Does Ambetter covers Cocaine rehab or detox centers?

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Ambetter is a health insurance company available in 27 states, where eligible enrollees can purchase state Health Insurance Marketplace Bronze, Silver, Gold, and potentially other plan types.1 “Select Your State Tab”, 2

As of November 2022, residents of Alabama, Arizona, Arkansas, California, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, and Washington may have access to these Marketplace plans. 1 “Select Your State Tab” Collectively, Ambetter plans serve 2 million members across these states.2

If you live in 1 of these states and are struggling with cocaine addiction, you may be wondering whether you can use your Ambetter health plan to cover some or all of the costs associated with cocaine rehab.

The Affordable Care Act, which is a federal healthcare reform law that established the Health Insurance Marketplace, mandates that all Exchange plans provide coverage in some capacity for mental and behavioral health services.3 This means that your Ambetter health plan must offer some level of coverage for cocaine rehab, but you may be limited to covered care at only in-network providers or facilities, and you may also be subject to various out-of-pocket costs (i.e., a deductible or copays) when you use your plan to cover the costs of rehab.

To find out what is or is not covered under your plan, call the number on the back of your Ambetter insurance card.

What Does Ambetter Insurance Cover for Cocaine Treatment?

Under the Affordable Care Act (ACA), mental health and behavioral health services are considered to be essential health benefits, and as such, all Marketplace plans must cover such services.3 Specifically, all plans must cover treatment for substance use disorder (e.g., rehab), inpatient mental and behavioral health services, and behavioral health treatment.3 Some of the following services for cocaine treatment may be covered under your Ambetter substance abuse coverage:

  • Screenings, Many healthcare providers will have patients undergo a screening or intervention before recommending treatment to assess their cocaine use and consumption to evaluate the extent of their addiction.4
  • Detox. Depending on your situation, you may need to undergo the process of ridding your body of cocaine and other substances, which is known as detoxification.5, para 2
  • Inpatient. Your provider may recommend inpatient treatment for you, which involves you living at a facility for the duration of your rehab program so that you can receive round-the-clock medically supervised care for days, weeks, or months.6, (How are behavioral therapies used to treat drug addiction?)
  • Outpatient. Your provider may recommend an outpatient rehab program for you, which involves traveling to a facility to receive your treatment 1 or 2 times a week but returning home after the session is over.6, (How are behavioral therapies used to treat drug addiction?)
  • Behavioral therapies. Throughout the course of your treatment, a provider may utilize various behavioral therapies. These behavioral therapies are intended to help patients refrain or stop using cocaine, modify their attitudes, and learn healthy ways to cope with daily stressors.7
  • Treatment for co-occurring disorders. Many people in the United States experience co-occurring disorder, which is when someone has both a mental illness and substance use disorder at the same time.8 Because the 2 conditions are interconnected, getting integrated or tandem treatment for co-occurring disorders, where each condition is addressed during treatment, is strongly recommended.8 “What should I do?”

Despite your plan being required to provide coverage for substance use disorder treatment, every plan and plans within states are different.3 Across all 27 states, Ambetter offers its Bronze, Silver, and Gold Care plans.9 The plans increase in cost and level of coverage, respectively, but deductibles decrease as the plan premium costs increase (i.e., Gold plans have the most expensive premiums but the highest level of coverage and lowest deductible).9

All metal-level plans have access to Ambetter’s network of providers.9 In some states and select counties, there may be additional plan options available starting in 2023.9 Every plan is different, and it’s best practice to call the number on the back of your plan’s card today to learn more about what your specific plan will cover.

What Ambetter does not cover for Cocaine Treatment?

Every Ambetter plan is different, but there may be specific cocaine treatment methods that are not covered by your Ambetter plan. When you call the number on the back of your insurance card, be sure to ask whether the following elements are or are not covered by your insurance:

  • Non-medical amenities
  • Holistic care services
  • Recreation programs
  • Food delivery
  • Private treatment services
  • Alternative therapies

How Much Does Cocaine Rehab Cost?

For many struggling with addiction, the cost is a primary concern and factor when deciding whether to get treatment. The overall cost of cocaine rehab will fluctuate and may be affected by your plan and the treatment you may need. Other aspects of treatment that will influence the cost of your care include whether the facility or provider you use is within your plan’s network, whether the facility is a luxury rehab center, and any additional amenities that may be provided at your facility.

Depending on your situation, your plan, and your treatment plan, it is possible that your Ambetter plan may not provide full or partial coverage for cocaine rehab. In this instance, you may be responsible for paying for the costs of cocaine rehab out of pocket.

Depending on the rehab center you choose to attend, you may be able to apply for special financing or for scholarship opportunities, which can help offset some of the costs of care you incur. Don’t be ashamed to ask for this type of financial assistance if you need help paying for your treatment.

