Ambetter of Tennessee Insurance Coverage for Rehab

Ambetter of Tennessee Covered Alcohol and Drug Rehab Centers in Tennessee

The state of Tennessee, which is home to about 6,975,218 people, reports that 6.5% of the population aged 12 or older cited past-year substance use disorder between 2017 and 2019.^{1, 2 (pg 26)} What’s more, in 2020, there were 3,032 drug overdose deaths, 18,733 nonfatal overdose outpatient visits, and 7,063 nonfatal overdose inpatient hospital stays in Tennessee.³

For many, getting addiction treatment at Tennessee alcohol and drug rehab centers is the first step to recovery. If you have an Ambetter of Tennessee health insurance plan, you may be able to use your Ambetter plan to fully or partially cover the costs of alcohol and drug rehab in Tennessee. Plan coverage will vary based on your plan and whether or not the facility where you receive care is in-network.

There are 4 Ambetter of Tennessee-covered alcohol and drug rehab centers in Tennessee, but there may be additional covered facilities beyond this number.⁴ To learn more about what rehab centers may be covered, or to learn more about your plan details, call the number on the back of your insurance card.

What is Ambetter of Tennessee?

Ambetter of Tennessee is the specific Ambetter health plan offered in the state of Tennessee. Ambetter is Centene Corporation’s health insurance plan.⁵ Centene Corporation is a Fortune 500 multinational company that has over 30 years of managed care industry experience, as well as a portfolio of specialty health insurance solutions.⁵

Ambetter of Tennessee health insurance plans are underwritten by Celtic Insurance Company, a Qualified Health Plan issuer in the Tennessee Health Insurance Marketplace.⁵ Across the country, Ambetter offers plans in 20 different states, insuring more than 2 million members.^{6, Experienced Healthcare tab}

Ambetter from Tennessee administers Marketplace health plans while connecting members to local Tennessee providers.⁵ There are 3 different types of plans available from Ambetter of Tennessee that are from the Marketplace.⁷ These include Bronze (Ambetter Essential Care), Silver (Ambetter Balanced Care), and Gold (Ambetter Secure Care) level plans, which vary in the level of coverage offered.⁷

Bronze plans have the lowest premiums, but the highest deductibles and out-of-pocket costs. Gold plans have the highest premiums but the lowest deductibles and out-of-pocket costs.⁷ Every plan has a specific network of providers. As previously noted, there are 4 in-network rehab centers in the state of Tennessee, but there may be other rehab centers that accept Ambetter of Tennessee plans.

What Substance Addiction Does Ambetter of Tennessee Cover?

Ambetter of Tennessee plans may offer some level of coverage for substance addiction treatment. This could include addiction to substances like alcohol, cocaine, heroin, crystal meth, opioid, marijuana, and prescription drugs. Plan coverage will vary, so be sure to call the number on the back of your insurance card to learn more about what is covered under your plan.

What Does Ambetter of Tennessee Insurance Cover in Addiction Treatment?

What your Ambetter of Tennessee Insurance healthcare plan covers in addiction treatment will depend upon your specific health plan. Coverage may also depend on where you live and the location of the treatment facility. A few common addiction treatment programs that may be covered under your Ambetter of Tennessee Insurance plan include:

• Inpatient/residential rehab – A residential or inpatient rehab program involves a patient staying at a facility for a set period of time, receiving medical supervision and care, which may include medical detox.^{8, Pg 8, “What types of treatment programs are available?”}
• Outpatient rehab/therapy – An outpatient program that involves coming to a facility once or twice a week to receive care, which could include counseling or therapy, but no overnight stay is required.^{8, Pg 10, Para 2}
• Intensive outpatient programs (IOP) – An IOP typically involves a patient attending a minimum number of hours of outpatient treatments every single week, but no overnight stay is required.^{8, Pg 10, Para 3}
• Partial hospitalization programs (PHP) – A patient often receives care (also known as a day program) at a facility multiple days per week, for 4–8 hours of treatment per day.^{8, Pg 10, Para 1}

Does Ambetter of Tennessee Cover Addiction Treatment Therapy?

Addiction treatment therapy is another type of addiction treatment that may be covered by your Ambetter of Tennessee mental health care coverage. What is covered by your specific Ambetter of Tennessee plan will depend upon your selected plan and where you receive care. To learn more about your plan details, call the number on the back of your insurance card or log in to your online portal. An Ambetter representative can help walk you through the details of your plan.

Does Ambetter of Tennessee Cover the Cost of Sober Living?

Sober living, which is a component of aftercare or continuing care, is a common step in recovery. ^{8, Pg 17, Para 3} Whether or not your Ambetter of Tennessee health plan covers the cost of sober living will depend on the specific plan you have and where you seek sober living care. Call the number on the back of your insurance card to learn more about your sober living coverage.

