Does AmeriHealth Cover Addiction Drug and Alcohol Treatment?
Does AmeriHealth Insurance Cover Alcohol and Drug Rehab?
AmeriHealth healthcare offers a range of insurance plans for individuals. If you are seeking a drug and alcohol rehab treatment program, you can count on AmeriHealth insurance to have coverage for you. Your AmeriHealth insurance benefits cover mental health and substance use issues, such as:1
- Substance misuse.
- Mental health disorders.
- Alcohol abuse.
- Other addictive issues.
With AmeriHealth rehabilitation coverage, you can move forward to seek a treatment plan that is appropriate for your needs. AmeriHealth coverage provides several types of insurance plans. These include individual and family PPO and HMO plans, as well as AmeriHealth Medicaid and Medicare. 2, 3
If you are in any of the following states listed below, your AmeriHealth insurance coverage is accessible for treatment:4
- New Hampshire
- New Jersey
- North Carolina
- South Carolina
- Washington, D.C.
To ensure that you have coverage at the rehab center of your choice, you can check AmeriHealth rehab coverage at the facility you want to go to. They will verify your insurance with the information you give them. Alternatively, you can call the number on the back of your insurance card and find out additional information about your specific plan.
Check AmeriHealth Insurance Coverage for Substance Abuse Addiction Treatment
Your AmeriHealth medical insurance can cover treatment for mental health and addiction issues, as mentioned above. For a more streamlined process, you can contact American Addiction Centers (AAC), and they will verify your insurance coverage for you. You can either call their helpline and talk directly to the admissions navigator or fill out the form below with your information. You can get an immediate answer about whether you are in-network or not.
What Is AmeriHealth?
AmeriHealth insurance was founded in 1983.5 With its origins in a hospital in West Philadelphia, the company grew to become one of the largest Medicaid managed care organizations in U.S.5 AmeriHealth now serves approximately 5 million people in 12 states plus Washington D.C. 5
What Will AmeriHealth Insurance Cover?
Your AmeriHealth rehab insurance coverage may vary from policy to policy based on the specific tier level you have. Other factors could affect the out-of-pocket costs you may incur from rehab treatment. These factors may include how long you’ve done the substances, how much you took, and what type of substances you were using.
A case management advisor can help create a personalized plan for treatment. This plan may consist of different treatment levels that help you reach your recovery goals. AmeriHealth rehab insurance may help cover some or all the cost of these treatment programs:
- Inpatient treatment program: You will be in a residential setting when going into an inpatient treatment program. This can be the perfect starting point to begin the journey to sobriety. The length of inpatient programs varies, ranging from 30 days up to one year or more if necessary. During rehab, you will participate in therapy, receive medication (when required), and be surrounded by a qualified care team.6(inpatient)
- Partial hospitalization program (PHP): At a PHP, you will receive a level of treatment that is almost as intense as an inpatient program. The main distinction between the two is that a PHP provides treatment all during the day, but you will go home in the evening. You don’t stay overnight at a PHP. This may be a good option if you feel more comfortable in your own home at night or need to go home to take care of some issues.7(partial)
- Intensive outpatient program (IOP): If you complete one of the above programs, you may be ready to move to the IOP. This program is an outpatient one but more intense than a standard type. During IOP, you will attend therapy sessions that fit your specific needs. Sessions may last several hours, and you’ll attend a few days a week.6(outpatient)
- Outpatient treatment program and therapy: The standard outpatient treatment program is an excellent choice if you’ve completed a couple of the other programs and are mostly independent. This type of program helps you learn the techniques to be successful with relapse prevention through therapy.5(outpatient)
Does AmeriHealth Insurance Cover Mental Health Care Treatment Facilities?
