You might be wondering if it is possible to break free from substance use and rebuild your life. With the support of friends, family, and professionals, you can overcome your addiction and live a happy and healthy life. Drug addiction can be a very difficult problem to overcome, but it is not impossible.
If you have health insurance through Sunshine Health (Ambetter) insurance in Florida, you might wonder if your insurance can help you afford the substance use treatment you need. Fortunately, because Sunshine Health (Ambetter) Florida healthcare plans are sold in the Health Insurance Marketplace, they do offer coverage for both mental health and substance use treatment.1, Top bulleted list, 5th bullet
In the U.S., there are at least 200 substance abuse and rehabilitation facilities that are within Ambetter’s network.2, map
If you’re curious about what your specific plan covers, you can have a substance use treatment facility check your insurance based on the information you provide, or you can call the customer service number on the back of your insurance card. Either way, you’ll learn what to expect from your Sunshine Health (Ambetter) rehab coverage.
What Is Sunshine Health Florida (Ambetter)?
Ambetter is the insurance plan that Sunshine Health offers on the Florida Health Insurance Marketplace.3, first paragraph The core belief of the company is that high-quality healthcare is best delivered locally.3, first paragraph Sunshine Health is owned by Centene Corporation, a Fortune 500 company with over 30 years of experience in the managed care industry.3, second paragraph You can find both Exclusive Provider Organization (EPO) and Health Maintenance Organization (HMO) plans provided by Sunshine Health in the Florida Marketplace.3, third paragraph
Ambetter has more than 2 million members nationwide and offers 20 state health plans.4, Experienced Healthcare tab Sunshine Health (Ambetter) Florida insurance coverage covers all the essential health benefits from the Affordable Care Act (ACA), including mental health & substance abuse care.5, You’re Covered on Essential Benefits There are 61 providers who specialize in substance use and rehabilitation that are in the core Ambetter network in Florida.6, map
Is Sunshine Health Florida (Ambetter) Part of Medicare?
Sunshine Health of Florida offers a wide variety of health plans, from Medicaid to family and individual coverage to Medicare.7, Get Insured That means that Sunshine Health Florida is not just a part of Medicare, although the company offers Medicare plans known as WellCare from Allwell.7, Get Insured
Is Ambetter the Same as Sunshine Health?
Sunshine Health insurance plans that are offered through the Health Insurance Marketplace are Ambetter plans.7, Get Insured However, the other plans that Sunshine Health offers are not Ambetter.7, Get Insured So they aren’t the same company, but they work together on specific health insurance plans.7, Get Insured
What Substance Addiction Does Sunshine Health Florida (Ambetter) Cover?
There are a variety of different substances that people misuse in Florida. For example, in 2019 14.6% of Floridians over age 12 reported using marijuana in the last year, and over 50,000 Floridians reported using heroin the past year.8, p. 25 2nd paragraph and p. 27 second paragraph
Commonly misused drugs include alcohol, cocaine, marijuana, opioids, meth, and prescription drugs.9, bulleted list These are the types of substance misuse problems that you can get treatment for using Sunshine Health (Ambetter) Florida rehab coverage.
What Does Sunshine Health Florida (Ambetter) Insurance Cover in Addiction Treatment?
There are many different types of treatment available for substance abuse, and the type that is best for you will depend on your specific situation. Your doctor will help assess your needs and recommend a treatment program. The doctor might recommend inpatient or residential rehab, outpatient rehab, or another option.
Some of the common substance abuse treatment options are:10,11
- Inpatient drug rehab is a type of rehab where people live at the rehab facility for the duration of their treatment. This can be a good option for those who need more intensive treatment and need to leave their home environment to get away from substance use.
- Outpatient drug rehab is a form of addiction treatment that allows people with substance abuse problems to continue living at home while they receive treatment. Outpatient drug rehab programs vary in intensity and can last anywhere from one month to a year.
- Intensive outpatient programs for drug addiction are an excellent resource for those who are seeking treatment for their addiction. These programs offer more intensive treatment while allowing you to still live at home.
- Partial hospitalization treatment for addiction recovery is a program that offers comprehensive care for people who are misusing drugs or alcohol. Patients in this program typically attend five days a week for the full day and receive treatment for their substance use as well as any co-occurring mental health issues.
Does Sunshine Health Florida (Ambetter) Cover Mental Health & Co-Occurring Disorder Treatment?
