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Ambetter Covered Alcohol Detox and Rehab Centers Near Me

On this page, you will learn about Ambetter health insurance coverage for substance abuse treatment and how to confirm what benefits are available under your specific plan.
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Ambetter Insurance Coverage for Alcohol Addiction Treatment

Provider Overview

Does Ambetter Nationwide Coverage Work for Alcohol Rehab?

About 14 million adults and children older than 12 are abusing alcohol on a regular basis in the U.S. To make things worse, about 1 in 10 children are living with a parent battling alcohol addiction.1

If you consider all forms of substance use disorders (SUD), about 70,000 people die from drug-related overdose each year. More than 60% of adults have used alcohol, tobacco, or illicit drugs at least once in a year prior.2 

Therefore, SUD treatment should be easily accessible and available to individuals from different demographic groups. However, only 2% of people who need treatment actually receive it. Most people who don’t get treatment stated that insufficient funds are the main reason why they didn’t go to rehab.2,3

People who go to treatment mostly fund it with the help of an insurance plan. Medicaid and Medicare remain the two most commonly used options. However, not everyone eligible for this type of coverage. Some struggling individuals opt for an alternative private insurance option, including different Ambetter insurance coverage plans.2

Ambetter Insurance: What Parts of Alcohol Rehab Is Covered?

All insurance providers must provide the same type of coverage for medically-necessary mental health treatment, which includes substance abuse, and for hospital care. This is regulated under the Mental Health Parity and Addiction Equity Act (MHPAEA), which came into effect in 2008. Therefore, most Ambetter healthcare plans will include alcohol addiction treatment at certain specialized facilities, depending on an individual’s personal coverage.4

The exact scope of coverage will depend on your plan, as well as the specifics of your  SUD treatment tailored to suit your personal needs. Every individual requires a different treatment approach that will affect the price and Ambetter coverage of treatment at specialized alcohol rehab centers in CA and any other state across the country. Your coverage may include some of the following aspects of treatment if deemed medically necessary:5,6

Is There Something That Ambetter Insurance Won’t Cover?

There are certain restrictions when it comes to Ambetter insurance coverage for alcohol addiction treatment. Most healthcare insurance providers won’t cover services that aren’t medically necessary, such as:7

  • Any types of recreational programs.
  • Amenities that aren’t medically necessary.
  • Chef-prepared meals & delivery of food.
  • Holistic care and other alternative therapies.
  • Treatment services not approved by a healthcare provider.

What Is the Price of Alcohol Treatment?

There are various factors that will influence how much treatment for alcohol addiction will cost. It’s not possible to make a precise estimation, at least not without a prior assessment of your alcohol abuse issue.4

Some of the factors that can affect the cost of treatment are:8

Inpatient Alcohol Rehab: Cost & Considerations

Alcohol rehab in an inpatient setting is usually designed for individuals with a long-lasting alcohol abuse. Inpatient treatment centers that accept Ambetter insurance coverage plans help patients recover in a setting carefully controlled by medical professionals.6

Due to the intensity of services, inpatient treatment can be more expensive than other forms of treatment. As an example, the average cost of treatment may be $500 – $650 daily. Since inpatient treatment can last from 1 to 12 months, this will effect the total price.6

Outpatient Alcohol Rehab: Cost & Considerations

Outpatient alcoholtreatment programs don’t require patients to stay at a facility. Instread, you can live at home, but still get the help you need. You can attend therapy in individual or group settings, depending on your needs and preferences.6

This is a rather affordable treatment type, as it doesn’t use as many resources as partial hospitalization programs or inpatient treatment. In some cases, you can expect treatment to cost you between $250 and $359 each day.6

What About Partial Hospitalization Programs (PHP)?

Partial hospitalization programs (PHPs) will allow you to spend the night in your own home, while providing you with a fairly intensive care. This makes PHP a balanced option, as it will allows the patient to get adequate treatment while also staying in a familiar evironment.6

As you don’t have to sleep at a treatment center, this may be a more affordable option compared to inpatient treatment. In general, daily costs of PHP may be around $350 – $450. 

What to Know About Medication-Assisted Treatment (MAT) Cost

The use of medications is a good way to provide additional support to an individual struggling with AUD. Different medications varying in price may be used to help battle alcohol addiction.9 

This makes the cost of medication-assisted treatment (MAT) challenging to predict. Not to mention that MAT can be used in combination with other forms of treatment. These are just some of the factors that need to be taken into consideration.9 

How Expensive Is Alcohol Addiction?

