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.
This is an ad and White OAK Recovery Center 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.
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.
Adult ProgramYoung Adult ProgramLGBTQ ProgramTeen Program
Private InsuranceSelf-Pay OptionsMedicareMedicaid
I have been in and out of treatment for 15 years, and this is by far the best recovery center I have ever been to. The staff genuinely care about every client and their well-being. They aren’t just out for money or treating people like another number—they truly want to see you heal, grow, and succeed. I have felt supported, understood, and cared for throughout my time here. Recovery is not easy, but this center has given me hope and the tools I need to build a better life. I’m incredibly grateful for this place and would recommend it to anyone who is ready to make a change.
Tara R.
3 weeks ago
I would not be where I am today without the help of Recovery Unplugged. I had two 30 day visits with them back in 2019 before moving on to a 90 program in Arizona. Everyone was friendly and you felt like you actually mattered. The musical component of it all was life changing and is still a huge support in my life today. It's outside of the box recovery and if you are looking for a place to start, this is it. I'm coming on six years of sustained recovery and now hold a masters in divinity while thriving in Tucson. AZ. None of this would have been possible without Recovery Unplugged and I could not be more grateful for all they provided in early recovery.
Jay Newman
1 month ago
The program and support is great, but once you finish no resources are provided. No follow-up with patients. They are all about profit. The providers can't even provide outside resources. This should be a warning sign they are out to make money.
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.
OTC was a great experience for me. I didn’t come to OTC for myself, but needed and finished treatment for myself. Also, the sunrises aren’t too shabby!
Matthew P
2 weeks ago
I’m almost finished here. This place is so nice. I’ve learned so much about who I am as an addict and how to live life sober. They want you to succeed here. You can do it if you want it. This is the best option for treatment. Totally worth the 6 hour drive here.
Jon Quillen
2 weeks ago
WOW! There are literally no words to express the amount of love and gratitude I have for this place. Starting from the first phone call to ask for help was patient and caring. Every single staff member no matter what position, Nurse, TA, therapist, cleaning staff , case manager,kitchen , nurse practitioner, counselors. Was the most kind, caring, loving experience I've ever had. I'm truly grateful for this place saving my life as well as my husband. This place will always hold a special place in my heart! Thank you!!!
Thank you guys for saving not only my life but my husband's as well!!! 5months clean now :)
This is an ad and Banyan Heartland 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.
Very nice hospital and staff was very courteous . It made my experience great
Carla Cervantes
3 weeks ago
I had a personal surgery done yesterday and I could not thank these amesome nurses,doctors and anesthesiologists enough. They were absolutely amazing in making sure I was comfortable and felt safe. The only nurse I can remember was Robyn. Thank you again Bryan west for having some of the best staff!!
S Thompson
3 weeks ago
Thank you to every staff members for your help with the care of our family members.
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 found the staff,the facility, and surroundings. To be educational as well as extremely informative. Would recommend to others!!!!
Dustin Esau
3 weeks ago
SRC really is the best. I went through detox and im currently at the residential and its amazing here. All the facilitators genuinely care and the BHT's. The pool,basketball court, volleyball court and putting green are a plus. They teach you so much here. Kelly. Natalie, and Genesis, are amazing. There's not 1 thing I can complain about. This place is teaching me how to love myself despite all the shit ive done. I recommend this place to everyone who needs help. Lee the CEO is awesome. Josh from admissions is cool and he helps tremendously. Genuine people!!!
Alyssa
1 month ago
Everything about Scottsdale Detox and Recovery is top tier. The level of care by the staff, the facility, and aftercare is exceptional. I was a patient here several months ago and also proceeded to their residential program and the level of care I received there was exceptional. Highly recommended
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 ProgramLGBTQ ProgramYoung Adult Program
Self-Pay OptionsPrivate insuranceSliding Scale Payment AssistancePrivate InsuranceFinancial Aid
Asheville Recovery Center has been so amazing, if not magical. The staff and clients have truly saved my life. It is comfortable and safe place to recover.
Kelsey M
2 weeks ago
Excellent staff and overall service
B Sharp
3 weeks ago
Hands down the best treatment center I’ve ever been to and it’s not the first! Staff are amazing, therapist are amazing, case managers are amazing, living quarters and clinical facility are great! Not a single need wasn’t met! If the need ever arises ARC is the only place I would go.
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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.
Matt, Ashely,Trish, Dick and Dean went above and the call of duty to help me achieve all my goals in my recovery. I really enjoyed my time there. They really helped put me back on the path to my true self. I'm proud to be a TSR alumni.
Clayburne Parker
2 weeks ago
Great place. This place helped me get my life back together. I can't say one bad thing about it. The staff is amazing!!!!
Michael
2 weeks ago
True Self Recovery is the best! I’ve been to several rehabs but not one like this. The people that work there truly care. Tiffany was such a blessing, she went out of her way to help me and was always just a phone call away! My house managers Amy and Carson were absolutely amazing and have became like family to me! Ella and Jody and Gena go out of there way to connect with everyone on personal levels. If you truly want help and want to learn a better way of life, this is the place to go. It’s not like any other rehab I’ve ever been too. I will stay connected with them forever. They all have a special place in my heart and I’m truly grateful!
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
2 months ago
This place is amazing....was in the RTC program and now in IOP! Staff is unbelievably supportive and compassionate!
Dorian Cruz
2 months 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.
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
This is an ad and Engage Wellness Massachusetts Drug & Alcohol Rehab 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.
I loved it it got me right. I highly appreciate it thanks so much
Kurl DaWorld
3 weeks ago
The most AMAZING rehab I have ever been to of all the rebas I went to. I just want to shout out to the director Johnny King, Aitana my therapist, and the case management team. Thank you so much for being there for me through it all. I will always be full of gratitude 🥰
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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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