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.
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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.
This place saved my life! Shout out to the alumni team for always supporting me through thick and thin!
kenneth hammett
6 months ago
Everyone has been an amazing help and have been very kind. I have enjoyed my stay and have enjoyed laughing again with new people I can call friends and an amazing community.
Gavin Kale
6 months ago
This place is amazing. The staff genuinely cares about your recovery and your personal wrll being. I have never been to a facility that goes above and beyond everyday to pour into the clients. I have been to several facilities over the past 12 years and Recovery Unplugged is the first one thus far that focuses on the underlying issues that lead to substance use, alcoholism, and addiction in the first place. Everywhere else that I have ever been wants to teach repeating classes on the brain chemistry and effects of drug use, relapse prevention, and codependency. All of those are useful, yes. But all of those are useless unless you address what got you there in the first place. I could go on forever but I will leave it at that. Oh and the food is AMAZING 😋
Great experience! Staff treats each person as an individual. Warm and caring environment. This facility can make a difference in anyone's life if they put forth the effort. They will meet you where you're at.
Tom B
7 months ago
Next Step Recovery is an amazing program in sober living community. The most incredible thing about this program is that everyone on the staff meets the clients where they are and motivates inspires, supports and encourages recovery growth and development in a safe, respectful and connected community.
J. Foster Battiste
7 months ago
Came to next step for iop/php after my inpatient stint. this was my first time in rehab and i am here as a result of legal issues, meaning i was here less than willingly. That being said I gained so much from this program, not just in sober time but mentally. The staff is amazing and they really care, as a few of them were former patients of next step themselves. There was not a day that i didnt feel as if i wasn’t important or that my needs werent met.The freedom and the trust is another big part, youre allowed to keep your phone and car, work, vape/smoke, and pretty much do as you please within reason. I hated my time where i did inpatient, but i genuinely enjoyed this program and the time i spent here. Im only 22 so i was the youngest person here for a long while, but i never felt out of place or anything of the sort. This would be a place i recommend 100%.
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
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
7 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.
Jim Heitz
9 months 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.
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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.
This place is like no other facility I’ve been to tons of freedom not locked down to a specific hallway. Has a full gym basketball court arcade 2 bowling alley lanes pickleball courts barber and more. Staff is incredibly helpful friendly and most are in recovery as well so they truly understand what we’re going through I recommend ICFR.
Timeye76
1 week ago
Great place to go for help and services.
Garrison McMillian
1 week ago
Christina is an amazing tech she helped me through so much.
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.
The staff are great. They're always courteous and accommodating to your individual needs. They are also very helpful in regards to your making the transition to PHP.
Marcus O'Rear
1 week ago
I had a great experience at haven. The staff was very interested in what I needed. Ms Lauren especially she has been a great help. .Ms Ashley,I have great respect for her because she won't lie to you,and will call you out if needed
. The staff as a whole was great.
Donald Ingram
1 week ago
My experience was nothing short of life changing. The staff are very supportive and encouraging and will help with whatever your needs may be. The counselors and very helpful and insightful, especially Sarah and Mike. Ashley and Roni are also very helpful with assisting you with aftercare plans and support while you’re here and moving on. A good place to become and stay sober. Thank you
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 was my first time ever at a detox and what I could actually say is that this is the best detox. I’ve experienced lots of amazing food and the staff is great TJ Kathy Jen and Jonathan were my favorite out of the whole crew not saying that the rest of them weren’t respectful, but they were always accommodating me on my needs and checking up on me and making sure that I felt comfortable, especially with it being my first time ever at a detox treatment I definitely recommend this spot to people who are trying to get off drugs. I have lots of freedom. I’m able to have my tablet. They have amazing food. They’re super nice. They also give the shakes because I’m skinny. And it’s very well needed because I needed to gain weight and honestly, I’ve been here for four days and I’ve already gained 8 pounds
Steph m
6 months ago
This place actually cares about clients. That’s more than you can say about most places in S Florida. I highly recommend Summer House.
Cole Goulet
6 months ago
Yo this place has helped me tremendously when I was down and out. I successfully completed my detox and they assisted me into another facility for more treatment and made me feel as if I was taken care of and they would continue to support me although I'm leaving. I definitely recommend and will come back here specifically if I ever do need some more assistance with my substance treatments. #ughhh #hofrome #illughhhminati #igot
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This place is ok. You have to realize this is Florida, so you are going to get cockroaches. Just ask staff for a fogger they are happy to get you one. I have had no problems with staff. Long days keeping you busy. Van rides get tiring. We do outings Everglades on a airboat was amazing all the Alligators was just coll. The best thing about this place is the LIV Program. Troy Adam Ericka, Daniel. Are the best we do all sorts of outings will miss them as going home soon. 🩷🐊
Trina Chambless
1 year ago
I have not personally had the experience of Recovery with Zinnia Health, but I do have friends that work there and I can not praise them enough as people. They are the hardest and kindest people who go above & beyond for their friends & patients!
sal jones
1 year ago
Amazing transition between there facilities, supportive environment and atmosphere.
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.
T’was an Honor to have had the pleasure to meet and learn from these Beautiful People I’m glad that their are still Some Good Hearted People in this world that are making a difference in peoples lives by being real and using their life’s experiences to help others the Work Ethics and Professionalism at Scottsdale Recovery is Truely the Best the effort in their dedication and commitment they make to servicing People of all walks of life is full of Top Level Care and some good old fashioned TLC I took the Peer Support Certification Class and successfully completed the course I have received my certification and achieved this along the side of some Awesome Men and Women whom I get to Network with and be of Support of these new Relationships I can’t wait to see where this road takes me I’m looking forward to the journey of continuous growth in personal experiences and helping others by extending all my support to service others with compassion understanding and using a nonjudgmental approach with respect and wisdom
Thank You Scottsdale Recovery for the opportunity!!
Celeste Pearl Jackson
7 months ago
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
9 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.
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 use to go to denton clinic last year and even years ago and I was honestly struggling very hard to keep up with payments and Im not here to bash... I blame myself for not communicating better. At the time I was forced to leave my denton home and stay with family in the colony and had to drive every day Mon thru Fri to denton. I finally tried looking for some place closer and thank the Lord He led me here. I called and they asked about insurance which I gave all my info about. I seriously had doubts that it would be of any help. Years ago methadone wasnt covered easily by insurance...
But they made my day when they told me yep they take my insurance which is through marketplace. AND I would not have to pay anything out of pocket!! I was singing and dancing. Been here ever since. Even when I messed up and missed open enrollment, they still worked with me without insurance... i was so worried but everyone reassured me that they would find a way to help me here and they did. Everyone is SO NICE also. Love it here.
Anita Earnest
3 months ago
I absolutely love this place from the front staff all the way to the back staff. Everybody is so amazing and so kind. The office manager helped me find a location where I could get my dose since I missed it on Saturday and I was so grateful for him to reach out because I finally got my dose I needed Because THEY CARE! I recommend this place to anybody struggling with opioid Use disorder or pain. Don’t be afraid to pick up the phone and call. Everybody is so nice and you’ll be taken care of🖤
Person
5 months ago
good attentive staff that will help you get the help you need.
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Great place to go to get back on track. Staff Is awesome and makes you feel welcomed.
adam miller
7 months ago
Wonderful people they'll help you just like family it's a family atmosphere
Jay Malo
7 months ago
The therapist are very professional especially carrie. Larry in discharge is super helpful and gets the aid you need while in therapy. Without him I would not of found housing. Highly recommend foundations wellness center
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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.
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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.
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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