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.
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
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
2 months ago
My experience at Banyan was great ,nurses and staff are great and the food is excellent 👍🏽.
This place changed my life. I’m clean for the first time since being a teenager thanks to them. The tools they give you, as well as how well you are treated here and how great the staff (also in recovery) is, makes this place perfect. I know I wouldn’t have had this experience anywhere else, and this place still plays a part in my sobriety to this day! The techs and nurses are great people, and the alumni team is nothing short of amazing! They will keep up with you and check on you even after you leave. They will continue to invite you places and show you that you have built a real community with them. There is no better rehabilitation than this place. Once you are finished with your stay, they will offer you virtual IOP through Recovery Unplugged. TAKE IT! This is a virtual program that continues to help you and hold you accountable. The group meetings are awesome and they have great hosts! Thanks RU!!
Steven Myers
3 months ago
I had a great exper Here at recovery unplugged and I recommend to any one in need to get a bed weather it’s for detox or residential. They have a php program and will help with an after care plan. The food is amazing and the staff are all great
Leeo Chitty
3 months ago
Recovery Unplugged truly felt like my home away from home. I went through both residential and PHP, and I can honestly say I’d highly recommend this program over any other in Tennessee. From day one, I felt so welcomed by the techs and the alumni community—it made a world of difference in my recovery. The beds were super comfortable, the food was amazing, and best of all, I was allowed to bring my pup, which made the whole experience so much easier and more comforting. I’ll always be grateful for the love and support I found here.
This place is ok. You have to realize this is Florida, so you are going to get cockroaches. Just ask staff for a fogger they are happy to get you one. I have had no problems with staff. Long days keeping you busy. Van rides get tiring. We do outings Everglades on a airboat was amazing all the Alligators was just coll. The best thing about this place is the LIV Program. Troy Adam Ericka, Daniel. Are the best we do all sorts of outings will miss them as going home soon. 🩷🐊
Trina Chambless
4 months ago
I have not personally had the experience of Recovery with Zinnia Health, but I do have friends that work there and I can not praise them enough as people. They are the hardest and kindest people who go above & beyond for their friends & patients!
sal jones
5 months ago
Amazing transition between there facilities, supportive environment and atmosphere.
This place has saved my life! Great program great staff 5/15/25 an update since first review: I have now completed the program here at SRC and its been the most amazing beautiful experience here! From the 2 week residential then to the IOP living at Trullies for 90 days, then completing the rest of IOP while I moved to sober living. Everyone from the CEO Lee to the therapist's to the facilitators, to the behavioral health staff, peer support staff, case managers, and receptionist they all work together closely for each individual patient and their case while they are apart of SRC. Each phase of the program is held delicate for the patient's, to make it a smooth transition on each phase. They offer OP (outpatient) for the patient's that have graduated so they still get continued doctor's appointments, and still are able to have therapy with the therapist that has been with the patient through out the whole program. SRC has offered my life back to me, has taught me many coping skills, relapse prevention skills, trauma therapy, communication skills. They offer job support, housing, reentry programs, medication management. I HIGHLY recommend SRC for substance abuse and mental health treatment. They have a wonderful detox center, that doesn't make you feel shameful. If you are needing help, there is no reason to look anywhere else. This place has saved many lives from experience and me personally witnessing it myself.
Heather Walas
2 months ago
SRC is the only place to go if you really want to find yourself and your path to recovery. The entire staff is amazing! They are empathetic, caring and supportive at a time when you need it the most. I highly recommend SRC for anyone who is trying to find their way through recovery. The amount of support and love you take with you when you leave this place is life changing!
Jonie Lynell White
2 months ago
they are very helpful and compassionate and I had a great experience. however the program is only 2 weeks long when they advertise a 30 day program.
This is an ad and Avenues Recovery Center at Clarksville 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
The clinicals were great smaller groups and the teachers have real life experience! Staff makes the place. Great food and you can vape!
Zach Rumell
1 month ago
Great program and facility. The staff goes above and beyond!
Savannah Tessmer
2 months ago
1st Time client, in which I'll be graduating this week and I'm going to a 6 month program at avenues complete in Philly. I've had a tremendous experience here in Clarksville Indiana God bless everyone.
I was here 2 years ago and it's been 2 years since I drank. Banyan saved me. Plus the food is great
Jessica Nguyen
2 months ago
What is sad is the bad comments here are about the Same Policies Any "Good Rehab" place follows. There are Good reasons for these Policies and part of the Important Recovery process. (They should Research this and WHY they are important process. These people just sound like they are not really ready for Rehab. My son is fixing to go here. I will confirm my post then.