Alcohol affects not just the individual in question and their personal life, but the life of people around them and society as a whole. A struggling individual may lose workplace productivity, resulting in a loss of income. At the same time, their medical expenses may increase, as there many health issues correlate with alcohol abuse.10

Alcohol will also alter the normal functioning of the brain. The longer an individual is using alcohol, the worse the consequences can be. Due to all of this, you shouldn’t hesitate to get the treatment you need. The more you prolong, the more extensive care may be needed. Over time, your medical bills will increase, you’re risking your job and personal relationships, and by the time you do get treatment, it will not only be much more expensive, but you will already be at a greater loss.4,11

For How Long Can You Use Ambetter Insurance Coverage for Alcohol Rehab?

No matter what illicit substance you’re abusing, SUD is a relapsing condition that requires help from trained medical professionals. One of the principles of effective treatment states that for a treatment to be beneficial, it should last for an adequate period of time.12

How long you should attend treatment should be decided by a professional. They will take the severity of your alcohol abuse, as well as a range of other important considerations, into account.12 Nonetheless, the longer you stay in treatment, the greater your chances of recovery are.12

In most cases, it takes at least 3 months of treatment to notice a significant decrease in relapse rates.12 To see how long your Ambetter insurance coverage for nationwide alcohol treatment  will last, your best option is to call an alcohol abuse hotline or a dedicated Ambetter helpline. Since calls to addiction hotlines are confidential, your information won’t be shared to any third party.13

Choosing Between Inpatient & Outpatient Treatment: Which Options Is Right for Me?

As mentioned, one of the factors that determine the cost of treatment is whether you’ll go to an inpatient or outpatient facility that accepts Ambetter insurance coverage plans. This will mainly depend on the recommendation from your medical professional.6

In most cases, inpatient rehab might be a better choice, as people who get treatment in an inpatient setting have lower relapse rates. This is not just due to a greater intensity of care, but also because inpatient facilities offer a focused, structured, and monitored treatment setting, ensuring there are no triggering situations that might cause you to consume alcohol once again.6,12

In inpatient facilities, you can connect with supportive individuals who understand what you’re going through. Additionally, inpatient treatment will give you a sense of accountability while keeping you in a safe environment.6

How to Use Ambetter Substance Abuse Coverage for Alcohol Rehab?

Even when you’re eligible for a specific Ambetter-covered substance abuse treatment facility, you need to follow an established procedure. There are a few steps you need to take so you can use your coverage.14

The most important thing is to obtain a referral from a medical professional stating that your treatment is medically necessary. Most of the time, Ambetter’s in-network substance abuse providers will require you to provide a referral to accept your coverage.14

To get a referral, you may need to reach out to your:14

  • Healthcare provider. 
  • Insurance provider.
  • Primary care doctor. 

How Can I Find Alcohol Rehab Centers That Accept Ambetter Insurance Coverage Near Me?

The first thing to do when you want to locate an accredited alcohol treatment facility that accepts Ambetter insurance is to check your plan with your insurance provider. You can call the Ambetter helpline and ask them if there are any nearby facilities where you can get treatment that are in-network with them. 

Another option is to call a local alcohol hotline to discuss your options. In addition to any possible questions and concerns you may have, you can ask a dispatche about the cost of treatment and any options you can use to finance your recovery such as treatment at facilities that accept private pay.

You might also call a treatment provider such as American Addiction Centers (AAC). Aside from calling their helpline, you can also use their online form for insurance and benefit verification. AAC’s team of admission navigators can verify your insurance and present other payment options that are available for you.  

