Before entering a drug treatment program, figuring out how you’re going to pay for treatment is a crucial first step. Many substance abuse rehab centers in Massachusetts partner with insurance companies like Ambetter to reduce your financial burden of covering treatment costs.
Recovering Champions is a leading drug and alcohol addiction treatment center in Cape Cod, Massachusetts that offers a range of substance abuse treatment programs. We partner with health insurance companies like Ambetter to help individuals access the treatment they need.
Ambetter Health Insurance Coverage Levels
Their three health insurance tiers include:
- Ambetter Essential Care (Bronze)
- Ambetter Balanced Care (Silver)
- Ambetter Secure Care (Gold)
These coverage levels differ in their deductible amounts, monthly premium costs, and out-of-pocket (copay) costs for medical and behavioral health services. The Bronze plan has the lowest monthly premiums, but higher out-of-pocket costs. The Gold plan is the opposite, while the Silver plan offers something in the middle.
All Ambetter health policyholders who have purchased health insurance through the Health Insurance Marketplace have access to Essential Health Benefits, regardless of their tier level. This is required under the federal Affordable Care Act. Limits on the amount of coverage may apply.
Essential health benefits for Ambetter policyholders include emergency services, prescription drug coverage, and mental health and substance abuse services among other health benefits.
What Types Of Addiction Treatment Does Ambetter Cover?
Ambetter insurance plans offer coverage for a wide range of behavioral healthcare services. This includes treatment services and rehab programs for drug and alcohol abuse.
Does Ambetter Health Insurance Cover Drug And Alcohol Detox?
Detoxification services — or detox — are often needed for people addicted to alcohol or drugs like benzodiazepines and opioids. Ambetter health plans offer coverage for detox.
The amount of coverage may be limited, however. By choosing an in-network detox provider, your coinsurance requirement may be anywhere between 0 to 20 percent, depending on your policy, where you live, and the treatment provider.
Does Ambetter Health Insurance Cover Inpatient Rehab?
Inpatient and residential treatment programs are the most effective treatment for substance use disorders. Ambetter does offer coverage for in-network inpatient drug rehab centers. Your coinsurance requirements may vary depending on the inpatient treatment center, your policy, and the state.
Does Ambetter Health Insurance Cover Outpatient Treatment Programs?
Ambetter health insurance plans offer coverage for a range of outpatient drug addiction treatment services.
Types of outpatient treatment programs eligible for coverage include:
- partial hospitalization/day treatment
- intensive outpatient program
- outpatient program
- outpatient behavioral therapy
- outpatient medication-assisted treatment (MAT)
Outpatient treatment services are offered by many Massachusetts treatment centers as part of a continuum of care. Receiving substance abuse and mental health services on an outpatient basis can improve a person’s chance for maintaining long-term recovery.
Does Ambetter Health Insurance Cover Prescription Drug Costs?
Prescription drugs like methadone, buprenorphine, and antidepressants are sometimes prescribed to support an individual’s addiction recovery.
Prescription drug coverage is covered as an essential health benefit within Ambetter health insurance marketplace plans. This includes Ambetter’s Bronze, Silver, and Gold plans. Copayment requirements for prescription medications may vary.
Using Ambetter Health Insurance To Pay For Drug And Alcohol Rehab
Using health insurance to pay for addiction rehab is common. But there are a few important things to understand about using insurance to cover treatment costs. Ambetter, like other insurance providers, may have certain requirements you must meet to be eligible for rehab coverage.
Before planning to use Ambetter to pay for drug rehab, consider checking the following:
- your responsibility for copayment
- which types of treatments are covered by your insurance policy
- which Massachusetts treatment providers accept your health insurance
- whether you’re required to meet a deductible to be eligible for coverage
- if you need to get pre-authorization (precertification) to receive coverage
Getting this information ahead of time can better prepare you for any responsibility for treatment costs. Talking to an addiction specialist or your insurance provider about these things prior to seeking treatment can reduce unnecessary stress. This can also streamline the process of getting yourself or a loved one into treatment.
Finding A Massachusetts Rehab Center That Accepts Ambetter Insurance
If you’re looking for addiction treatment for yourself or a loved one in Massachusetts who has Ambetter insurance, our addiction treatment specialists at Recovering Champions can help.
Recovering Champions is an accredited treatment facility that serves the greater New England area. We offer a range of outpatient treatment programs for substance use disorders and co-occurring mental health disorders.
With your permission, our addiction specialists can:
- verify your insurance coverage
- explain your treatment plan options
- help you determine which treatment program best suits your needs
During COVID-19, our drug and alcohol treatment center has continued to provide life-saving treatment services for people struggling with substance abuse and those in early recovery.
Contact us today to learn more about our treatment programs and to speak to one of our addiction specialists.