Ambetter Health Insurance Coverage for Addiction Treatment
Discover Ambetter Health Insurance’s addiction treatment coverage, including rehab options and perks. Find the right plan for your needs.
Ambetter Health Insurance Coverage for Addiction Treatment
Discover Ambetter Health Insurance’s addiction treatment coverage, including rehab options and perks. Find the right plan for your needs.
Ambetter is a health insurance company that started offering ACA compliant insurance plans in 2014. They’re owned by Centene Corporation. Their geographical span is nearly nationwide with plans available in 29 states and they serve more than four million members.
The company primarily offers individual and family plans on the Insurance Marketplace of each state they operate in. They can also help employers set up an Individual Coverage Health Reimbursement Arrangement (ICHRA) to provide employees with health coverage.
Beyond regular health insurance plans Ambetter also offers dental and vision insurance in most states.
If you’re comparing treatment centers or want a broader view of programs available in your area, you can also learn more about rehab options to explore nearby facilities.
By Michelle Tavares
Michelle Tavares is a registered nurse with over 15 years of experience in mental health nursing. She has worked in inpatient and outpatient settings as well as in bedside and administrative roles. She is a fighter of stigma and an advocate for getting people the mental health services they need.
Medically Reviewed by Anna Spooner
Anna has 10 years of experience in insurance and has been a content and copywriter since 2011. She strives to make all of her writing approachable and easy to understand while drinking copious amounts of tea. Anna writes about accessing addiction treatment, insurance, and finance.
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center's quality right now.
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.
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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.
1 month 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
2 months 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.
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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.
Thank you Oxford for helping me get my life back right. This place is absolutely amazing. If your looking for a place to go that actually cares about your recovery and puts it first then this is where you need to be...
Mark Traller
2 weeks ago
I absolutely love the facility and my therapist Shelby, she was the GOAT! I would definitely recommend this to anyone who needs to turn their life around from drugs or alcohol abuse. The counselors and TAs here are more than helpful and knowledgeable in the rehabilitation field and the grounds are great.
James Charlton
2 weeks ago
He is a very caring person and he explained everything very clearly
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 year, I've undergone two surgeries, and despite some delays, the team worked diligently to provide quality service. I sensed that they are short-staffed in certain areas, which could lead to longer wait times when working with the surgical team, as they are constantly busy. During my hospital stay, I encountered some exceptional individuals who made me feel at home despite my homesickness. I would like to extend special thanks to Jihan, Jeliesa, Arrienna, and many others for their incredible support.
Md. Shirajur Rahman
2 weeks ago
Bryan West gave me impeccable Healthcare! Everyone there seem to care genuinely and Debbie the caseworker or impeccably to make sure I could get to Madonna where I needed to be when I was released. Becky was great, but the star of the show was Kelsey!
Cat Beekley
2 weeks ago
Very professional, courteous and got me through the process quickly and efficiently.
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 a wonderful experience the staff were excellent
Renardo Bryant
1 week ago
Great facility. Good accommodating staff. Ive been to a few rehabs with a few more amenities but I will honesty say my facilitators, case manager, and therapist were exceptional. Best groups I've ever attended anywhere. Shout out to Barvetta, Julia, Sarah & and my guys Shane, Ray, D, & Phil! Make the right choice & come to Avenues! Your worth it!
Michael Kneller
1 week ago
I felt so good! I couldn't believe how much they made me feel loved and cared about. There's no like this.
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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.
i have been to over 15 detox centers from all across the country. i have a lot of trauma from being mistreated and scammed. i came here in March and discovered the magic of this detox center but unfortunately i didn't continue my treatment after detox.
Natalie is exceptionally good at the world she does here and if you have a chance to experience a conversation with her as well as many others, you will be considerably rich in life. Mora, Dana, Melissa and Nicole are quite literally the most amazing nurses i have ever had experience with and i would trust them with my life. this isn't just a detox center. these people put their entire hearts into running this detox smoothly and will happily and easily transition you to residential and if you are wanting more treatment after that, all you need to do is ask. detox is hard, but this staff makes it almost painless. Most of the staff here has been through this program before and they will continue to share their experience, strength and hope and whatever else advice and support they can provide you. all you need to do is ask. if you are looking for a recovery center that actually wants your best interest at heart, on my soul you will find it here. the doctors are incredible and will ensure they can keep you as comfortable as physically possible through the withdrawal. this place saved my life and i'm looking forward to completing their residential program so my sobriety sticks and stays this time but i wouldn't have ever had my foot in the door if it wasn't for this place. i hope you get the chance to experience the magic within these 4 walls and i wish you the best in your recovery. let it start here, you are safe.
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
ARC is the best rehab i’ve been to. the staff is great especially Sarah Conner, one of the case managers. she helped me get my legal troubles resolved and helped me setup appointments and a strong aftercare plan for when i leave. The staff here genuinely cares about helping and educating people with addiction. i would def recommend come to asheville recovery center if you’re thinking abt going to rehab.
katelyn wells
3 weeks ago
helped tremendously
Slepp
1 month ago
Staff and clinician teams were great. The groups were helpful and the admission process was very smooth. Had opportunities to attend activities and go to 12 step meetings. The lodging was good as well.
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 program literally saved my life. They took very good care of me and showed me how to take care of myself. Please if there is anyone out there suffering from addiction give trueself a call. It's amazing
cheri jobe
1 month ago
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
1 month 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!!!!
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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.
I (unfortunately) needed to go here. Best choice I ever made. I stayed at a very clean house, cooked meals 3x a day, and awesome staff. I'm just remembering to write this because it was 2 years ago November 1st. Even when your scared, they make it easy. Believe me. So worth it. And shout out to Phil. Super cool guy. I tried to get someone else to go here before I decided to cut ties... But, this place is great. Also snacks in the waiting room.
Matt Poulter
2 weeks ago
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
3 months ago
This place is amazing....was in the RTC program and now in IOP! Staff is unbelievably supportive and compassionate!
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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