Does Ambetter of Tennessee Cover Medication-Assisted Treatment?

Medication-assisted treatment (MAT) is another common type of addiction treatment. It will depend upon your specific Ambetter of Tennessee health plan in regards to whether MAT is covered under your policy. Call the number on the back of your insurance card to learn more about your plan’s coverage details.

Does Ambetter of Tennessee Cover Mental Health & Co-Occurring Disorder Treatment?

Under the Affordable Care Act (ACA), all Marketplace plans, including Ambetter of Tennessee plans, must provide some level of coverage for mental health and co-occurring disorder treatments.⁷ Mental health and substance abuse care are considered to be essential health benefits (EHBs).^{7 “You’re Covered on Essential Benefits”} Specifically, all plans must cover mental and behavioral health inpatient services, substance use disorder treatment (e.g., rehab), and behavioral health treatment (e.g., counseling).⁹

This federal mandate ensures that insurance companies provide coverage for mental health care and treatment, allowing people to get both stand-alone drug rehab or co-occurring disorder treatment. Co-occurring disorder is the term that is used when someone experiences both a substance use disorder and mental illness simultaneously.¹⁰ Experts believe that of those with mental illness, it is twice as likely that they will experience a substance use disorder.¹⁰ Getting the help you need is essential, and this mandate helps ensure that you can get the care you need. Your insurer must cover some portion of these costs.

How Long Does Ambetter of Tennessee Cover Inpatient Alcohol and Drug Rehab Programs?

The length of time that your Ambetter of Tennessee health insurance plan will cover inpatient alcohol and drug rehab programs will vary based on the plan you have, where you live, where you seek care, and the care that you need. Every plan is different, so it’s important to check your benefits before seeking care to help avoid any surprise medical bills. Call the number on the back of your card and speak to a representative who can help you learn more about your plan.

Despite coverage details, it’s important to note that longer treatment times are typically tied to better outcomes. Most experts recommend that treatment lasts at least 90 days to maintain the most positive outcomes.¹¹ Your recommended course of treatment may vary based on your unique situation. Remember to heed the advice of your medical provider or team of providers, as they’re the most knowledgeable about your situation.

What If My Ambetter of Tennessee Policy Does Not Cover an Inpatient Drug Rehab Program?

Depending on your specific Ambetter of Tennessee policy, it is possible that it may not fully or partially cover the cost of an inpatient drug rehab program, or the cost of treatment at all. If this is the case for you, you may be responsible for paying for the cost of rehab out-of-pocket. But, don’t worry. There may be additional payment options available to you, which may include special financing opportunities or scholarships.

Be sure to ask the rehab center you choose whether these options may be available to you. It’s important to get the treatment that you need right now, as it is critical, rather than pushing it down the road. If you push treatment down the road, your addiction could worsen, which could result in longer treatment times and more care needed.

Ambetter of Tennessee In-Network vs. Out of Network Inpatient Drug Rehab Centers

The term “in-network provider” is one that can be confusing for many. An in-network provider is one (e.g., doctor or facility) that is a part of your Ambetter of Tennessee insurance plan.^{12, “Questions About Plans and Benefits”} They’re contracted with your Ambetter health plan to provide their health services at a set cost, which is typically at a lower cost than what an out-of-network provider would charge you. ^{12, “Questions About Plans and Benefits”}

Every plan is different, but some plans do not provide any amount of coverage for out-of-network provider visits unless it’s a true emergency, which could result in high out-of-pocket costs for you at an out-of-network provider. To check whether a provider is in your plan’s network, you can use Ambetter’s Find a Doctor tool, call the number on the back of your insurance plan, or ask the rehab facility directly to verify their network with your insurance.

What Rehab Centers Take 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 tele-health, 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 tele-health, 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 tele-health.
• 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 tele-health, 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 Ambetter of Tennessee Coverage for Inpatient Drug Rehab Centers in Tennessee?

Verifying your Ambetter of Tennessee coverage for inpatient drug rehab centers in Tennessee may seem overwhelming, but it doesn’t have to be. American Addiction Centers (AAC) is here to help you check your insurance coverage. You can call the helpline and speak to a real person over the phone to help you check your benefits while you’re on the phone. They can also help you find a rehab center that’s in your network near you.

Using your Ambetter of Tennessee insurance plan to finance your rehab costs is a common thing to do. Your insurance may be able to help you offset some or all of the costs associated with rehab.

Although there’s not a statistic available that shows how many people go into rehab every year financed through Ambetter of Tennessee, millions of people use their health insurance every year to get medical care. Don’t wait any longer to get the care that you need. AAC has leading treatment centers across the country, including around Tennessee. Click here to find a treatment center near you.