AmeriHealth Insurance Coverage for Addiction Treatment
If you have AmeriHealth insurance coverage, and you are suffering from a drug addiction or an alcohol addiction, you may be covered for drug treatment. Thanks to the Affordable Care Act (ACA), drug and alcohol addiction treatments are covered as one of the ten elements found in the section on essential health benefits, and AmeriHealth plans are legally required to cover rehab and mental health services. Depending on where you live and the exact AmeriHealth health plan may vary, limiting:
- The number of days you can spend in a detox program per year
- The number of days you can spend in inpatient drug or alcohol rehab per year
- The number of outpatient treatments you can access per year
Your insurance provider will determine whether the treatments are medically necessary before covering the costs (preauthorization), and AmeriHealth may not cover treatments like hypnotherapy, music therapy, equine therapy, etc. You can challenge any coverage denials by asking for reconsideration.
How Much Does Addiction Treatment Cost?
The cost of addiction treatment varies, depending on the types of treatment and medications you access and how long you are in treatment for. Depending on your AmeriHealth coverage, you may have a set deductible you have to pay before your in-network coverage kicks in (or you can speak with an out-of-network provider to try and negotiate a rate with AmeriHealth). Once you have met your deductible, insurance will cover a set amount, and then you will have to pay the remaining amount. Co-pays may also be required before or after you meet the deductible, and if you have co-insurance, that is required after you meet your deductible. There may also be an “out-of-pocket” maximum, meaning that if you pay the stated amount through your deductible, co-pay, or co-insurance, the remaining costs of drug rehab will be covered.
Treatment Programs Covered by Insurance
Treatment programs covered by insurance include:
Detox programs – medical detox involves medical care and medications to keep you healthy and comfortable as you avoid withdrawal symptoms and detoxify your body
Inpatient treatment/residential treatment – in inpatient treatment (residential drug rehab) you live inside the sober, structured recovery center for a set amount of time, spending your days in therapy, groups, and meetings, usually with medical care or mental health care
Partial hospitalization outpatient rehab – during partial hospitalization, people with substance use disorders generally live at home or in sober living homes, coming in for full days of treatment 5 to 7 days a week, with medical care, counseling, therapy, and more, then going back home at night
Intensive outpatient program – in an intensive outpatient program for drug and alcohol rehab, substance abusers live outside the treatment center, and attend treatment for 2 to 3 hours a day for 2 to 3 days a week, usually in the mornings or evenings so you can live a normal life, go to work, etc. as you access treatment
Outpatient programs – outpatient treatment programs are usually scheduled types of therapy like individual or group therapy, usually once a week for an hour, usually provided as a follow-up aftercare program after a comprehensive drug rehab program
AmeriHealth insurance may cover treatment costs like:
- Medication including medication-assisted treatment plans
- Therapy (group therapy, behavioral therapy, family therapy, and individual therapy)
- Residential costs (lodging, meals, etc.)
Contact TruPath to Verify Your Insurance today!
At TruPath recovery center, we can help you verify your AmeriHealth insurance before you move forward with your substance abuse treatment. They may pay for some or all your care, including:
- Medical care and medications
- Cognitive behavioral therapy
- Dialectical behavioral health
- Holistic treatments and experiential therapy
- Individual therapy, group therapy, and family therapy
- Dual diagnosis programs for co-occurring disorders
- Case management services
- Sober living homes
Please call us to verify insurance, or if you have any questions about alcohol and drug addiction treatment. We offer all levels of care including medical detox, inpatient rehab, and outpatient rehab, and are here to support you as you heal the underlying causes of addiction, as you overcome your substance use disorder.