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.
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.
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 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
2 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
2 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.
staff is friendly, stayed long enough to get the help that I needed
Richard Hauser
6 days ago
My experience at ICFR was great. The facility was nice. My therapist was excellent. The only thing negative keeping the from 5-stars was the lack of communication. I gained more about the place and where I needed to be from my peers rather than receiving instruction from faculty.
David Carpenter
1 week ago
I have been to this place twice and would highly recommend to anyone struggling with mental health or substance abuse. Staff is great and so is the brother and sisterhood you will build.
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
2 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
4 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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Pam Cox was very friendly and professional and helpful, she really helped me with my son's situation and alot of people out there needs people like her..... Thank you Pam Cox for I really everything.... Tim Taylor, son Brandon Taylor
Timothy Taylor
1 week ago
at avenues i learned not too move so quickly. That Rome was not built in a day, and that you have too learn to crawl before you can walk.
Justin
1 week ago
This place is awesome!! My case manager Trent really went all out to make sure my after care was what I wanted. Also the bhts was on point with taking care of whatever was in their reach to make shit easier. (Stephanie, Jen, Chuck, Mike, Lonnie, Gonzo) I recommend this place to anyone is truly ready to change their lives and willing to do whatever it takes!!
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 honestly can’t thank this place enough, it honestly saved my life. When I came to the haven I had literally gave up on life. I had overdosed when I got here and they got me to the hospital fast enough to save my life. The next 3 days were pure hell. The staff truly does care. Roni is amazing(has great style to) always had a smile on her face. Anthony and Shawn were my go to if I needed something done, they always made it happen. Ashley and Lauren were great always running around like crazy getting things done for people. Most of the BHT were cool. The night BHT’s were more down to earth. Shaggy is definitely one of my favorites when I wanted to give up he told me to keep pushing. I could keep ranting on and on about how good the place is but we would be here for hours. Thank you to the Haven for giving me my life back!
Kaila Clark
1 week ago
The Haven is a great place very helpful and attentive. Roni helped out a lot and Anthony. And my therapist Robert is amazing. And Lynn helped me so much for my medical needs. I appreciate u guys so much. Y'all have helped me more than you all would ever know.
Shayna Becker
1 week ago
I had a great experience at The Haven Detox center. All of the staff were very friendly,helpful and I was treated like I was the best person there, The nurse practitioner Jessica Percites was very helpful,Roni, the Administrator was so helpful. Kerry, Nesha, Lauren, Stephanie, Harriet, Jose, we’re always helping me with anything I needed. Anthony, the client Care Coordinator was amazing, Shawn, another Client Care Coordinator was extremely supportive and helpful withe all of my needs.
If I ever needed to come to a treatment center again, I would definitely come back here.
I made many friends and will keep in touch with all of them.
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
2 weeks 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
2 weeks 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
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
2 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
4 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.
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I am so grateful for avenues and all the staff they help me in so many ways not only with my addiction but my mental health and to deal with some trauma so thank u each and every one of the staff I appreciate y'all for sure
Timothy Letner
5 days ago
This place is really awesome they are great every resident every staff I have come in contact with down to the nursing team their great I’ve been in treatment this is my sixth time and I’ve really enjoyed the work and time that the staff as well as my therapist Darcy I love her sooo much ms. Casey is the truth for real if you’re thinking about going to inpatient ft.Wayne avenues is one of the best inpatient facilities I’ve ever been to and I’ve been everywhere but this place and the people running it made me feel like this was a home while I was here thank you avenues for everything the skills the time the patients because coming of the street and drugs can be very hard on both ends the support that I’ve gotten is the greatest Christmas gift I could get this year ohhh my man Joe if you come get to know him he’s one of us that has a great story my man Travis Kelsey Sarah my techs ms Rita ms siane Malissa the tech and my case manger Malissa she was great made me feel right at home they took good care of me thank you avenues you’ve gained a alumni for life I love you guys thanks for having me Merry Christmas from me and my family and thanks so much for having me on to strive I go ❤️🤞🏾💪🏾🫶🏾✌🏾
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.
good attentive staff that will help you get the help you need.
