Amerigroup Insurance Coverage For Alcohol and Drug Rehab Treatment
Understanding your insurance coverage is important, especially if you or a loved one are thinking about getting help for a substance abuse problem. Getting informed about your coverage and treatment options can feel intimidating. However, it doesn’t have to be. This page will explain Amerigroup insurance plans and policies as well as Amerigroup insurance coverage for substance abuse treatment and mental health treatment services.
What is Amerigroup Insurance?
Amerigroup is a managed care company that offers health insurance for eligible Medicaid, Medicare, and State Children’s Health Insurance Program members. 1(1st paragraph) Amerigroup insurance is offered in 9 states across the country. Coverage for both Medicaid and Medicare is available in Iowa, New Jersey, Tennessee, Texas, and Washington.2 Plans in Georgia and Maryland offer Medicaid coverage only, and Medicare coverage is available in Arizona and New Mexico. 2
Substance abuse rehabilitation centers can help you determine your Amerigroup insurance coverage for their services. The treatment center can contact Amerigroup to verify your coverage, or you can call the number on the back of your insurance card. You can also call or fill out an electronic form online, both of which will be explored further.
Does Amerigroup Insurance Cover Drug or Alcohol Rehab?
Drug and alcohol rehab can involve many different types of services that range from highly intensive to minimally intensive. Detox and inpatient/residential rehabilitation are the most intensive and restrictive forms of substance abuse treatment services, followed by partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), and outpatient services such as individual and group therapy. The more intensive the treatment, the more services are offered. For example, a residential treatment setting may offer individual and group counseling, room and board, case management services, and relapse prevention.
Amerigroup insurance may cover all or some of these treatment services, depending on your particular plan and the state in which you live. Also, keep in mind that some services may require a referral. It is important to talk with your insurance provider to determine whether your substance abuse services require a referral and to determine what services are covered.
Does Amerigroup Insurance Cover Substance Abuse Treatment?
Substance abuse treatment services that may be fully or partially covered by Amerigroup insurance include:3(pg. 18 and 19)
- Inpatient hospitalization services.
- Outpatient group substance abuse treatment services.
- Individual outpatient visits.
- Residential treatment facility services.
- Partial hospitalization programs.
As previously mentioned, the amount and types of services offered vary depending on the type of treatment you receive. Inpatient programs that includes around the clock care is going to involve more services than an individual outpatient therapy session. Your coverage may vary depending on the type of treatment you receive.
Does Amerigroup Insurance Cover inpatient Mental Health Facilities?
When a mental health disorder and substance abuse disorder exist together, that is considered a co-occurring disorder. Studies have consistently shown since the 1980s that people who suffer from anxiety and other mood disorders are nearly twice as likely to suffer from a substance abuse problem.4(page 2, right hand side)
It is important to address mental health disorders and substance abuse disorders conjointly because they influence one another. For example, people struggling with depression may turn to stimulants to help improve their mood and increase energy levels. Conversely, individuals with anxiety may turn to sedatives or depressives (such as alcohol) to help reduce those symptoms. Failing to treat an underlying mental health disorder is failing to treat the entirety of the substance abuse problem.
The Affordable Care Act (ACA) was passed to help make access to mental health and substance abuse services more attainable. One of the largest expansions of substance abuse and mental health coverage in the U.S., the ACA requires many of the insurance companies that offer small company and individual coverage to cover substance abuse and mental health services.4(1st paragraph) Many substance abuse treatment facilities may be covered by Amerigroup insurance.
How Long does Amerigroup Insurance Cover Rehab?
The work of substance abuse treatment essentially begins after detox ends. Detox—a medically based intervention that helps a person eliminate substances from their body—is usually the very first step in the treatment process. The next step for most people is to enter an inpatient or residential treatment facility.
The road to recovery can be full of challenges and, yes, relapse can be a part of the recovery process. Science has shown that certain variables can increase your chance of a successful recovery and reduce your risk of relapse. People who stay in treatment for longer periods of time and who actively participate in the treatment process have shown successful recovery outcomes; treatment over 3 months or more has also been shown to increase recovery outcomes.5(Goals and Effectiveness of Treatment-5th paragraph) Thus, active participation and duration of treatment can greatly impact whether treatment is successful.
