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
4 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
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The facility, staff and overall program was first rate. I cannot recommend Discovery Point enough to those seeking help with learning to control an addiction and living a clean healthy life.
Jim Heitz
1 month ago
I don’t even know where to begin. This treatment center is truly changing lives. My husband attended their program during one of the hardest times our family has ever faced, and I can confidently say they gave us hope and confidence in his recovery.
From day one, the staff treated him with compassion and dignity. They weren’t just professionals—they were caring, patient, and truly passionate about helping people rebuild their lives. The counselors went above and beyond, not just helping him work through addiction, but helping him rediscover who he is without it.
What meant the most to me as a spouse was how they kept family involved and supported throughout the process. I felt heard and understood. This wasn’t just treatment—it was transformation.
Christi Singleton
2 months ago
Discovery Point is an amazing place. I’ve only been here for a week, but it already feels like home. A pool, nice gym, great staff, and amazing chefs. Drew (chef) on top of her great cooking, is so positive and always smiling, and Star makes the best desserts - we even get desserts at breakfast when she’s here!! At the support staff and nurses are so kind and patient.
So if you need a place to heal and recover from your addiction issues - this is the place:)
First off, the all staff were nice and friendly.
Food was fantastic 5 star chef, nurse's on site 247 techs also. It's on the water, you can fish. Get massages or acupuncture. They really make you feel like home. Aa na meetings daily. I have nothing negative to say about summer house detox, the best in south Florida hands down
Rob Osceola
1 week ago
This is the best detox center by far! The staff is amazing! They genuinely care. It’s a very relaxed comfortable place. I would recommend this to anyone that is struggling with alcoholism/addiction. It truly is an amazing place! Not a bad word to say about this place!
Taylor Filiatreau
1 week ago
My experience at Summer House was incredible! The staff were so kind and attentive — they really made me feel cared for from the moment I arrived. The beds… oh my gosh, like sleeping on clouds! And the food? Wow. It honestly felt like eating at a restaurant every day, from breakfast to dinner.
The nurses truly care about your health, and the therapists put so much heart into helping you heal mentally and emotionally. I’ve never felt so safe or supported in any detox before.
I would recommend Summer House to anyone who needs help. Thank you, Summer House — you truly saved my life and helped me start fresh on my journey to recovery.
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
2 months 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
2 months 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.
This is an ad and Avenues Recovery Center at Clarksville is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More
Avenue's saved my life. Love the staff and everybody working there thanks y'all!
Daniel Sikes
2 weeks ago
I highly recommend Avenues for anyone needing to start recovery! I am extremely happy to have had the opportunity to come here! They are all ready for you and will even call you a ride! The staff is absolutely amazing, and I feel so blessed to have met each and every one of them! Thank yall so much! My life has changed for the better and it’s just the beginning! God bless you all! 🥹🥰👏🏼👏🏼👏🏼
Paige
2 weeks ago
Avenues was very empathetic towards my needs. I was able to continue my college work while here and I was well taken care of.
These people have helped me recover from the worst point in my life to become a much better happier person today. I owe my life and my family to this place. Especially Leia, Cynthia, and Mary. But I want to thank everyone else for being a part of this process.
Daymond Johnson
2 weeks ago
They Ubered me to the clinic when my car broke down and even they stayed open late because of the bad weather. These people always go the extra meter to take care of me no matter what. Five stars!!!
Gwen R
3 months ago
Everytime I come here the staff are beyond amazing very personable no judgement passed on and extremely helpful always quick and easy Cynthia is still my favorite though ;)
This program was the best experience of my life. It brought me out of a very dark time. I learned how to love myself and be disciplined. I had a slip up in the program but they didn’t turn there back on me. The treehouse community is like home to me. When I left I went home for awhile and messed up. But I called Matt Sawires and he got me set up to come back to CA to detox the next day. And I was accepted back into the community immediately
Garrett Geib
2 weeks ago
If you’re looking for a quick fix, this isn’t the place for you. But if you’re ready to truly heal and have a second chance at life, Treehouse Recovery in Costa Mesa, California is it.
It’s the best addiction treatment I’ve ever experienced. Their program demands more time, energy, and sweat than typical centers — but the results are real. I left stronger, with more energy for my friends, family, and myself, and in the best mental and physical shape of my life.
The addiction counselors here don’t just hand you another pill; they guide you through real work that leads to lasting recovery. This is the only place I’ve seen people truly get better and stay better.
luke
2 weeks ago
I want to thank Matt and everyone at Treehouse Recovery. Matt was instrumental in getting my nephew into the program. Matt walked him through the whole process of taking the leap of faith and going 3000 miles away to join this unique program. Matt is an amazing asset to Treehouse. The program is unbelievable for the men that are brave enough to join this program. If you have a love one battling addiction, Treehouse Recovery, in my opinion, is the best program in the country!!!!
Great program incredible staff. Offers great lessons in patience, introspection, and learning to take things a day at a time. Shout out Paul and Gary K for being amazing facilitators. If you’re experiencing any major medical issues that need a doctor visit, take care of that first before staying with CWC.
Dan Hunsicker
3 weeks ago
I went to treatment here twice, and what I will say is this place is a real gem but your experience is going to depend upon your mentality, take accountability people that’s the most important part. When it was my second time coming into treatment I was baker acted out of state. I called Jennifer the virtual manager in the late hours of the night annd she picked up and I told her I was going to end my life. I was tired. She stayed on the phone with me until police came and calmed me down. I remember sitting there with my eyes closed just listening to her voice telling me to breathe and she’s going to help me. She’s an angel in human form she’s one of the sweetest most caring humans I’ve ever come across. Next up is Paul Paul will open his arms to you and make you feel welcomed like there’s never no judgement with the guy he’s very supportive and my god is he smart. The man is great. He’s written a few books the past year and every word deserves to be seen by everyone. Tarah I love you thank you for always being supportive and a shoulder to cry on you are such an inspiration. Ron you’ve got the best attitude better than anyone I ever met your always so happy. Malika is sweet and has the best smile she’s so funny and always makes others smile and laugh. Gary I don’t have enough words for you your very valuable in my recovery journey don’t ever forget that. Most important jason thanks for even having this place, thank you for hiring the best staff there is, thank youuu for the dream and vision and being the type of owner that’s on site and talk to clients like we are normal people you mean more than you know to everyone you bring into your center. Cwc is the best I hope everyone takes care and im happy to have had such a great program and great people. You made me want to live again.
Joey
1 month ago
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
AlcoholismOpioid AddictionDrug AddictionDual DiagnosisSubstance AbuseMental Health
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program
Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceFinancial Aid
Simply an awesome caring facility. The staff gives 100 percent and then some! They display a true genuine concern for those in their care. Communication is exceptional! My son has been in many facilities over the years and Provive Welles is the best place that he has been in and made the most progress. Everyone that I’ve communicated with was phenomenal.
However, the majority of my communications were with Megan, Emily and David. I must give them special recognition for my sincerest appreciation.
Thank you Provive Wellness for caring for my son above and beyond my expectations.
Tina & Thomas
Tina and Tom Roberts
3 weeks ago
I’ve been with Provive for about a month or so now. I was having urges to drink myself into a blackout state. Been this way for about a week….I mentioned it in front of the house manager and nothing happened. Today was the worst of my urges. Megan had reached out to check on me and she was able to help me through without relapsing…. Thank you, Megan for all your help!!
MarySue
1 month ago
Brittnay was so helpful with placing my son in a perfect environment for him to heal!
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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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