Cost of Inpatient Cocaine Rehab

Inpatient cocaine rehab costs can vary. The Ambetter plan you have, where you seek care, and how long you are in treatment will influence the overall costs you may have to pay for your cocaine addiction treatment.

Even though every plan is different, it’s important to note that costs for inpatient rehab may be higher than other forms of rehab, as you’re living at the facility for the duration of your care and receiving round-the-clock medical care. Be sure to ask the rehab center if they are able to give you a quote for the cost of your care.

Cost of Outpatient Cocaine Rehab

Outpatient cocaine rehab costs will be affected by both the Ambetter insurance plan you have and where you seek care. Specific to outpatient rehab for cocaine addiction, your costs will also be affected by the number of sessions you attend for treatment, and the more sessions you have, the more services you use and the more you may have to pay for care. However, every health plan is different, and after you spend a certain amount, the remaining costs of care may be fully covered.

Be sure to work with an Ambetter insurance plan representative to go over your summary plan description (SPD) and find out your coverage details as it pertains to outpatient cocaine rehab.

Cost of Cocaine Partial Hospitalization Programs (PHP)

If you’re enrolled in a partial hospitalization program for cocaine addiction, you may be wondering how much you’ll end up paying for your care. The facility you attend, its amenities, and the frequency of your program will have a significant impact on your overall healthcare costs. Work with the rehab center you intend to attend to find out what may or may not be covered under your plan.

Cost of Medication-Assisted Treatment (MAT)

In some rehab programs, providers utilize medication to help patients manage the side effects of withdrawal and abstaining from using cocaine.10 Most Ambetter health plans provide coverage for prescription drug costs, but you may owe copays depending on the plan design and the prescription drug prescribed to you. Work with your provider and insurance plan to determine if MAT is right for you and what it may cost you under your plan’s coverage details.

Cocaine Rehab vs. the Cost of Cocaine Addiction

Cocaine is a highly addictive and illegal drug (stimulant) that contributes to a high risk of incarceration and death.11 In 2020, cocaine was involved in 19,000 overdose deaths, and the overall cost for illicit drug use and cocaine use totaled $193 billion annually.11,12 What’s more, on top of these numbers, cocaine use, because it can lead to incarceration, can result in families being torn apart and lost income.

Beyond the socioeconomic costs of cocaine addiction, there are health effects of cocaine addiction. Those who struggle with substance use disorder tend to develop other chronic conditions, which are expensive to treat and can include lung disease, cancer, heart disease, mental illness, and stroke.13 To avoid all of these negative outcomes, getting a handle on your cocaine addiction and getting treatment today is essential.

What Length of Cocaine Rehab Does Ambetter Cover?

Remaining in treatment for an appropriate length of time has a direct effect on the overall outcome of your treatment. While every person is different, most experts recommend that patients remain in treatment for at least 90 days to reduce or stop drug use and improve outcomes.14, bullet 5 You should work with your mental healthcare provider to determine the most appropriate length of treatment for you.

You should also note that because there are many different types of policies and tiers of Ambetter plans, the length of time covered by Ambetter will depend upon the specific plan that you have. You can find out more about your plan’s details by reviewing your insurance card and calling the number on the back of the card to talk to an Ambetter plan representative.

Choosing between Ambetter Inpatient vs. Outpatient Cocaine Rehab Centers

Depending on your unique journey to recovery and cocaine addiction, you may be able to choose between going into an inpatient cocaine rehab center or seeking outpatient treatment. While each center can provide high-quality care, one may be a better fit for you than the other.

You should consult your mental healthcare provider or primary care doctor and discuss the quality of care provided at either facility, as well as the treatment ecosystem, level of support, environment, and accountability provided at both inpatient and outpatient rehab centers. Only you and your provider can make the best choice for you.

How to Use Ambetter Insurance for Cocaine Rehab?

Using your Ambetter insurance for cocaine rehab doesn’t have to be complicated. In most cases, you’ll begin the process by consulting a doctor to determine what type of treatment you may need. You can ask them to refer you to a suitable rehab that accepts your Ambetter health plan and mental health coverage. You can also work with the rehab center directly to find out your ability to use your health insurance plan there. You can also call American Addiction Centers (AAC) for assistance verifying your benefits, using your insurance, and finding a covered cocaine rehab center.

How to Find Cocaine Rehabs That Accept Ambetter Insurance

If you’re ready to take the next step in overcoming your cocaine addiction,  AAC is here to help you by verifying your insurance coverage for you. AAC is an industry leader in addiction care and has a handful of top-notch treatment centers across the country. By calling our helpline today, you can connect with a trained professional who can speak to you or a doctor about treatment for cocaine rehab and speak to you and check your benefits right while you’re on the phone.

Don’t wait any longer to prioritize your recovery. AAC can help you find a cocaine rehab near you that accepts Ambetter Insurance. Call the AAC helpline today to take the first step.

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.

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