Addiction treatment can be very expensive without healthcare insurance coverage from companies such as Centene.
Insurance plans available through Centene will cover an array of evidence-based services and multiple levels of care to help people achieve lasting sobriety.
Does Centene Insurance Cover Rehab?
Yes, Centene will cover drug and alcohol rehab services. It boasts a large network of medical care providers and facilities so policyholders can access addiction care.
The Affordable Care Act (ACA) mandates that all insurance plans offered on the insurance marketplace must offer coverage for behavioral health services.
The level of coverage provided by Centene will depend on the service, the length of the treatment program, and the details of the insurance plan.
Substance Abuse Treatment Services Covered By Centene Insurance
Below are some of the substance abuse treatment services covered by Centene insurance.
| Treatment Type | Covered | Not Covered |
|---|---|---|
| Long-Term Residential | ✔️ | |
| Residential Treatment | ✔️ | |
| Inpatient Treatment | ✔️ | |
| Inpatient Detox | ✔️ | |
| Partial Hospitalization Program | ✔️ | |
| Intensive Outpatient Program | ✔️ | |
| Outpatient MAT | ✔️ | |
| Dual Diagnosis Treatment | ✔️ |
Centene Insurance Coverage By Treatment Type
One of the main considerations when choosing a rehab program is looking at the treatments available at the facility. Centene plans will cover an array of addiction services in residential or outpatient settings.
Centene Insurance Plan Types
Centene is the largest Medicaid managed care organization in the country and serves over 15 million Medicaid members.
Health care plans available through Centene encompass a range of coverage levels and benefits.
Health Maintenance Organization (HMO)
HMO plans are affordable types of insurance that have lower premiums and deductibles as well as fixed co-pays for doctor visits. HMOs require that members use in-network providers, however.
These budget-friendly plans are a good choice for people with limited financial resources who don’t have substantial health issues.
Point Of Service (POS)
These plans may require that policyholders get a referral from a doctor to see a specialist, but they do cover out-of-network providers.
POS plans usually feature a higher premium than an HMO.
Preferred Provider Organization (PPO)
PPOs have some of the highest premiums but will allow members to see a specialist or out-of-network doctor without a referral. Co-pays are also low using a PPO.
Medicaid Managed Plans
Medicaid managed care provides healthcare benefits and additional services through arrangements between state Medicaid agencies and managed care organizations (MCOs).
These types of plans are some of the most affordable, and will typically only cover medically necessary treatment options.
How To Use Centene Insurance Coverage For Substance Abuse Treatment
Before attempting to enroll at a rehab facility, policyholders should first find out if they need a referral from a doctor before they can seek treatment.
When and if a referral is obtained, members will then need to verify that the facility is within the network of providers. This can be verified by contacting a Centene representative.
Depending on the specifics of the Centene plan, members may also be able to go directly to the rehab facility with their insurance card in hand.
The admissions staff will use the client’s insurance card to verify coverage and any out-of-pocket costs that may be assessed.
Centene Co-pays And Deductibles For Addiction Treatment
The cost of deductibles and co-pays through Centene will vary based on the type of plan a member has purchased.
When purchased on the healthcare marketplace, Centene plans are divided into metal tiers so potential buyers can determine which level of coverage is right for them.
The Bronze and Silver tiers will feature lower monthly premiums but much higher deductibles and co-pays than the Gold plans.
Gold-tier coverage will have higher monthly premiums with much lower co-pays and deductibles.
Costs will also be affected by whether the program is in or out-of-network. In-network services are typically much cheaper than rehab programs located out of network.
What Addictions Does Centene Insurance Cover?
Centene insurance can cover treatment for people battling cocaine, opioid, alcohol, methamphetamine, prescription drug, or illicit drug addiction.
Gambling addiction and other behavioral health issues may also be covered depending on the details of the insurance plan.
Centene’s HALO (Health Assistance, Linkage, and Outreach) program leverages evidence-based addictive modeling to identify and prevent members at risk of developing substance use disorders.
This approach to substance use intervention helps identify early issues with substance abuse and co-occurring disorders.
What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?
If you or your loved one does not have adequate insurance coverage or cannot afford private health insurance, you may be wondering what other options are available.
There are several other ways to get affordable or free addiction treatment.
Other payment options include:
- scholarships for addiction treatment
- faith-based or non-profit rehab centers funded through donations
- free drug rehab centers
- sliding fee scales
- payment assistance plans
- self-pay using cash or credit cards
- crowdfunding
Some rehab facilities may be funded through block grants, such as the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUBG).
This grant is available in all 50 states and is designed to help pregnant women, people who use IV drugs, people with HIV/AIDS, or people with limited income get the addiction care they need.
Finding A Rehab Center That Accepts Centene Insurance
Finding a drug and alcohol rehab center that accepts Centene can be accomplished by calling the Centene customer support helpline and asking for help with locating an in-network facility.
The Substance Abuse and Mental Health Services Administration (SAMHSA) search tool can also be used to find a behavioral health treatment center that accepts private insurance.
Policyholders can also talk with their primary care provider about reputable substance abuse treatment centers in the area. A doctor can usually offer a referral to a facility nearby.
Find Substance Abuse Treatment Today
Contact AddictionResource.net today for more helpful information about drug rehab facilities.
Updated on November 2, 2023
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Centene Corporation — Whole Health Interventions for Substance Use Drive Positive Change
https://www.centene.com/news/whole-health-interventions-for-substance-use-drive-positive-change.html - HealthCare.gov — The health plan categories: Bronze, Silver, Gold & Platinum
https://www.healthcare.gov/choose-a-plan/plans-categories/ - Substance Abuse and Mental Health Services Administration (SAMHSA) — Find Treatment
https://findtreatment.gov/ - Substance Abuse and Mental Health Services Administration (SAMHSA) — Substance Use Prevention, Treatment, and Recovery Services Block Grant
https://www.samhsa.gov/grants/block-grants/subg
