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.
I drove by Avenues yesterday and it made me reflect on how far I ve came since leaving there in November. Today marks 160 days in recovery and since leaving avenues, I ve moved into a new place, got a new job, got a new car, started repairing relationships, working on my steps and most importantly, I have all my babies back home. This week is spring break for my kids and I m able to take them on vacation. We re currently in Nashville for the next couple of days and I just get to enjoy my time with them. I know without avenues and all the amazing staff, I wouldn t be where I am today. There were so many awesome staff members that cared and took the time to talk, I know a few times I thought about leaving but glad I didn t and am glad everyone who talked to me. I wish I remembered all their names but I don t. I ve been to another avenues about a year and a half before going to this one and I have to say hands down this one(Clarksville) blows the other one out of the park. From the staff to the food to how the program is laid out, they care and will go the extra mile. I only wish I lived closer so that way I could work there once I hit my year. I will always remember the kind hearts of those that work here. This place got me my life back and I know my kids are thankful for that.
Jacqueline Hiatt
2 months ago
There are some amazing facilitators at avenues recovery in Clarksville who understand what I was going through and helped me understand what recovery was all about. Avenues helped me better understand myself and helped me make an aftercare plan so that i can remain sober. I recomend Avenuse to anyone who is serious about getting sober and staying sober.
Brandon Rexroat
2 months ago
I really enjoyed my stay. Top notch care from people that will demonstrate love during you first step towards sobriety.
Symetria of Lewisville is a great place to all those in recovery. The entire staff is super friendly and helpful. They re there to help. Trust me. Special thanks to Cynthia and Ashley. Keep up the great work!
Ross
2 months ago
Costello is my SAG name. My name is James Dupee. I have been visiting the clinic for over a year and have been very pleased. Adam is the best Counselor/Therapist I have ever confided in. He is personable and understanding as well as straight forward with his advice. Cynthia is the most amazing face of a company I have ever met. She is kind and professional yet makes me laugh every time I stop in. The nurses are equally professional and personable. 5 Stars from me.
Jimmy Costello
2 months ago
Symetria Recovery saved my life!! I was driving down the highway suffering major withdraw from opioid addiction. I found Symetria Recovery and they had me in the very next day. When I got tested, I was positive for Fentanyl, which had to of come from something off the street. I nearly had a panic attack thinking about my life ending, leaving behind my wife and 3 beautiful children. I've been here for about 18 months clean and sober and have never been happier. It feels great to be "me" again. Addiction causes you to lose yourself. With the help of the staff at Symetria, you CAN be saved!! Come get saved at Symetria Recovery!!
Thanks to Luminous and the caring staff, I was able to get down to the core issues I went through in my adolescence, now I have the confidence and tools to begin a productive life.
They offer personalized treatment plan. That makes a huge difference.
Thomas Moody
1 month ago
I was at a place in Indiana that i thought was the best until I came to luminous. The support system and help they have n give there exceeds all expectations! I originally was going to a different program but couldn't wait for a bed n luminous took me the same day I called! By the grace of god I found this place because it's had a huge impact on my recovery. Getting sober is the easy part n recovery the real battle is STAYING sober n if u need help with the tools to doing so I suggest you call luminous. Scott (coach) runs amazing groups you can actually take from, Sean is a great therapists and doesn't miss a beat and Ed runs a great program. I'm not a bot and wasn't paid to leave this review lol I'm a resident who is just truly greatful to have had a chance to be in this program. Thank you guys at luminous I have a long journey ahead of me and I appreciate yal more than you know!! Wish I could explain more but trust me, from one addict to another you choose wat you get from a program and Theres a lot to take from this place. Thanks
MurcI MurcI
2 months ago
I think that luminous was great fit for me and would recommend it
This placed saved my life the staff are amazing I learned so much while I was in there Paul the director was always so nice to talk to and was always open to talk I can see that he just does not do this for the money he cares and is an amazing man thank you Kemah palms and thank you Paul
Matthew Styskel
2 months ago
Love this place saved my life help me get in tune with myself discover who I am and find new meaning in my life the director their Paul is just such a passionate guy very caring and really has a deep understanding and commitment to recovery also their affordable sober living right across the street has allowed me to participate in their alumni program outside of treatment highly recommend to people struggling with a substance use disorder
Grant Anderson
2 months ago
Kemah Palms Recovery has saved my life! All of the staff was amazing! I d like to give a special shout out to Paul. He put his sweat and tears into this recovery program. Going as far as providing sober living, alumni meetings twice a week, a specialty class at 3 every Monday-Friday, PHP, IOP, the list goes on! I can never thank yall enough for giving me the tools to turn my life around.
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 week 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.