How to Read Your Insurance Provider Card
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  • 1Insurance Provider Name
  • 2Policy Member's Full Name
  • 3Policy Membership/Subscriber ID
Local Alcohol Rehab Near Me
Local Opioid Rehab Near Me
Sources
  1. National Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help.
  2. National Center for Drug Abuse Statistics. Drug Abuse Statistics
  3. Substance Abuse and Mental Health Services Administration. (2011). Health Insurance Status of Adult Substance Abuse Treatment Admissions Aged 26 or Older: 2011.
  4. FindTreatment.gov. Paying for treatment.
  5. Ambetter Health. About Us.
  6. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction.
  7. Ambetter Health. Terms and Conditions.
  8. Substance Abuse and Mental Health Services Administration. (2014). What is Substance Abuse Treatment? A Booklet for Families.
  9. National Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help.
  10. Centers for Disease Control and Prevention. (2019). Excessive Drinking is Draining the U.S. Economy.
  11. Substance Abuse and Mental Health Services Administration. (2018). National Survey of Substance Abuse Treatment Services (N-SSATS): 2017. Data on Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  12. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.
  13. Substance Abuse and Mental Health Services Administration. Substance Abuse Confidentiality Regulations.
  14. Department of Managed Health Care. Behavioral Health Care.
  15. Centers for Disease Control and Prevention. (2021). Alcohol Use and Your Health.
  16. Patrick, M. E., Wightman, P., Schoeni, R. F., & Schulenberg, J. E. (2012). Socioeconomic status and substance use among young adults: a comparison across constructs and drugs. Journal of studies on alcohol and drugs, 73(5), 772–782.
  17. National Institute on Drug Abuse. (2020) Substance Use in Women.
  18. Ambetter Health. Health & Wellness.
  19. Journal of Substance Abuse Treatment (2002). Patient attitudes concerning the inclusion of spirituality into addiction treatment.
  20. Collins, Susan E., Ph.D. (2016). Associations Between Socioeconomic Factors and Alcohol Outcomes. Alcohol Research Current Reviews, 38(1), 83-94.
  21. Ambetter from Superior Healthplan. Becoming Medicare Eligible? Stay with the health plan you trust.

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Frequently asked questions

What’s It Like in Ambetter-Covered Addiction Treatment Nationwide Centers?
In general, treatment will help you take steps to abstain from alcohol abuse and prevent possible consequences, such as injuries, violence, alcohol poisoning, risky sexual behavior, and health problems. The exact aspects of your treatment will depend on your individual plan and may include individual counseling, group therapy, and MAT.15 Ambetter insurance coverage is likely to pay for at least a portion of the costs. Still, you may need to pay for some expenses out-of-pocket. If you decide on Ambetter out-of-network coverage, these costs might be a bit higher.
Will Ambetter Cover Luxury Amenities at Alcohol Treatment Centers?
Certain rehab facilities may offer special amenities such as high-end accommodation, spas, chef-cooked meals, and many other perks that can make your stay more comfortable. These treatment centers are known as luxury rehab. However, since insurance covers only medically necessary aspects of treatment, these additional benefits may not be included in your Ambetter coverage.16
Is Ambetter-Covered Treatment Effective for Alcohol Abuse?
Alcohol abuse and addiction an cause severe problems for an individual and can be very challenging to treat. Fortunately, even individuals who’re battling severe AUD for a long time can benefit from evidence-based treatment.9 No matter how long you’ve been struggling, you’ll have greater chances to achieve lasting sobriety if you undergo alcohol addiction treatment. Approximately 1 in 3 people who go to rehab manage to stay sober for at least a 12-month period.9
Can Mothers/Women Apply for Ambetter Insurance Coverage to Attend Alcohol Rehab?
When it comes to women who use alcohol, there are some factors unique to them that have to be taken into consideration. For instance, pregnant women who use alcohol are at a greater risk of fetal deformities. They may also need special or more extensive care.17 There are no gender limitations as to who can use Ambetter insurance coverage. There might even be some special plans or benefits specially designed for women and mothers.7,18
Does Ambetter Cover Alcohol Rehab for Christians?
Spirituality and religion may help certain individuals reach success in treatment, as they provide them with a feeling of comfort, while also making them feel responsible for their actions. Faith-based rehab facilities are very popular for this very reason.19 However, insurance covers evidence-based, medically necessary treatment. To learn about whether your Ambetter healthcare plan will cover the cost of treatment at a Christian rehab facility, you need to call your insurance provider and check the extent of your coverage.
Does Ambetter Insurance Include Executive Alcohol Rehab?
Executive treatment programs are there to help busy professionals battling SUD. Some top-level executives may require flexible treatment plans that will allow them to go to work while also receiving the treatment they need. Otherwise, they’re risking a significant loss of income.10,20 Contact your Ambetter healthcare provider to see whether this treatment at these facilities is covered.
Can You Go to Alcohol Rehab With Ambetter Medicare Plans?
Whether you’re looking for local or nationwide Ambetter-covered rehab facilities, you might be eligible for an Ambetter Medicare plan known as Allwell. If you are, chances are this type of healthcare plan will cover the cost of alcohol rehab due to the requirements set by the MHPEA. Call your insurance provider to see if you’re covered.4,21

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