.
Wright Family
3 weeks ago
Provive Wellness is a genuinely caring and effective program for people facing substance use and mental health challenges. The staff create a safe, supportive environment where real healing can happen. It’s the kind of place I’d feel good about sending someone I care about.
I want to thank Luminous Care center for being the turn in my recovery. I especially want to thank Edward when I arrived I was physically and emotionally depleted Edward was the one person who helped me get into a detox and was very supportive his compassion is truly what addiction centers need I know he genuinely cares for the clients.I couldn't thank him enough .I've learned so much from Dan's groups I thank him for the tools I've learned . I was able to successfully complete the program due to the structure and support I received there thank you so much Luminous Care
Tammie S
3 weeks ago
Staff truly cares and wants their clients to succeed!
Jo W
1 month ago
My experience started out rough but that changed and as hectic as it gets the staff shows up for us. Ed gave me hope, Dan gave me experience and strength, Scott gave me knowledge and Jamie gave me his time when no one else could along with a great tool through a video he suggested that showed me some new coping methods!! Tenisha was my therapist and she listened to all my shit with a smile along with good coping skills she gave I had a good experience ! PUT IT THIS WAY THE STAFF ARE ALL HUMAN ! Yes there are flaws and the owner is responsible for most of them! BUY A VAN OR TWO ! Sometimes it is good to clear the way for new employees that are stagnant and not helping but hindering and causing a lot of added stress and more problems for the clients ! Oh Charlton always made the long rides fun and got me laughing when I was sour ! Shawna has a huge heart and she and I relate on things and I could go to bed anytime! Thanks to all the Luminous staff I will leave tomorrow with 95 days sober!
I am very thankful for this program and the people who work there starting with Jennifer and Tarah plus . Paul and Ron plus many more .This is a recovery program which knows how to guide u the way u need to go. Love u all and thank u for all the staff here
Alonzo Graydon
1 month ago
Today, we justly give back to the people who have helped us along the way, for everyone at CWC is a care giver even the clients. They show care and compassion for one another everyday.
John Howell
1 month ago
The level of care I received was excellent. The support from the team of facilitators was impeccable, from the heart! There Intensive outpatient with Jennifer, and Paul Lawler helped make me the strong women in am today with a tremendous amount of hope and faith in the program of recovery. Powerful place to understand recovery today.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramLGBTQ ProgramYoung Adult Program
Self-Pay OptionsPrivate insuranceSliding Scale Payment AssistancePrivate InsuranceFinancial Aid
Ashville recovery center was a great place. I was there for eight weeks. I was able to learn a lot about myself. The community is a great place As well as the staff members. They make you feel heard and cared for. If you are struggling with an addiction, I definitely suggest coming to Asheville recovery center.
Elena Hayes
1 week ago
Friendly staff. Helpful classes
Jeremy Ireland
2 weeks ago
A great place to go if u need help with drug abuse and alcohol. I love the staff they are the best
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Frequently Asked Questions
What Types of Plans Does Ambetter Carry?
You can get a plan from them that’s either an HMO or an EPO or a PPO. There are a few rare instances where you can get a POS plan. Here’s how each plan works.
If you have an Ambetter Health Maintenance Organization (HMO) plan you’ll need to name a primary care provider (PCP). This will be the main doctor you see and they will coordinate your care by providing referrals to specialists. An HMO also requires you to use in network providers unless you’re in a life threatening emergency.
In most cases an addictions counselor and psychiatrist count as specialists who you need referrals for and you may also need preauthorization before you start treatment. That’s why it’s important to work with your PCP to create a treatment plan before you choose a rehab.
In an exclusive provider organization (EPO), you’ll only be able to get services from providers that are part of your plan’s network. Any care you get from outside of their network won’t be covered. However you won’t need to coordinate care through a PCP or get referrals to see specialists. You might still need preauthorization for certain services though so be sure to double check before you start treatment.
Ambetter has Preferred Provider Organization (PPO) plans in some states. These types of plans are usually more expensive in terms of monthly premium because they give you more freedom to choose who you want to see. They still have a network that they encourage you to use but if you want to see someone outside the network they will usually cover at least part of the cost. If you go out of network you’ll have a higher out of pocket costs and deductible than if you use an in network provider.