I was admitted into detox at summer house very impressed with the staff, and especially Jen. She was very helpful with whatever questions I have. She answered immediately.I couldn't have done it without her.
Gary Brown
2 months ago
Awesome place great staff
Jeff
2 months ago
I couldn't recommend this place enough. All staff are exceptional and care genuinely about your well-being. The facilities are clean and comfortable. The nursing staff are attentive. God forbid I ever need a medical detox again, this is the only place I'd want to go. And I don't say this lightly: they've truly saved my life.P.S. The food is amazing.
I can t say enough good things about recovery unplugged in Brentwood! Andy was amazing to work with in the admissions process, Laura G was incredibly kind, and Lauren is a phenomenal therapist!
Justin Smallwood
2 months ago
I absolutely loved this place.. everyone that works there is friendly and helpful.. You become family I've never felt so welcomed as Recovery Uplugged... Awesome Experience.... 10 stars
kristie stroud
2 months ago
Best place I ve ever been to with an awesome staff.. food was great and the therapy I received was top notch. From top to bottom I would recommend this place to anyone. Austin in Alumni is the man and has been there for me since the beginning of my journey
Tree House is truly an incredible place. My life was changed in so many ways thanks to Tree House and the amazing staff. I love this place with all my heart and the people I got to know during my time there. The structure of the program combined with the camaraderie of the people around you is a match made in heaven. Thank you Tree House for giving me the life I live today.
clint wilson
2 months ago
Hands down the best decision I made for myself to save my life. I had no idea what to do with my life as I was spiraling into a seemingly inescapable abyss until I reached out to Treehouse. I had my reservations about going to a place like Treehouse as a member of the LGBTQ+ community but the amount of support and acceptance I received even before I committed to going was incredible. I gained the knowledge and tools that I use on a daily basis that help me live life to the fullest potential. I discovered new things about myself while going through the program by living outside of my comfort zone and allowing myself to try things I never thought I would be interested in. Treehouse was able to create a space where I could explore these new things and create strong bonds with guys that impacted my recovery in the best way possible and gave me a stronger foundation to move forward with my life. The therapy was life changing, shoutout to Chuck and Ryan, they saw something in me that I could not see for myself and helped me bring that out. The coaches were incredible as well, shoutout to Dylan, he taught me so much that went above and beyond physical fitness and weight training. Vechi and Brandon were instrumental in working with me to get me the help that I needed and incredible human beings. Words cannot express how grateful and honored I feel to have gone through and graduated from this program. If you're looking for a place that'll give you the best chance at success in recovery, this is it. You are worth it.
Salvatore Bonilla
3 months ago
When I first walked through the doors at Treehouse, I was lost, broken, and trapped in a cycle of addiction that I never thought I could escape, Never! I had become a prisoner to alcohol and drugs, and my life was spiraling out of control. The guys at Treehouse, there programs, and there unwavering support, helped me find my way back to the person I was meant to be!At my lowest point, I felt like there was no hope But within the walls of Treehouse, I found Compassion, Understanding, and the TOOLS I needed to fight for my sobriety. Through counseling, support groups, and the kindness of those who had walked this path before me, I learned that I was NOT alone. I discovered strength within myself that I never knew existed, and for the first time in a long time, I believed in the possibility of change. I learned to take Responsibility for my Actions, to heal from the pain I had caused myself and others, and to embrace a FUTURE filled with HOPE. TREEHOUSE gave me the courage to rebuild relationships, to Chase Dreams I had long abandoned, and to live a life of PURPOSE and CLARITY.Today, I am proud to say that I am sober. Every morning, I wake up with a sense of Gratitude instead of dread. I have regained my health, my relationships, and most importantly, my sense of self-worth. NONE of this would have been possible without the GUIDANCE and SUPPORT that Treehouse provided me during my darkest days.I just want to say Thank You for being the place where I found healing, hope, and a second chance at life. I have and will carry the lessons I have learned within me ALWAYS, and I hope to one day give back to others who are fighting the same battle. Because of you, I am no longer just surviving, I am truly living!Much Love..
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Don’t wait! This is what you’re looking for. Absolutely the best recovery center in Texas. Phenomenal staff and a mature mix of clients who take their recovery seriously. Beautiful facility that’s comfortable and serene.
Jason Bowman
2 weeks ago
This place saved my life! Awesome staff!!! Great program and support!
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.
Jeff Wagner
3 months ago
This place is amazing. The admin coordinator Christina was extremely patient and helpful with my situation and all the help I have received from everyone else has been life changing. I can't thank them then enough!
Brienne Curry
3 months ago
I love this place, you feel like u have a cozy home to work on yourself. It's very comforting and the staff are people that have been thru addiction as well so they can relate to you which makes it so much easier.
Jaime Emerson Newcomb
3 months ago
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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.
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