When it comes to obtaining the care you need for substance use disorder or mental health disorders, your well-being should be a priority. However, for many people, having access to insurance to help cover the cost of care is essential. For those who have Ambetter insurance, the good news is that many plans will provide coverage for therapy. There are a few key things you need to know about this coverage, though.

Will Ambetter Cover Substance Abuse Treatment?

Yes, Ambetter does cover substance abuse therapy. Ambetter health insurance plans typically provide some coverage for substance abuse treatment. Each plan is a bit different, though. Most plans will cover emergency medical care you may receive due to an overdose or other emergency. They may also cover treatment for addiction, even if that is not emergent. Here are some factors to keep in mind.

Where can you go to get treatment?

While Ambetter health insurance typically provides coverage for mental health and substance abuse treatment, there could be some restrictions on where you can obtain that treatment. For some people, treatment may be limited to specific facilities that meet the insurance provider’s requirements. Other plans are more lenient in providing coverage to a wider range of providers.

What types of therapy are covered?

Many types of Ambetter coverage exist that offer treatment options to fit most needs. Some plans will cover the level of care deemed necessary after an assessment of your health and well-being. Typically, these plans may cover the following:

  • Outpatient therapy: This includes meeting with your therapy provider one or more times a week or less often, depending on your needs.
  • Residential therapy: For people with moderate to severe substance abuse disorder or mental health disorders, residential therapy may be covered. This will include care in a treatment facility where you will live for an extended period of time.
  • Intensive outpatient therapy: In this form of treatment, a person will live at home but will spend numerous hours each day, several times a week, in a treatment facility working on their recovery.
  • Medication therapy: Some health insurance plans provide medication coverage, which means they will cover costs associated with medications to minimize withdrawal symptoms or drug treatment for addiction.
  • Mental health care: Many people with substance use disorders also suffer from mental health disorders. Nearly all Ambetter health insurance plans provide coverage for mental health care as a component of substance abuse treatment.

What amount of care is available?

Another difference between Ambetter health insurance plans relates to the amount of care provided. Some plans offer coverage for 30 days, 60 days, or 90 days for inpatient care. Some may offer care for a longer period with a maximum amount of coverage paid out over the year. The key here is to know what limits exist if any are present.

What types of restrictions apply?

It is also important to learn if your Ambetter health insurance has any restrictions on the type of care you receive. Some may not cover all forms of mental health care or substance abuse care. They may only offer coverage for science-based treatments, for example.

Steps to Take to Know What Coverage You Have

There are several steps you can take to get the information you need. You can look up your health insurance plan online through your membership account or call your health insurance plan to get more information. This process can be the more complex method simply because you may not know what type of care you need just yet.

The second option is to turn to a substance abuse treatment center for guidance. 1st Step Behavioral Health is a substance abuse treatment center that is in-network with Ambetter. When contacting us you can learn a lot about the level of care you need, but also what type of coverage your insurance offers. An admissions counselor can help you cover these things with this within just a few minutes:

  • Gather information about your insurance policy from you.
  • Verify the type of coverage you have.
  • Provide you with any additional cost information that may be out of pocket.
  • Help you to get an assessment to determine what level of care you may need.
  • Get you into treatment and approved through your health insurance provider for coverage.

Are You Unsure If You Have Coverage?

Ambetter Health Insurance coverage may be available to you. The easiest way to find out about paying for therapy is by contacting us. You can also reach out to First Step Behavioral Health’s admissions team by calling today at (855) 425-4846. Speak to the admissions counselor about what you’re facing and what your needs are. We can then gather some basic information from you and verify your insurance coverage.

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