AmeriHealth mental health coverage is part of your overall plan with AmeriHealth insurance. Since the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, all insurers are now obligated to provide coverage for mental health and substance misuse.8
In addition, the Affordable Care Act (ACA) also mandates that insurance companies do not turn away claims for substance abuse and/or mental health issues.9 Research shows that people often have co-occurring conditions that consist of substance misuse and a mental illness.10 The mental health disorder could be anything from an anxiety disorder, depressive disorder, ADHD, PTSD, or something else.10 The main point to remember is that treating both conditions in tandem will be beneficial to you versus treating things separately.10
Experts recommend a co-occurring disorder treatment plan. So, check for AmeriHealth rehab centers that offer this type of treatment.10
How Long Does AmeriHealth Insurance Cover Rehab?
Your AmeriHealth drug rehab treatment length will vary from other people since everyone has a unique road to recovery. Your rehab journey will be based on your specific needs and issues. For example, if you are just starting rehab and need to progress through several levels of treatment, your recovery may take a while. Whereas someone who has already gone through detox and withdrawal may just need to participate in one of the outpatient programs.
Whichever AmeriHealth insurance for the addiction treatment program you need, you can be sure that it will be personalized for you. Professional recovery experts recommend a 90-day stay to get you started on the road to recovery.11
An admissions navigator can verify your insurance coverage to see if the program you require will be covered or if you need to make an AmeriHealth insurance payment.
What if My AmeriHealth Policy Does Not Cover Rehab?
If you’re feeling worried that your AmeriHealth mental health will not cover all your rehab costs, don’t delay in seeking treatment. You may be able to find an AmeriHealth rehab center that offers scholarships, financial aid, or reduced payment. In fact, in 2020, there were just over 7,000 substance use facilities that offered treatment at no charge or minimal pay for those who could not pay.12
Contact the AmeriHealth hotline to find out more information about any payment options.
AmeriHealth In-Network vs. Out-of-Network Alcohol & Drug Rehab Centers
When selecting a rehab center, be sure to ask if they are in-network with AmeriHealth insurance. In-network status means that the facility works with the insurance company in a negotiated contract to give the best prices. These prices get passed to the consumer/member. So, when you select an in-network facility, you may have the services covered or mostly covered.
When working with an out-of-network rehab facility, you will incur more costs for services. It’s beneficial to contact the rehab in advance and have them verify your insurance to see if it’s in-network.
AmeriHealth offers several types of insurance plans to fit every need. These are as follows:13
Health Maintenance Organization (HMO): With this plan, there is a network of doctors and other healthcare providers who have an agreement to provide services at a certain rate, allowing the costs to stay low. Your primary care physician (PCP) manages the care for you, referring you to the appropriate doctors that are within the network.
HMO (Plus): The plus version of HMO allows you to see a specialist or doctor without a referral. But you must stay within the network.
Point-of-Service (POS): A POS plan also has the PCP coordinate care. You can go where you want for services even if it is out of the network.
POS (Plus): POS Plus provides all the benefits of the Point-of-Service plan, but you won’t need a referral for services.
PPO: This provides you with a more expansive network of doctors and specialists from which to choose. You don’t need a referral either.
- AmeriHealth Caritas Louisiana. (2022). Covered mental health and substance use treatment services.
- AmeriHealth Caritas New Jersey. (2022). Individual health plans.
- AmeriHealth Caritas. (2022). Home page.
- AmeriHealth Caritas. (2022). Our national footprint.
- AmeriHealth Caritas. (2022). Our story.
- National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
- National Institute on Drug Abuse. (2020). Treatment settings.
- FindTreatment.gov. (n.d.). Paying for treatment.
- HealthCare.gov. (n.d.). What marketplace health insurance plans cover.
- National Institute on Drug Abuse. (2018). Comorbidity: substance use disorders and other mental illnesses DrugFacts.
- National Institute on Drug Abuse. (2020). Principles of effective treatment.
- Substance Abuse and Mental Health Services Administration. (2020). National Survey of Substance Abuse Treatment Services (N-SSATS) state profile.
- AmeriHealth.(2022). AmeriHealth New Jersey: Plan types & referrals
- Insurance Provider Name
- Policy Member's Full Name
- Policy Membership/Subscriber ID