Ambetter of Tennessee Insurance Coverage for Drug and Alcohol Addiction

Ambetter of Tennessee Insurance Coverage for Drug and Alcohol Rehab Near Me

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Ambetter of Tennessee Covered Alcohol and Drug Rehab Centers in Tennessee

If you or a loved one live in Tennessee and are struggling with alcohol or drug addiction, you may be researching rehabs in the state. For many, going to alcohol and drug rehab centers for addiction is a common step toward recovery. But enrolling in rehab can be expensive.

Ambetter of Tennessee insurance plans may provide coverage for drug and alcohol treatment. This means that if you have this health insurance plan, you may be able to receive full or partial coverage for the costs of your care. Every health plan is different in design, which means you may have network or cost-sharing requirements that affect how much, if any, treatment costs are covered.

To find out what’s covered under your plan, you can call the number on the back of your insurance card, or you can work with rehab centers directly to find out what may and may not be covered under your plan.

What Is Ambetter of Tennessee?

Ambetter of Tennessee is not one type of plan but rather all of the health plans offered by this health insurance provider.1 “Local Community” tab Tennessee is just 1 of 20 states where Ambetter plans are offered. These plans are underwritten by Celtic Insurance Company, which is a Qualified Health Plan issuer of Health Insurance Marketplace plans in Tennessee.1 “Experienced Healthcare” tab, 2 last para All in all, across the 20 states, more than 2 million people have an Ambetter health insurance plan.1 “Experienced healthcare” tab

As a whole, Ambetter is the health insurance plan company from parent company Centene Corporation, a multinational Fortune 500 company.2 para 1 Collectively, the company has a robust portfolio of specialty health insurance solutions and more than 30 years of managed care industry experience.2, para 2

The health insurance plans offered by Ambetter of Tennessee are those offered on the federal Health Insurance Marketplace Exchange.3 These 3 tiers of plans are known as Bronze (Ambetter Essential Care), Silver (Ambetter Balanced Care), and Gold (Ambetter Secure Care) level plans, which vary in the level of coverage offered.3

Bronze plans, also called Ambetter Essential Care, have the lowest premiums (cheapest option monthly) but the highest out-of-pocket costs and deductibles.3 “Bronze” Gold plans, also known as Ambetter Secure Care, have the highest premiums (most expensive option monthly) but the largest range of coverage, as well as the lowest deductibles and out-of-pocket costs.3 “Gold” Silver plans, also known as Ambetter Balanced Care and the “best value,” are the mid-tier option offered by Ambetter of Tennessee.

Understanding what plan you have and what is covered by it can help you keep your healthcare costs in check. Call the number on the back of your Ambetter of Tennessee plan to speak to a representative and find out what’s covered under your plan.

What Substance Addiction Does Ambetter of Tennessee Cover?

Your Ambetter of Tennessee insurance coverage may extend to a variety of different types of substance addiction. For example, your plan may cover addiction to substances like alcohol, cocaine, heroin, crystal meth, opioid, marijuana, and prescription drugs. However, every health insurance policy is different. Call the number on the back of your insurance card to learn more about what is and is not covered under Ambetter of Tennessee healthcare plans.

What Does Ambetter of Tennessee Insurance Cover in Addiction Treatment?

What is covered under your Ambetter of Tennessee insurance plan may depend upon the specific one you have. Plans may limit coverage to in-network providers, so where you live and where you seek treatment may also affect your addiction treatment coverage. Despite the variances in coverage, there are a few common addiction treatment methods that may be fully or partially covered under your Ambetter of Tennessee insurance plan:

  • Inpatient or residential rehab. If you attend an inpatient or residential rehab program, you will live at the facility for the duration of your treatment program. Here, you’ll receive round-the-clock medically supervised care, which may include medically supervised detox.4, Pg 8, “What types of treatment programs are available?”
  • Outpatient rehab or therapy. If you attend an outpatient rehab program, you’ll be going to a facility 1 to 2 times a week to receive your addiction treatment, which could involve a counseling or therapy session. However, you don’t have to stay overnight with an outpatient program.4, Pg 10, Para 2
  • Intensive outpatient programs (IOP). If you attend an IOP, you will have more structure than a standard outpatient program, but you still won’t need to stay overnight like you would in an inpatient or residential program. You will have to attend a minimum number of hours of outpatient care and treatments per week.4, Pg 10, Para 3
  • Partial hospitalization programs (PHP). If you attend a partial hospitalization program, which is commonly called a day program, you’ll go to a facility for 4 to 8 hours per day, multiple days a week. Still, you don’t stay at the facility overnight.4, Pg 10, Para 1

Just because the treatments above are listed does not mean that they will be what’s recommended for you on the path to your recovery. Similarly, it does not mean that coverage for these services is guaranteed. Call the number on the back of your card to find out what treatments may be covered under your plan. And work with your provider to determine the best addiction treatment for you.

