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 Southeastern Recovery Center – 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.
RU is amazing. The staff here is phenomenal and they truly care. I truly love Becca, Teigan, Ellie, Bailey, and will. They’re all so good at making people feel like they can do whatever they set their minds to and accomplish their goals!
Logyn Street
1 month ago
I checked myself in for alcoholism and opiate abuse. I was drinking so much I was falling and hurting myself and ruining my marriage and on a path to possibly loosing job and even land myself in jail. I was miserable and at rock bottom. Once there after the detox period i started attending group therapy sessions, individual therapy session’s sessions, and working with the techs to become involved in my recovery process. First 5 days i was detoxing and once that was over i got super involved in the program and day by day got better each day. I received excellent nursing and medical provider support. I had amazing group therapy sessions. I was fed delicious meals every day. I had a great case manager and had a primary therapist who was absolutely perfect. The staff was absolutely first class and my treatment started me on a successful path to recovery. This place literally changed my life. They took care of my every need physically, mentally, and emotionally. I highly recommend if you need help for addiction this is where you need to be.
John Abbott
1 month ago
This place has changed my life. I have been to rehabs before but I felt like this place is where I would get clean for the last time since i walked in the doors. The music assisted therapy was perfect for me and the staff is all amazing. The groups are really beneficial and really got down to the core of why i turned to drinking every time something upset me. I felt like they really listened to me and i felt heard and seen. I am excited to continue on with alumni and events and life long friendships.
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.
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
5 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!
kevin ling
5 months ago
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.
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 good treatment facility but needs improvement on communication with family members when something happens I had to go to the hospital an it took 7 hrs for someone to answer the phone when my wife was calling trying to find out how I was an she is my emergency contact but other than that it's great
James Imel
2 months ago
Woodland was great!! Really nice & loving staff! They actually care about you & do everything they can to help you! The teachers are amazing! I absolutely loved it! Anyone needing help I definitely recommend woodland. ❤️
Lacey Walton
2 months ago
I was very satisfied with my Experience at Woodland Recovery.. I learned alot and many tools to continue my Recovery and life .. Thank You so Much ..
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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.
Great sense of community! Being surrounded by others who understand what you’re going through makes a huge difference. The programs are well-structured, and there are plenty of resources available to support long-term recovery.
Joe Hunter
3 months ago
As a patient that has been in other programs, TPRC has been by far the best! Between the staff, the medical team, and the clients themselves, the experience has been great. Starting the program can be a process with insurance and finding a bed/opening, but it's like that no matter where you go. Don't let that turn you away from this great program!
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.
Oh my goodness, this was the best treatment facility. After they take me to Chattanooga, I feel it will be my last. I'm going to miss the staff; Mrs V has been so awesome, and Ms. Mechell, and Mrs, Tamiyah, and Desmond just a few that have made it a great experience.
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 had an out patient procedure done and everyone was wonderful! Even my anesthesiologist was great! He talked to me prior to my procedure to go over what he was going to use and what he might need to do if necessary. I was treated well & was kept long enough after my procedure to be fully out of the anesthesia.
Barb Kucera
1 month ago
Friendly, welcoming, and knowledgeable staff
Jeanne Weisbrook
1 month ago
This is the best hospital ever. The care is fantastic. I reccomend it 100%
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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.
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
5 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
8 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
Wonderful program with one on one sessions with highly skilled therapists and a very caring staff. Warm and inviting environment that includes massage, acupuncture, pool and yoga.
Holli Shindler Burns
1 month ago
Place was absolutely snazzy, #excellent experience 🤙
Garrett Burns
1 month ago
Senergy was such a blessing in so many ways. I have dealt with high anxiety, panic attacks, and it came to a point where it was hindering my personal relationships and my health. Senergy was a place of personal healing and growth with the incredible staff and the friendships I gained. There are opportunities to find ways to cope in many ways. From yoga, dance, circuit workouts, a walking trail, music therapy, art therapy, clay art, group and one-on-one therapy, there are many opportunities to find something new to take with you! Thank you Senergy!
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
1 month ago
I am interested in the facility in Rogers AR or Wilbur mills
Michele Gaylord
5 months ago
This is a really good place when they answered the phone they were so nice on the phone
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.
AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental HealthMental Health And Substance Abuse
Adult ProgramSeniors ProgramLGBTQ Program
Private insuranceSelf-pay options
Ya era hora que esta Isla contara con un centro completo e integral. Un salvavidas para los que de VERDAD BUSCAN Y QUIEREN un cambio en sus vidas. Un faro de esperanza para sus familias. Un personal muy dedicado. Un lugar muy agradable. El centro esta en fase de crecimiento y en desarrollo de sus facilidades lo que les permitira mas pacientes y mas servicios. Aqui encontraras los 28 dias que marcan un buen comienzo a aquellos con mente y corazon dispuestos a un cambio de rumbo.
Remax Zone Puerto Rico
2 weeks ago
Excelente lugar, gran servicio y el personal realmente se preocupan por ti.
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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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