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.
If you’re comparing treatment centers or want a broader view of programs available in your area, you can also learn more about rehab options to explore nearby facilities.
By Michelle Tavares
Michelle Tavares is a registered nurse with over 15 years of experience in mental health nursing. She has worked in inpatient and outpatient settings as well as in bedside and administrative roles. She is a fighter of stigma and an advocate for getting people the mental health services they need.
Medically Reviewed by Anna Spooner
Anna has 10 years of experience in insurance and has been a content and copywriter since 2011. She strives to make all of her writing approachable and easy to understand while drinking copious amounts of tea. Anna writes about accessing addiction treatment, insurance, and finance.
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
I dropped my son off nine months ago at NSR. At that time, I didn’t realize how much of a codependency I had with my son. Even after dropping him off, I tried to stay involved in the day-to-day details which was the very reason I dropped him off in the first place. So i wouldn’t have to stay in the details and could focus on me. My advice is to let the process work. My son is now in a much better place and said this was the best decision he had ever made. I am also in a much better place and the Tuesday night parent calls are a must do for any one that has family in the program. NSR provides more freedom and flexibility in their program that a lot of other places did not. That was a deciding factor when I was initially looking for a place for my son to go. NSR has my vote. 👍
Marshall Kearney
3 weeks ago
When I found next step recovery I was at my lowest, I had found my bottom. I had my mind made up that suicide was my only way out. Then I found next step, and my second chance at a better, clean and sober life. I've been in and out of rehabs and detoxes my whole life. But this facility was different. I was welcomed like I was family and I had come home. With the love and compassion, not judged, but given a real chance at a better life. I'm currently living in the sober living house, and unlike a lot of places. The houses are very nice, clean, and up to date homes fully furnished. The staff is excellent, and always available to help with anything I need. Today I feel like a better man, a better husband, a better father, and I owe it all to next step recovery.
Mitchell Willard
6 months ago
One of the best experiences of my life!!!! Saved me!!!! Love you Beth, bo, Susan, Colby, Terry, Phil, Charles and everyone there!!!! Sorry for those I left out! I miss you guys! Much love! Keep up the good work!
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
My time with Woodland this go around has been insightful as towards my recovery. I have learned some learned new coping mechanisms that I had not learned my last two times. And THEY WORK!! I have had to implement these new methods already and has been a LIFE CHANGING experience for me.
Jason Ford
3 weeks ago
I would highly recommend this program to anyone that is really wanting to change their lives, it will guide you in the right direction that will lead you to a life changing opportunity and if you continue to follow the recipe that this program advise you to follow, your life will be changed forever, it has mine and I'm grateful for them
Christopher Ingram
4 weeks ago
Great place for recovery the staff we’re kind and caring the patients the therapist we’re spot on
This is an ad and The Haven Detox – Arizona 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
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Turning is an amazing center that helps in many areas. The staff is amazing and very personable and I would recommend the center for all recovery needs
Renee Berry
1 month ago
This place is amazing....was in the RTC program and now in IOP! Staff is unbelievably supportive and compassionate!
Dorian Cruz
1 month ago
TPRC is the best I went to the RTC program and now I’m in IOP. This place is amazing, I love it!
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Glad I came here to get help with my mental health. Employees really care about everyone and want to help you get better. The facility is clean and very nice. Highly recommend
Patrina Avila
2 weeks ago
nice and friendly staff who put client care first and super nice and clean facility
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
This is an ad and Avenues Recovery Center at Indianapolis 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
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramYoung Adult ProgramProgram For MenProgram For Women
Private InsuranceSelf-Pay OptionsFinancial Aid
I came here at a very low point in my life so I wasn't expecting a whole lot..they were going thru a transition at the time but they were trying to make the process work. The staff were the absolute best though. Cindy Kendra, Kate jj were the high point of my stay. Starr in that kitchen had me always anticipating something good she would be putting together. BREA is the best counselor ever!!!!!