A Point of Service (POS) is the plan type that Ambetter offers the least frequently and it’s not available in most states. If you happen to be considering one the important thing to know is that your primary care provider acts as your care coordinator.
For any specialty care you’re thinking of getting you will have to see your primary care and get a referral. This will likely include your counselor and psychiatrist. The way this plan differs from an HMO is that you do have the freedom to get care from outside the plan’s provider network. You will likely have a higher deductible and higher copayments and coinsurance if you do.
What Perks Are Available With Ambetter Plans?
With Ambetter Perks you get deals on products and services that support your health and well being. You can get discounts on gym memberships and meal services as well as travel, entertainment and restaurant services. My Health Pays® also rewards you for keeping up with good health practices like getting a yearly physical exam and eating well.
Other perks like DispatchHealth and health management programs along with the 24/7 nurse advice line and Walgreens SmartSavings make healthcare and prescriptions more affordable and accessible with your membership.
What Inpatient Addiction Treatment Does Ambetter Cover?
Ambetter offers coverage for medically necessary care. That’s why before you choose a rehab facility you should devise a treatment plan with your doctor. This way you can get the referrals and documentation you may need to get coverage for inpatient addiction treatment.
Before you receive treatment getting the ASAM Criteria Level of Care Assessment from your doctor will help determine your specific needs and whether or not they recommend inpatient care. You may also need to meet certain criteria for residential care like a diagnosis of chemical dependency and medical stability after detox.
Medical detox gives you supervision from medical professionals who can provide care to help you manage your withdrawal symptoms. That sometimes includes medication assisted treatment (MAT) as well as other types of care.
When you enter residential care be prepared to continue with your program for 30 to 90 days depending on your treatment plan and care needs. During this time you’ll receive structured care including group and individual therapies and do various therapeutic activities. Having access to medical detox and inpatient treatment can offer additional support that increases the likelihood of long term recovery.
What Outpatient Rehab Does Ambetter Cover?
Ambetter covers various forms of outpatient treatment depending on your plan and what is medically necessary for your treatment. It may cover partial hospitalization programs (PHP) and intensive outpatient programs (IOP) as well as general outpatient treatment.
PHPs and IOPs both offer more structured treatment than general outpatient treatment. With a PHP you typically get at least 20 hours of intensive treatment each week including group and individual and even family therapy as well as holistic treatments. An IOP usually involves 9 to 15 hours of weekly therapy spread over several days and it has more flexibility than a PHP.
General outpatient treatment lets you go about your daily life and work your treatment around it. You may do treatment sessions in the evenings or on weekends, and the intensity of that treatment varies based on your needs. It can also be included as part of aftercare from a residential, PHP, or IOP program. Aftercare can act as continued support through recovery meetings and peer support along with counseling.
Does Ambetter Cover Methadone & Suboxone (MAT)?
Ambetter may cover MAT if it is a necessary part of your substance use treatment plan. You may need MAT as part of medical detox or for continued treatment for opioid and alcohol use though the extent to which you receive it depends on individual factors.
Much of the time you’ll receive methadone or suboxone to help reduce withdrawal symptoms as you detox or to help you stay medically stable over a longer period of time so you can pursue treatment with a lower risk of relapse.
Both medications are synthetic long acting opioids that block the euphoric effects of opioids like heroin or oxycodone. Suboxone combines buprenorphine and naloxone and is sometimes used as a less addictive option than methadone. However with professional supervision both are safe treatments for addiction.
Does Ambetter Cover Other Mental Healthcare?
Ambetter only offers ACA compliant insurance so your plan does cover other mental healthcare. It covers care options like psychotherapy and psychiatry through group and family therapy. You may also be able to get inpatient treatment and crisis support for many mental health disorders. That can include anxiety and depression as well as bipolar disorder and OCD and many more.
Because substance use disorders often co occur with other mental health disorders it’s important to treat them too. By understanding and treating these co-occurring disorders simultaneously you can increase your success with long-term recovery by giving you more tools and support so you have the right care for all your needs.
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