List Of Drug Rehab Centers That Accept Ambetter Insurance

Ambetter is a suite of health insurance plans that Centene Corporation designed specifically for the Affordable Care Act’s Health Insurance Marketplace (HIM.)

Ambetter insurance plans are available in 18 states:

• Arkansas
• Arizona
• Florida
• Georgia
• Illinois
• Indiana
• Kansas
• Mississippi
• Missouri
• New Hampshire
• Nevada
• North Carolina
• Ohio
• Pennsylvania
• South Carolina
• Tennessee
• Texas
• Washington

Ambetter provides addiction treatment as one of its Essential Health Benefits.

Coverage options through Ambetter are classified into bronze, silver, and gold coverage tiers. Each tier includes a number of plans covering different health care services.

That means that each plan is associated with a different premium and, therefore, with different out-of-pocket costs.

You can expect to incur higher out-of-pocket costs using Ambetter insurance for addiction treatment if you have a bronze plan, for example, than if you have a silver plan.

Rehab Centers That Accept Ambetter Insurance

Some of the states in which Ambetter offers coverage don’t have any drug and alcohol rehab centers that accept Ambetter. However, if you find a rehab center you like, you can travel to it because your Ambetter policy should cover both in-state and out-of-state addiction treatment.

Your policy may provide full or partial coverage at inpatient rehab centers that accept Ambetter depending upon the rules stipulated by the type of plan you purchased.

Certain Ambetter insurance policies will allow you to seek treatment at out-of-network providers, but you should anticipate paying higher out-of-pocket costs.

Rehab Centers That Accept Ambetter By State

The following is a list of rehab centers that accept Ambetter by state, in alphabetical order.

Arkansas addiction treatment centers that accept Ambetter:

• Phoenix Rising Wellness Center

Arizona addiction treatment centers that accept Ambetter:

• Fountain Hills Recovery
• Desert Mountain Health

Florida addiction treatment centers that accept Ambetter:

• Turning Point of Tampa, Inc.
• Rally Point Palm Beach
• The Source Addiction Center

Georgia addiction treatment centers that accept Ambetter:

• Blue Ridge Mountain Recovery Center
• Atlanta Detox Center

Kansas addiction treatment centers that accept Ambetter:

• Synergy Executive

Mississippi addiction treatment centers that accept Ambetter:

• Extra Mile Recovery

Missouri addiction treatment centers that accept Ambetter:

• CenterPointe Hospital Addiction Treatment
• SSM Behavioral Health Treatment & Recovery
• Denver Recovery Center

Nevada addiction treatment centers that accept Ambetter:

• Immersion Recovery | Luxury Addiction Treatment

North Carolina addiction treatment centers that accept Ambetter:

• Harmony Recovery Center
• First Step Services, LLC.
• The Source Addiction Treatment Center

Ohio addiction treatment centers that accept Ambetter:

• Phoenix Rising Wellness Center
• Riverwalk Ranch

Pennsylvania addiction treatment centers that accept Ambetter:

• Fresh Start Recovery Center
• Riverwalk Ranch

Tennessee addiction treatment centers that accept Ambetter:

• Extra Mile Recovery
• Immersion Recovery | Luxury Addiction Treatment
• Phoenix Rising Wellness Center

Texas addiction treatment centers that accept Ambetter:

• Riverwalk Ranch
• Woodland Recovery Centers – Beaumont
• Burning Tree Lodge

Ambetter Coverage For Substance Abuse Treatment

Every Ambetter insurance plan includes access to Essential Health Services, and those Essential Health Services include mental health and substance abuse services.

The Affordable Care Act of 2010 mandated that health insurance companies offering policies through its marketplace must pay for all or a portion of the costs associated with addiction treatment.

When you enroll with Ambetter, you’ll be given the option of joining one of three plans categorized as Bronze, Silver, and Gold.

Each of these plans gives you access to the same set of medical services. Where they differ is in how much the insurance company will pay toward these services. The lower your monthly premium, the more likely it is that you’ll end up making higher out-of-pocket payments.

Does Ambetter Cover The Cost Of Inpatient Drug And Alcohol Treatment?

Addiction treatment is now considered a medical necessity and covered by all Ambetter health insurance plans. Inpatient rehab, also called residential treatment, is the most intensive form of addiction treatment.

Ambetter coverage for residential rehab programs varies by coverage tier and individual insurance plans. Inpatient treatment programs differ in length and treatments offered. Coverage may not be available for all rehab centers, such as those which do not follow evidence-based treatment principles.

Also, your Ambetter insurance plan may only provide coverage for up to a certain number of days. Health insurance plans typically cover at least 30 days of inpatient treatment (short-term rehab), with extended care coverage determined by medical necessity and insurance policies.

It’s important to note that Ambetter insurance may only cover anywhere from 40 to 60 percent of residential treatment costs. However, most rehab centers will work with addicted individuals and their families to determine a payment plan that works for them, including sliding-scale fees.

Does Ambetter Cover The Cost Of Outpatient Addiction Treatment?

Outpatient treatment for addiction is also covered by Ambetter health insurance plans. In fact, some insurance carriers require that you attempt an outpatient rehab program before covering inpatient treatment.