John Carter
1 week ago
This place is so well managed and organized! The staff is seriously amazing!! Front desk is amazing!!!! Everyone is so kind and actually cares about you and your recovery!! I LOVE THIS PLACE. Legit the best if you need help!
Juliet Newton
1 month ago
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.
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’m writing this review today with the most gratitude and hope I’ve had in a long time. Tree House recovery was a lifesaver for my kid and our family.
When my kid made the brave choice to go to rehab, Treehouse moved at great speed and with such care to envelope us with a plan and reassurance, offered support at many levels, and provided a loving atmosphere for my kid to land. The comprehensive program, education, therapy, and positive, practical support empowered our young son in ways I thought not possible at the time. I am in awe of his growth, mindset and choice to stay sober.
Forever grateful to the program, staff and the people who continually support his growth. Thank you Treehouse! People CAN recover and thrive. Best choice we ever made.
Sarah Medal
1 week ago
I was dealing with severe cocaine and alcohol addiction. After serving in the military and coming home, I needed help. And I knew that the average rehab and recovery program wouldn’t work with me. I needed something challenging, something different. Treehouse provided that. With a wide range of different and unique approaches to treating addiction like challenging workouts, team building, riding waves on the beach of Costa Mesa on rafts with other men struggling with the same disease, addiction education to help me better understand my disease on a scientific level, and outdoor adventures like going camping, taking trips to cool beaches to surf at. This place isn’t just a recovery center, it’s a family. I am now 6 months sober and graduated the program and I couldn’t feel more grateful and proud of myself. And I know my family could say the same. Anyone struggling with addiction and looking for a program that heals you both mentally and physically NEEDS to give this place a shot.
k to the roc
3 weeks ago
My son has been struggling with alcohol for years which grew into a full blown addiction. He tried a 30-day program which didn't last. Only when we found Treehouse Recovery in Costa Mesa did we find a place that could really help him. The staff are exceptional and they have cared for our son's success long after he completed his program. If you or your son need help look no further.
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
1 month 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
1 month 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 😋
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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
7 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
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'm David Moore that went thru the program! It was rough for me at first but the whole experience was amazing. The staff was very caring,loving,understanding and respectful. You get one on one therapy as well as group settings.Thinking of groups I learned so much about myself and made some true friends. We helped each other grow and lift the ones that needed a helping guiding hand. Remember we are all broked in our own way.Reach out please to Transitions Recovery! You will find yourself and learn all about your own true self and feel love and you will really find out how amazing you really are. TO ALL OF TRANSITIONS RECOVERY STAFF I LOVE SND THANK YOU 😊 ❤️! Y YOU TOO JOSH AND AUSTIN THE MIKE'S MISS JANET SUMMER WILL STEPHAN too many to list i love ❤️ you guys
David Moore
2 months ago
Transitions Recovery Program in Miami didn’t just help me get sober it gave me a life beyond my wildest dreams. I walked in lost, broken, and unsure if real change was even possible. What I found was a deeply compassionate and structured environment that not only supported my recovery, but challenged me to grow in ways I never thought I could.
The staff is incredible many of them are in recovery themselves, so they get it. They met me where I was without judgment, but also didn’t let me stay stuck in old patterns. The clinical team, the group sessions, the one-on-one therapy, and even the everyday accountability they all played a part in reshaping how I saw myself and the world around me.
What really sets Transitions apart is that they don’t just focus on staying sober they teach you how to build a meaningful, fulfilling life in recovery. They helped me reconnect with who I really am, helped me process trauma, build healthier relationships, and most importantly, believe in myself again.
I’ll never be able to fully put into words how grateful I am for this place. Transitions helped me reclaim my life and then some. If you’re struggling, if you’re feeling hopeless, please know that change is possible. This program showed me that.
Chaston karr
5 months ago
Transitions literally saved my life. It’s like no other rehab I’ve ever been at before, I’ve been to over 20 different rehabs and this one will definitely be my last lol. The staff here treat you like family and really care about you here. The outings were always so much fun, the groups were great, and I love how it’s a reality based program. 10/10 if you are thinking about coming here do it. Shout out Abe, Will, Shiffra, Josh, and Austin 🐐🐐🐐
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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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