Tracie Knobloch
2 months ago
Amazing experience. I have been to several treatment centers and this was by far the most helpful I have found. Staff is amazing and the facility is very comfortable and gorgeous. I strongly recommend
AlcoholismOpioid AddictionDrug AddictionDual DiagnosisSubstance AbuseMental Health
Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program
Private InsuranceSelf-Pay OptionsSliding Scale Payment AssistanceFinancial Aid
Was recently at the provive office and my experience was phenomenal! The office was immaculate and I had a chance to talk with Noel and it was an absolute pleasure. He is extremely passionate about helping anyone that has any substance abuse or mental health issues. Amazing experience overall!
John Ballard
1 month ago
I’ve seen firsthand how much heart and care the team at Provive Wellness puts into their work. The staff is warm, professional, and truly committed to helping people heal. Highly recommend to anyone seeking support for mental health or addiction.
Cwc is about one of the best places ive been through for recovery they really do care about you even when you leave they try and help out the most making sure you stay on the right path of recovery and that's mainly Jennifer from viop who has helped in many ways make sure I was safe and happy when I left. And then there's mike he gives a lot of good advice while your there and will tell u straight up as blunt as possible no sugarcoating he's kinda Mr know it all lol mike don't play lol and also throws the best cookouts. If you really do want to recover cwc is the place.
Slimy Shifty
1 month ago
Great experience and fantastic staff! Especially Yolanda, Lakiesha, Mike, Nurse Jillian, and BHT’s Simone, Keisha, and Michelle all deserve recognition for the incredible job they do! They all went above and beyond to make sure I was comfortable there and that my needs were being met.
Andrea Demoulin
2 months ago
CWC made me feel at home. I highly recommend this facility if you are ready for treatment. Thank you to all the techs and facilitators for a great job 👍👍👍
I left this place early due to my own personal reasons, but you will not find a more passionate, caring, and loving staff. This place changed my life completely.
Jessica Bowlin
4 months ago
An amazing place with an amazing team. Healthy relationships are formed here. I came through over a year ago and I still talk to a lot of staff. If you are serious about recovery then this is where you need to be.
Lynn Jackson
5 months ago
9 months ago I was broken with nothing left accept the consequences of my addiction .. English Mountain (miracle mountain) gave me the start to what is now an amazing recovery journey at 9 months clean … The staff was amazing in all aspects , from the directors down to the kitchen staff … if you are serious about getting and staying clean this place is a great start
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse
Adult ProgramLGBTQ ProgramYoung Adult Program
Self-Pay OptionsPrivate insuranceSliding Scale Payment AssistancePrivate InsuranceFinancial Aid
This placed help save my marriage, and my life. When I got here I did t want to be sober this place helped me find my want. If you are looking to get sober let this be your sign from god. This place can save you if it can save me. God bless ARC
Tony Sanders
1 month ago
Asheville Recovery was the perfect place for me to begin my recovery journey. From the cleanliness and professionalism at the lodge to the structure and balance provided at groups in clinical, I couldn't imagine a better fit. The staff, my therapist, and my case manager were amazing and very instrumental in my continued recovery process. I can't thank Sarah Karges (my amazing therapist) and Sarah Conner (my amazing case manager) enough for their support and guidance. I would strongly recommend ARC to anyone who is ready to make the next step towards recovery in a safe and supportive environment.
Russell Amsler
2 months ago
I came to Asheville and Otter House To stop drinking as I had a huge problem. My expectations were far exceeded. Otter House So much more than that. It gave me a strong foundation to go out and not only stop drinking, but to live a much better life through identifying my values, what’s important to me, my perceptions, paradigm everything. The counselors are outstanding, and if you’re willing to put in the mental and emotional and spiritual work, you will come out With a fresh, renewed outlook on life that will guide you through the rest of your journey. I simply cannot say enough wonderful things about this place and the people who work there. My experience was Wonderfully life-changing. I am grateful and blessed to have gone there And experienced it.
The combination of filters you have selected has no results. Please refine your selections and try again.
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.
Calls to any general helpline will be answered or returned by a paid advertiser.
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.
Sponsored Helpline
800-784-1361
Alcoholism
Drug Addiction
Opioid Addiction
Substance Abuse
Dual Diagnosis
Adult Program
Military Program
Private Insurance
Self-Pay Options
Military Insurance
Medicare
Medicaid
LGBTQ Program
Financing
Mental Health and Substance Abuse
Young Adult Program
Financial Aid
Sliding Scale Payment Assistance
Program For Men
Program For Women