It’s common for mental health concerns to occur alongside substance use disorder. In fact, 50% of those with substance use issues will have a mental health diagnosis at the same time, which is known as a co-occurring disorder.12, second paragraph It’s vital to treat both mental health issues and substance use at the same time because integrated treatment has been shown to have better outcomes than treating only one problem or the other.13, first paragraph
Can you rely on your Sunshine Health (Ambetter) Florida mental health and substance use coverage? The answer is yes, as mental health and substance use treatments are considered essential health benefits for insurance plans.1, Top bulleted list, 5th bullet The exact coverage you receive will depend on your specific plan, so be sure to verify coverage before you commit to a treatment program.
How Long Does Sunshine Health Florida (Ambetter) Cover Inpatient Alcohol and Drug Rehab Programs?
How long should a rehab program last? There is no one-size-fits-all answer to this question, as the length of treatment will vary depending on your specific needs. However, in general, substance use treatment should be long enough to help the individual overcome their addiction and learn how to live without drugs or alcohol. Research indicates that most of those with substance use disorder need at least three months of treatment to make a significant change and that the best outcomes occur with longer treatment programs.14, point 5
To learn more about the specific types of treatment your insurance plan covers, you’ll want to call the number on the back of your insurance card. The representatives at the company can help you review your plan and understand the details.
What if My Sunshine Health Florida (Ambetter) Policy Does Not Cover an Inpatient Drug Rehab Program?
If your insurance doesn’t cover a specific drug rehab program, there are still options available to you. You can ask if the rehab facility offers a sliding scale payment plan, which allows you to pay based on your income.
You might be able to get a loan or borrow money from family or friends. Finally, you can find out if the rehab center offers financing or payment plans, or if there are scholarships available.
It’s very important to get drug treatment now instead of putting it off. When you put off substance use treatment, you’re only making the problem worse. You could wind up with more health problems, and you may even find yourself in legal trouble. Substance treatment is a big decision, but it’s one that you should make as soon as possible.
Sunshine Health Florida (Ambetter) In-Network vs. Out-of-Network Inpatient Drug Rehab Centers
When looking at rehab treatment centers, it is important to consider which centers are in the health insurance network. The health insurance plan’s network is made up of providers who have agreed to accept a certain price for providing care.15, p. 1 What’s a Provider Network This means that you will have lower out-of-pocket costs and better coverage if you go to one of these providers.15, p. 3, second paragraph If your provider is not in the network, you will likely have to pay more for care, or you might not have insurance coverage at all.15, p. 3, second paragraph Check with the rehab programs you are interested in to ensure that they are within the Sunshine Health Florida (Ambetter) provider network.
What Rehab Centers Take Sunshine Health Florida (Ambetter) Insurance?
American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Ambetter insurance plan, the following AAC facilities accept Ambetter for drug and alcohol addiction rehab.
- Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth, all in a luxurious setting with high-end amenities.
- Desert Hope Treatment Center: Located in Las Vegas, Nevada, Desert Hope provides individualized care programs as well as offering a full continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, and tele-health.
- Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and telehealth, all with individualized treatment programs.
- Recovery First Treatment Center: Located in Hollywood, Florida, Recovery First treats substance use disorders by combining evidence-based therapeutic modalities with top-level care. Recovery First provides a personalized continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth.
- River Oaks Treatment Center: Located in Riverview, Florida, River Oaks treats substance use disorders through combining evidence-based therapies with world-class amenities. Provided care includes detox, residential treatment, behavioral disorder treatment, dual-diagnosis treatment, outpatient services, and telehealth, all with individualized treatment programs.
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 Sunshine Health (Ambetter) Coverage for Inpatient Drug Rehab Centers in Florida?
Are you ready to get started with your recovery? American Addiction Centers (AAC) can help verify your insurance coverage over the phone in just a few minutes. Our Admissions Navigators are available anytime and can help connect you to an in-network treatment program.
There are two excellent AAC centers in Florida. River Oaks Treatment Center is in the Tampa area and offers art therapy, mindfulness activities, and more to help you move toward a holistic recovery.
Recovery First Treatment Center is in Hollywood Florida. You’ll find a wide range of services along with social activities, chef-prepared meals, and more. Those in recovery learn to change their mindsets and develop new habits that support a substance-free life.
Getting free from substance use disorder will change your life for the better. There’s no reason to wait. Contact us today to get started on your journey to a happier, healthier lifestyle.