Ambetter Insurance Coverage for Addiction Treatment
Ambetter provides health insurance to more than 2 million people in the United States.1 The company provides insurance plans that cover some or all healthcare costs — including the cost of substance use disorder treatment — for members.
In Florida, Ambetter from Sunshine Health provides healthcare coverage in 62 counties.2
Does Ambetter Cover Substance Abuse Treatment?
If you are looking for treatment for substance use disorder and Ambetter is your health insurance provider, at least some of your treatment will be covered by your Ambetter insurance plan. How much coverage is provided depends on your specific plan.
Under the Affordable Care Act, all health insurance providers provide some coverage for substance use disorder treatment and mental health care.3 Depending on your plan, you may be covered for inpatient rehab, outpatient rehab, medications, counseling, and more.
In the state of Florida, Ambetter from Sunshine Health serves more than 1 million members across its Marketplace, Medicare, and Medicaid plans.2 The company provides coverage for essential health benefits including mental health services, substance use disorder treatments, and medications.2
River Oaks Treatment Center in Riverview, Florida, is in-network with Ambetter. To verify your coverage and find out what types of care your plan may cover, you may fill out our
Types of Addiction Treatment Covered by Ambetter
Ambetter health plans cover various types of drug and alcohol addiction treatment. The level of coverage provided depends on the plan you have. Types of treatment that are covered by Ambetter include:5
- Inpatient or residential care: Inpatient rehab requires you to live in the treatment center for a certain number of days. While in inpatient care, you will have access to staff 24/7 and attend individual and group counseling. You will be supported for all of your physical and mental health needs.
- Outpatient rehab: Outpatient rehab centers allow you to live at home and attend treatment during the day at the treatment facility. Outpatient programs vary widely—some require you to attend every day of the week and others expect you to attend a certain number of evenings each week. This allows you to tend to work and family obligations throughout the day.
- Medication-assisted treatment (MAT). Ambetter may also cover medication-assisted treatment; how much is covered depends on your particular plan and what has been deemed medically necessary through an evaluation conducted by your primary care physician or another healthcare provider. MAT combines medications, counseling, and behavioral therapies that assist with detoxification from drugs and alcohol to help you safely withdraw from substances.
The addiction treatment you receive will be tailored to your specific needs and will take into consideration the substances you are using, how long you’ve been using, and any other health conditions you have. Each person who enters rehab is assessed, and a care plan will be developed to ensure that all of their healthcare needs are met.
How Much Does Drug and Alcohol Rehab Cost with Ambetter?
The Ambetter health insurance plan dictates how much of your treatment will be covered by your insurance plan and how much you will be expected to pay out-of-pocket. In Florida, at least some parts of treatment will be covered by your Ambetter insurance, regardless of the plan you have if the facility you are attending accepts your insurance.
If you have out-of-pocket expenses for addiction treatment, there are other ways to pay for services that aren’t covered by insurance. Click here to read more about payment options.
How to Use Ambetter Insurance to Pay for Rehab at River Oaks
Ambetter provides coverage for addiction and mental health treatment in most cases If you choose a treatment facility that is in-network with Ambetter, this can keep your out-of-pocket expenses lower.
The staff at River Oaks will be happy to help you through the process—you don’t have to go through it alone. Contact us at to talk with an Admissions Navigator who can answer all of your questions, check your insurance benefits, and get the process started for you.
Ambetter Insurance for Rehab in Florida
More than 14% of Florida residents admit to using illicit drugs in the past year.6 Drug overdose rates in 2020 were 43% higher than the previous year, and the overdose rate is projected to be 59% by the end of 2021.7
Fortunately, rehab is more accessible than ever. In the state of Florida, almost 72% of rehab facilities accept private health insurance such as Ambetter, and 63% accept Medicare and Medicaid.8
Treatment for drug and alcohol addiction saves lives. No matter where you are in your journey to sobriety, it is never too late to get the help you need. If you’re ready to seek treatment to get and stay sober, now is the time. The staff at River Oaks is here to welcome you, support you, and help you every step of the way.
To start the process of getting into treatment, fill the form out below to see if your insurance is accepted at River Oaks.