WellCare New Jersey (Ambetter) Rehab Centers in New Jersey
Across the country, 162.5 million people over the age of 12 used tobacco, an illicit drug, or alcohol in the past month.1, pg 1 “substance use” In New Jersey alone, from 2017–2019, of those aged 12 or older, 6.7% of that population—or 464,000 people—had past-year substance use disorder.2, pg 26 Of that group, 38,326 people in the state of New Jersey were enrolled in healthcare treatment in a single-day count in March 2019, which includes alcohol and drug rehab centers.2, pg 27
For many, getting treatment for substance use disorders, mental health conditions, or both is the best way to overcome addiction, but it often comes at a cost. If you have insurance, including a WellCare New Jersey (Ambetter) health plan, you may be able to use your plan to cover at least some of the costs associated with treatment. Coverage details can vary based on the plan you have, so it’s important to call the number on the back of your insurance card to gather more information about what may be covered under your specific policy. Or, you can call rehab centers directly and ask them whether they’d accept your WellCare New Jersey plan or if they’re an in-network provider under your plan. The number of rehab centers in New Jersey or the country that may be in-network with your WellCare New Jersey plan may vary based on your specific plan, which is why it’s crucial to verify your insurance before seeking care whenever possible.
What Is WellCare New Jersey (Ambetter)?
WellCare, a subsidiary of Centene Corporation, has provided Medicare products to eligible members for more than 20 years.3 Across all 50 states, WellCare serves 4.1 million Medicare Part D beneficiaries and 1.2 Medicare Advantage beneficiaries.3 In New Jersey, WellCare provides Medicaid services as well.4
The number of rehab centers in New Jersey that accept WellCare (Ambetter) New Jersey plans vary based on the type of plan you have, as not all centers accept Medicare and Medicaid insurance. Be sure to carefully review your plan details and work with rehab facilities you’re interested in attending to ensure proper coverage.
What Substance Addiction Does WellCare New Jersey (Ambetter) Cover?
The exact coverage details of your WellCare New Jersey (Ambetter) plan will depend on your specific insurance policy. But most plans provide some level of coverage for substance use addiction, including addiction to substances such as alcohol, cocaine, heroin, crystal meth, opioids, marijuana, and prescription drugs. To verify your coverage, please call the number on the back of your insurance card.
What Does WellCare New Jersey (Ambetter) Insurance Cover in Addiction Treatment?
WellCare New Jersey plans may vary in the extent of their addiction treatment coverage. Additionally, the treatment plan that’s recommended for your path to recovery may vary from the treatment plan recommended for another person’s recovery. Despite this, here are some common types of addiction treatment with which you should be familiar.
- Inpatient/residential rehab: A patient receiving inpatient or residential rehab services will live in an inpatient facility full-time for days, weeks, or months to receive the round-the-clock care and supervision that they need.5, Pg 8, “What types of treatment programs are available?”
- Outpatient rehab/therapy: A patient receiving outpatient rehab services would attend 1–2 outpatient therapy sessions per week but does not stay overnight in a facility.5, Pg 10, Para 2
- Intensive outpatient programs (IOP): As the name suggests, an IOP is a type of outpatient program that involves receiving a minimum number of hours of treatment each week.5, Pg 10, Para 3
- Partial hospitalization programs (PHP): PHPs, which are also known as day programs, involve 4–8 hours of care per day multiple times a week but do not involve overnight stays at the facility.5, Pg 10, Para 1
There may be additional rehab programs that a provider may recommend for you that are not listed above. Be sure to follow the instruction of providers to put yourself on the path to recovery that’s right for your needs.
Does WellCare New Jersey (Ambetter) Cover Mental Health & Co-Occurring Disorder Treatment?
In the United States almost all health plans, including the Medicare and Medicaid plans offered through WellCare New Jersey (Ambetter), are mandated by the Affordable Care Act to provide coverage for mental health and substance abuse services in some capacity.6 Plans are specifically required to provide some level of coverage for treatment for substance use disorders (e.g., rehab), inpatient mental and behavioral health services, and behavioral health treatment.6
What this means for you is that regardless of whether you need to receive treatment for standalone drug rehab or treatment for a co-occurring disorder, your WellCare New Jersey plan must provide coverage for at least some level of treatment. A co-occurring disorder is the term used to describe when someone has both a mental health condition and substance use disorder at the same time.7 Because each condition can affect or influence the other, it’s recommended that treatment for each condition be received at the same time.7
How Long Does WellCare New Jersey (Ambetter) Cover Inpatient Alcohol and Drug Rehab Programs?
Because there are a variety of plans and tiers of plans that may be available to members, there is not one standard length of time that WellCare New Jersey plans cover inpatient alcohol and drug rehab programs. To learn what is covered by your specific plan, call the number on the back of your insurance card or log on to your online member portal to check your coverage. Despite what may be covered under your plan, it’s important to remember that remaining in rehab for the length of time recommended by your provider is the best course of treatment. Research indicates that remaining in rehab for the proper treatment length is directly tied to good outcomes, and that treatment should last at least 90 days to increase the likelihood that you can maintain positive those outcomes.8
What If My WellCare New Jersey (Ambetter) Policy Does Not Cover an Inpatient Drug Rehab Program?
If your WellCare plan doesn’t fully or partially cover inpatient drug rehab programs or other rehab programs, there may still be payment options that you can receive to help offset the costs of treatment. Be sure to ask the rehab facility you attend whether there are financing or scholarship opportunities available to you. Getting the treatment you need today is of the utmost importance and should not be delayed or pushed down the road.
WellCare New Jersey (Ambetter) In-Network vs. Out-of-Network Inpatient Drug Rehab Centers
A network refers to the suppliers, providers and facilities that are under contract with your WellCare plan to provide services at a set cost.9 Typically, seeing an in-network provider is more cost-effective than seeing a provider that is outside of your plan’s network. To learn more about which providers are in your plan’s network, call the number on the back of your WellCare New Jersey plan card.
What Rehab Centers Take WellCare New Jersey (Ambetter) Insurance?
There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Ambetter insurance.
How Can I Check My Wellcare (Ambetter) Coverage for Inpatient Drug Rehab Centers in New Jersey?
There are a variety of different ways to check your WellCare (Ambetter) coverage for inpatient drug rehab centers in New Jersey. The first way is that you can call the number on the back of your insurance card and speak with a WellCare representative. You can also log on to your member portal online and review your plan’s details.
Another option for checking your coverage is to contact the rehab facility itself and ask a staff member to help check your benefits and coverage.