Does Ambetter of Tennessee Cover Mental Health & Co-Occurring Disorder Treatment?

The Affordable Care Act requires almost every U.S. health plan, particularly those offered on the Health Insurance Marketplace Exchange, to provide coverage in some capacity for mental health services.5 Ambetter plans abide by this mandate, providing coverage for mental health and substance abuse care in all plan tiers.3 “You’re Covered on Essential Benefits “section (scroll down)  What this means for you is that whether you need stand-alone heroin rehab or treatment for a co-occurring disorder, your Ambetter plan may provide some level of coverage for the costs of this type of care.

If someone has a co-occurring disorder, they have both a substance use disorder and a mental illness at the same time. About 17 million adults in 2020 were diagnosed with a co-occurring disorder.6, para 2

Co-occurring disorders are relatively common, as those with a substance use disorder are twice as likely to develop a mental illness at some point in their lifetime and vice versa.7 “Does one cause the other?” Because the conditions can be interconnected, many experts recommend patients receive integrated or tandem treatment, where each condition is treated simultaneously.6, “What should I do?

How Long Does Ambetter of Tennessee Cover Inpatient Alcohol and Drug Rehab Programs?

The length of time of inpatient alcohol and drug rehab programs that your Ambetter of Tennessee plan covers will vary. The specific type of plan that you have, where you seek care, and whether the facility and provider are in- or out-of-network will affect the length and breadth of coverage extended to you from your Ambetter plan.

It’s recommended that you check your plan’s benefit details prior to seeking care whenever possible to avoid surprise medical bills and keep your healthcare costs as low as possible. You can do so by looking up your plan’s information on your insurance card and calling the number on the back of your card.

Regardless of what your plan covers, it’s important to prioritize staying in treatment for an adequate amount of time. While every person is different, generally speaking, longer treatment times are typically most effective. Specifically, treatment programs should last at least 90 days to improve outcomes overall and reduce or stop substance use.8, bullet 5

What if My Ambetter of Tennessee Policy Does Not Cover an Inpatient Drug Rehab Program?

It is possible that your Ambetter of Tennessee rehab coverage does not fully or partially cover an inpatient drug rehab program. If this happens to you, don’t worry. Depending on the rehab center that you choose to attend, there may be alternative payment options that are available to you.

Some of the alternative payment options that could be available to you include scholarships and financing opportunities. Be sure to talk to the rehab center directly to find out whether these options could be available to you. And, remember, getting the treatment that you need right now is more important than pushing it down the road.

Ambetter of Tennessee In-Network vs. Out-of-Network Inpatient Rehab Centers

Knowing the difference between in-network and out-of-network providers can help you keep your healthcare costs as low as possible. According to Ambetter, an in-network provider is one that is a part of your insurance plan, and they’re contracted with your plan to provide services to you at a lower cost than what out-of-network providers can charge you. 9, “Questions About Plans and Benefits”

While every plan is different, some Ambetter of Tennessee plans do not provide any level of coverage for out-of-pocket providers unless it’s an emergency. To verify whether a provider is within your plan’s network, check Ambetter’s Find a Doctor tool, ask the rehab facility directly, or call the number on the back of your insurance plan.

How Can I Check My Ambetter of Tennessee Coverage for Inpatient Drug Rehab Centers in Tennessee?

If you need to check your Ambetter of Tennessee coverage for nearby inpatient drug rehab centers in Tennessee, American Addiction Centers (AAC) is here to help. To do so, call our helpline and speak to a real person over the phone who can check your benefits for you right away. They can also help you locate a nearby rehab facility that is within your Ambetter of Tennessee health plan.

Using your Ambetter of Tennessee health insurance plan to help pay for rehab is common and can help you offset the costs of rehab. If you’re in need of care, don’t wait any longer to get the care you need. AAC is here to help you understand your insurance and find a nearby facility or check whether your plan is accepted at any of the industry-leading AAC facilities across the country. Click here to find a treatment center near you and get started today.

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