Outpatient treatments vary by length, intensity, and treatment approach. Which rehab program will be right for you or a loved one depends on the severity of your addiction, any co-occurring disorders, and whether you have completed inpatient treatment.

Some addicted individuals choose outpatient treatment if they can’t commit to a residential program. Outpatient rehab tends to appeal to those who have children at home, other dependents, or demanding jobs.

Types of outpatient drug and alcohol treatment include partial hospitalization programs, intensive outpatient programs, medication-assisted treatment programs, and outpatient counseling and therapy.

To better understand exactly which addiction treatment services your Ambetter plan covers, contact your insurance carrier’s customer support department. As an alternative, you could also talk to one of our addiction treatment specialists who can verify your plan coverage for you.

Does Ambetter Cover The Cost Of Partial Hospitalization Programs?

Partial hospitalization programs (PHP) serve as a next level of care following inpatient rehab programs and are covered by Ambetter insurance. Also known as day treatment, PHPs help recovering individuals who have completed residential treatment and want to continue their commitment to sobriety.

Partial hospitalization varies in length and intensity, but the average program may last from 12 to 16 weeks, with counseling and therapy taking place three or four days a week for four to seven hours each day.

Does Ambetter Cover The Cost Of Intensive Outpatient Programs?

Once a person no longer requires medical care or intensive day treatment, they are ready for intensive outpatient programs (IOP) which are covered by Ambetter health plans.

How much Aetna pays toward intensive outpatient treatment can depend on whether you have completed residential treatment, completed an IOP before, and whether the program you choose is in-network with your Ambetter insurance.

Intensive outpatient programs involve counseling, therapy, and case management and are similar in length to PHPs. Treatment sessions may be shorter though, with therapy and counseling totaling one to three hours per day, two to three days per week.

Does Ambetter Cover The Cost Of Suboxone?

Suboxone is a medication that is part of many opioid treatment programs. Medication-assisted treatment (MAT) helps many people with opioid use disorders quit the use of addictive drugs and enter recovery.

Suboxone may be covered by Ambetter insurance plans, but since this medication is typically part of a long-term treatment plan, it’s a good idea to know whether it’s covered before electing this treatment route.

All essential benefit healthcare plans include pharmacy benefits or medication coverage. However, Ambetter coverage for Suboxone may come with a co-pay. Speaking with an insurance representative can help you be prepared for your out-of-pocket costs if you need MAT with Suboxone.

Does Ambetter Cover The Cost Of Methadone?

Methadone is another form of medication-assisted treatment that offers long-term treatment for opioid addiction and is covered by Ambetter insurance policies.

Methadone maintenance therapy is often combined with other treatments, like individual counseling, group therapy, and behavioral therapy. For the best recovery results, methadone is taken daily (in pill form) or monthly (as an injection) to help recovered individual’s stay sober.

As with other medications, the cost of methadone may be covered by Ambetter, but your co-pay amount may vary by plan and by the type of methadone you’re taking.

For a more thorough overview of your addiction treatment coverage through Ambetter talk to your insurance company or a treatment representative prior to finding your rehab program.

Do Rehab Centers Have To Be In-Network To Accept Ambetter?

Health insurance carriers negotiate with doctors and medical facilities to provide more favorable rates. Doctors and medical facilities that have contracts with a health insurance provider are referred to as “in-network” with that provider.

Like other health insurance providers, Ambetter would prefer you to seek care from its inpatient healthcare providers because it costs the company less.

If you want to be reimbursed for procedures and treatments that are out-of-network, you will need to call your Ambetter representative for pre-approval.

Staff members at the rehab center you’re interested in attending may also be able to help you verify whether your Ambetter policy provides partial or full coverage at their facility.

You will typically pay higher deductibles and coinsurance costs when you seek treatment with out-of-network providers.

Which Rehab Centers Accept Ambetter Insurance?

A partial list of drug and alcohol rehab centers that accept Ambetter insurance can be found above. Keep in mind that rehab centers continuously add to and change the list of private insurance companies that they work with.

If Ambetter is not listed on the insurer list of a rehab that you believe may be able to help you begin your recovery journey, it is always worth contacting the admissions team at that facility to speak about the situation.

Your insurance coverage will probably vary according to whether a facility is an in-network or out-of-network provider. It may be possible to negotiate pre-approval for treatment at an out-of-network treatment provider if you speak with your Ambetter policy representative.

Seeking Addiction Treatment Using Your Ambetter Plan

Your ability to pay should not be a factor in seeking the addiction treatment that will allow you to begin your recovery journey. Ambetter insurance plans offer various levels of coverage for an individual who seeks to end the vicious cycle of alcohol or drug abuse.

Depending upon the type of plan you have, you may end up paying anywhere between 0 and 40 percent in coinsurance with an in-network rehab center once your deductible is met. You may end up paying more if you elect to work with an out-of-network rehab center.

To learn more about rehab centers which accept your Ambetter insurance plan, or to find a rehab center for you or a loved one, contact us today.

Updated on July 24, 2020

Written by the Addiction Resource Editorial Staff