Michael Brunson
7 months ago
DPR was truly an amazing experience. They genuinely care about you and your recovery journey. Lucus pours his heart into this place and it shows. Cindy, TJ and JJ were extremely supportive and personable. The nurses, Amanda, Kenya, Bradie, and Kate were so kind and helpful. And of course Drew and Star were a highlight with the awesome food they prepared and had really great insight. It is truly a gem in the recovery community.
Lakyn Discher
10 months ago
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.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionMental Health And Substance AbuseSubstance AbuseMental Health+1
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary ProgramProgram For Women
Private InsuranceSelf-Pay Options
I am writing to share my experience at Synergy, which has far exceeded my expectations. From the moment I stepped onto the property, it felt like home.
The staff is nurturing, loving, and supportive, offering a holistic approach to recovery that equips clients with unique skills and tools. The opportunity to experience new things in a safe, well-balanced environment helps the brain establish new pathways, supporting the skills taught during the stay. Furthermore, the clients you go through recovery with become your biggest fans and closest friends. Synergy also provides informative resources to continue introspection, healing, and growth after departure.
My stay focused on Complex PTSD, Anxiety, and Depression. Although I was initially nervous about taking this step for myself in an environment with mixed treatment needs, I quickly realized I made the right decision.
I cannot recommend Synergy enough. The skills I learned and the self-love I gained will journey forward with me for a lifetime.
Kelly D
2 weeks ago
I learned so much here. Such an amazing place I would recommend to anyone in need! The staff are so welcoming and loving. I had no regrets coming here.
Jadyne Curnutt
2 weeks ago
Choosing to stay at Synergy Recovery Center was one of the most challenging decisions I’ve ever made—and honestly, one of the best.
I am forever grateful for every single person who works there, as well as my Synergy recovery sisters. The connection, support, and deep healing I experienced were truly unmatched. I went into the process with an open mind, and I gained everything I was searching for and so much more.
I will always be grateful for my time at Synergy and the people who helped me along the way. đź’š
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
I don’t usually leave reviews, but I felt like this one needed to be written.
Matt Lapham has been one of the biggest blessings during my time at True Self. What makes Matt different is that he has been where many of us have been. He understands the struggles, the setbacks, and the challenges of recovery because he’s lived it himself. That experience allows him to connect with people in a way that can’t be taught.
Matt goes above and beyond for every single client, often without looking for any recognition. Whether it’s making sure someone has hygiene products, helping people find clothes and socks, taking clients to food banks, or simply being there when someone needs support, he’s always finding ways to help. If someone is in need, Matt is usually already working on a solution before they even have to ask.
One thing that always stands out is the way he takes care of everyone at the house. He cooks dinner every night without complaint, and somehow manages to make it feel like a home instead of just a place to stay. The meals are always great, and it’s clear he puts his heart into everything he does.
Matt also teaches classes at True Self, and every class leaves an impact. He has a way of making people think deeply about their recovery, their choices, and their future. Even when he doubts himself or feels like he could have done better, those of us listening know he’s doing an amazing job. His honesty, experience, and passion for helping others come through every time he speaks.
True Self is fortunate to have someone like Matt Lapham. The amount of time, energy, and compassion he pours into helping others is truly inspiring. He may never realize how much of a difference he makes, but I can honestly say that he has made a positive impact on countless lives, including mine.
Thank you, Matt, for everything you do.
Matt Collins
3 months ago
I am interested in the facility in Rogers AR or Wilbur mills
Michele Gaylord
7 months ago
This is a really good place when they answered the phone they were so nice on the phone
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
El mejor lugar para tratar la adiccion de un ser querido. Un excelente grupo de profesionales que hacen mas q su trabajo, es su vocacion. Recomendado al 100% El mejor centro en Puerto Rico. Mi agradecimjento a Josefina q fue la persona contacto en Puerto Rico, quien con mucha paciencia y amor nos facilito llegar a este lugar maravilloso
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Frequently Asked Questions
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.
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.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
Calls to numbers on a specific treatment center listing will be routed to that treatment center. Calls to any general helpline could be forwarded to SAMHSA or a verified treatment provider.
If you wish to connect with non-sponsor centers, you can browse top-rated listings, visit our homepage and browse by state, or visit SAMHSA.
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