How Do I Know if My AmeriHealth Covers Rehab or Not?

When you or the person you love finally reaches the stage where they are willing to accept help, it’s a great relief. But, it also invites some pretty big questions. Does AmeriHealth cover rehab? Where should I go to treatment? Are they in-network for me? What will my out-of-pocket costs be like?

The last thing you should do is panic here. Sure, organizing an admission to a drug and alcohol rehab can be a little stressful, but there’s no reason for it to be a harrowing and overwhelming experience. This article from 1st Step Behavioral Health answer common questions, like does AmeriHealth cover rehab? (the answer is yes!). It will also help you make sense of insurance jargon and rules so you can make a smart decision for yourself or your loved one. That said, let’s dig in!

Does AmeriHealth Cover Rehab for Addiction?

A series of laws passed over the past 25 years or so have helped expand substance abuse and mental health treatment coverage in the United States substantially. Thanks to three specific laws, every private health insurance policy in the U.S. must include overage for substance abuse treatment. Not only that, but it must be equivalent or similar to the other medical coverage.

The finer details are not important to you, perhaps, but the three laws we’re talking about are:

  • The Mental Health Parity Act of 1996 (MHPA):
  • The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
  • The Affordable Care Act of 2010 (ACA)

What that means is, if you have a private AmeriHealth medical insurance policy: The answer is YES; your AmeriHealth covers rehab for addiction. In fact, it’s required by law.

Does AmeriHealth Cover Rehab for Mental Health?

Part of what the Mental Health Parity acts and the Affordable Care Act did was to ensure that addiction and mental health did not get short shrift. In the past, health insurance companies would sometimes make policies that simply didn’t include behavioral health benefits at all, or which offered very little compared to the medical portion of their plans.

These laws changed that by requiring all health insurance companies to provide equivalent coverage for mental health and addiction as for any other medical conditions requiring treatment. This means your AmeriHealth policy offers coverage for mental health counseling and even residential/inpatient treatment for depression or anxiety, if you need it.

Does Amerihealth Cover Rehab Completely?

No health insurance plan covers the cost of treatment completely. Like any other medical services you receive, you are still subject to your deductible, out-of-pocket and co-insurances. But, going to a rehab that’s in-network with AmeriHealth, like 1st Step Behavioral Health, is definitely the best way to keep your costs as low as possible.

Your portion of the cost for rehab will depend mostly upon how much of your deductible and out-of-pocket maximum for the year has been met so far. If you’ve already met your deductible and out-of-pocket responsibilities for the calendar year, then your portion could be quite small.

The easiest way to get an idea of how your benefits will work and what your costs might look like is to ask for a verification of benefits. You can do that by calling or texting 1st Step Behavioral Health at (855) 425-4846 or by just submitting your insurance info using our confidential form here.

How Do I Know if I Have “Private” Insurance or Not?

When we refer to “private” medical insurance, this simply means that the health insurance plan was either paid for by you or a family member or provided by your employer (or a family member). Any health insurance not provided by the state or federal government, i.e., Medicaid or Medicare, is considered private insurance. We make that differentiation because only certain programs can work with state or federally-provided insurance and the rules are somewhat different.

What Does In-Network or Out-of-Network Mean?

Insurance companies, like AmeriHealth have contract agreements with some preferred healthcare providers. These providers make up your “network.” What that means is AmeriHealth has assessed the healthcare provider to make sure they meet or exceed their standards, and the provider has agreed to pre-determined rates for certain services.

What it means to you personally, is that a rehab that is in-network with AmeriHealth, like 1st Step Behavioral Health, already has a good working relationship with them and has been vetted. It also means you will pay much lower “in-network” rates for your rehab services.

The fact that AmeriHealth has a contract with that provider also means you won’t get any nasty surprise bills you weren’t expecting after treatment. Finally, many insurance plans do not offer out-of-network benefits in the first place. So if you deal with an in-network rehab from the beginning, you know you’re not wasting your time.

Benefits of Going to a Rehab That’s In-Network with AmeriHealth:

  • Peace of Mind: You know that AmeriHealth has verified the facility meets standards.
  • Saving Money: An in-network rehab facility means lower in-network costs for you.
  • Cooperation: AmeriHealth has an agreement with the rehab, which means no nasty surprise bills afterward.

Final Thoughts

Now you know your AmeriHealth insurance covers rehab. You also know the advantages to choosing an in-network rehab. If you have insurance with out-of-network (OON) benefits, going to a facility outside your network will mean paying higher rates for OON services and that usually includes a much higher out-of-pocket maximum.

The difference can quickly add up to thousands of dollars. If you have an HMO or similar plan that does not offer OON benefits, then your decision is simple. In either case, 1st Step Behavioral Health is in-network with AmeriHealth and we’d be happy to help you.

Take Your 1st Step Toward a Better Future

1st Step Behavioral Health has over 22 years of experience helping people like you or your loved one overcome addiction and mental health disorders. We are also in-network with AmeriHealth, for your peace of mind. Give us a call at (855) 425-4846 with any questions you have about substance use disorders, treatment or using your insurance here. You are also welcome to submit your insurance info using our confidential form here.

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