Most insurance plans will cover either all or a portion of the treatment.
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SUD treatment executive, national news contributor & keynote speaker.
Navigation:
- Overview
- What Treatment Services Does Ambetter Cover?
- How Do I Find Out What My Ambetter Plan Covers?
- Find Rehabs That Take Ambetter
Overview
Ambetter is emerging as one of the leading providers of insurance coverage for substance use disorder and mental health services. If you or your loved one are covered by an Ambetter insurance policy and are struggling with substance use or other mental health challenges, you can use your coverage to make treatment more affordable and accessible.
Ambetter plan types are generally divided into three different categories (Gold, Silver and Bronze), with Gold plans offering the most comprehensive scope of coverage. While the Silver tier of coverage usually provides the best value, it’s essential that your coverage accommodates your unique treatment and support needs.
What Treatment Services Does Ambetter Cover?
While each person’s coverage will vary based on what type of plan they have, the essential substance use treatment services covered by Ambetter include, but are not limited to:
- Medical Detox and Withdrawal Management
- Residential Inpatient Rehab
- Medication-Assisted Treatment (FDA-Approved Medicines as Part of an Approved Alcohol or Opioid Treatment Plan)
- Intensive Outpatient (IOP) Programs
- Virtual Drug Rehab Services
Treatment services must be deemed medically necessary, and coverage may also vary based on your state, the treatment facility you’re considering, and other factors. It’s also important to note that some services, such as medication-assisted treatment, may be limited.
How Do I Find Out What My Ambetter Plan Covers?
The best way to determine what your Ambetter plan covers is by contacting an admissions representative from the facility you’re considering or an Ambetter service rep. They will be able to provide a full breakdown of your options and determine what percentage of treatment, if any, will need to be covered out of pocket. Ambetter Insurance utilizes the American Society of Addiction Medicine (ASAM) criteria to determine the medically necessary substance abuse services. Understanding these guidelines can help you stay more informed and empowered in your search for treatment.
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Find Rehabs That Take Ambetter
We created a directory or addiction treatment centers that accept Ambetter insurance for Substance Use Disorders.