Your length of treatment will depend on individual factors including your mental health, physical health, insurance plan, and state you live in. Amerigroup insurance offers a variety of plans with different policies and tiers of coverage. To learn more about your Amerigroup drug rehab coverage, call the number on the back of your card to speak with a representative who can help clarify the details of your plan and help identify Amerigroup insurance drug treatment programs in your area. You can also verify your coverage by contacting the rehab facility directly.
What If My Amerigroup Insurance Does Not Cover Rehab?
Time is of the essence when it comes to substance abuse treatment and addiction. If you are worried about the cost of treatment, keep in mind that many substance abuse rehab facilities offer financing or scholarship options. It is important that you don’t put off getting help. Each day you suffer from addiction is another day you are at risk of experiencing devastating consequences. The longer you wait to treat your addiction, the more difficult it can be.
Amerigroup Insurance In-Network vs. Out of Network Rehab Centers
Many insurance companies offer policies that require you to choose providers who are in-network. An in-network provider simply means that your health insurance company has contracted with specific facilities, professionals, and suppliers to provide healthcare services to you.6(top of page) This helps to control the costs of services.
An out-of-network provider is one that does not have a contract with your insurance company. Depending on your insurance provider and policy, your services may or may not be covered if you choose to use an out-of-network provider. You may also have higher out-of-pocket costs. Call your insurance provider or the treatment center to verify your coverage and whether the treatment provider is in or out of network.
How to Check Amerigroup Insurance Alcohol and Drug Rehab Coverage?
American Addiction Centers (AAC) is a leading provider of effective substance abuse treatment across the country. They offer inpatient and detoxification services to help you achieve your recovery goals. When you’re ready to get help, call our helpline at and speak with one of our compassionate admissions navigators, who are trained to help you 24 hours a day, 7 days a week. Your call will remain 100% confidential and you can verify your benefits over the phone. You can also reach out online—enter your information here to help determine whether an AAC facility near you is in network or out of network.
AAC understands how difficult it is to live a life in addiction. We also understand that recovery is possible. Many of our admissions navigators have personal experience with addiction treatment and substance abuse, so they understand what you are going through. Your life doesn’t have to be defined by addiction—you deserve to live a happy and healthy life. Let AAC help you understand your health insurance benefits and find a treatment center that meets your unique needs.
Frequently Asked Questions
- Amerigroup Corporation. (2021). Creating healthier lives, together.
- Amerigroup Corporation. (2021). The States We Serve.
- Amerigroup. (2020). 2021 Summary of benefits.
- National Institute on Drug Abuse. (2010). Comorbidity: Addiction and other mental illness.
- US Department of Health and Human Services. (2019). Does the affordable care act cover individuals with mental health problems?
- US National Library of Medicine. (n.d.). Chapter 5- Specialized substance abuse treatment programs.
- US Centers for Medicare & Medicaid Services. (n.d.). Network.
- Amerigroup. (2022). Understand Your Medicare Plan Options.
- Amerigroup. (2022). Medicare Advantage Plans with Amerigroup.
- Substance Abuse and Mental Health Services Administration. (2020). National Guidelines for Behavioral Health Crisis Care Best Practice Toolkit.
- Amerigroup. (2022). Medical Necessity Criteria.
- National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction DrugFacts.
- FindTreatment.gov. (2019). Paying for Treatment: Understanding the Cost of Treatment.
- Amerigroup. (2014). Texas Prior Authorization Program Clinical Edit Criteria.
- Amerigroup. (2021). Buprenorphine Enhanced and Supportive Medication-Assisted Recovery and Treatment (BESMART) Network Provider Requirements and Program Description. Division of TennCare.
- Amerigroup. (2022). Individuals with Mental Health and Substance Use Needs.
- Amerigroup. (2020). Opioid Treatment Program (OTP) Description for SAMHSA Certified Facilities Division of TennCare.
- World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva: World Health Organization.
- Healthcare.gov. What marketplace health insurance plans cover.
- Amerigroup. (n.d.). Individuals with Mental Health and Substance Use Needs.