Does Amerihealth Cover Addiction Treatment?
Does Amerihealth Cover Addiction Treatment?
Addiction, also known as substance use disorder, is a serious mental health condition that tends to get worse over time. Individuals suffering from drug or alcohol addictions find it impossible to stop or control their substance abuse, no matter how valiantly they attempt to do so. It isn’t an issue of not having enough will power. Addictions not only destroy relationships, health, sanity, and lives — but they also lead to permanent neurological changes in the brain that make it impossible for individuals to stop even when they recognize how bad things have gotten. It is essential to get quality addiction treatment services. Recovery is possible for those who reach out and get the help they need.
If you are insured through AmeriHealth, you have many options for addiction treatment. AmeriHealth offers comprehensive coverage for substance use disorder treatment. No matter where you are on your recovery journey, AmeriHealth has you covered. Their coverage is especially strong when members make use of rehabs or facilities within their network of service providers, such as NuView Treatment Center, Los Angeles’ preeminent outpatient rehab.
AmeriHealth, or AmeriHealth New Jersey, is a health insurance company based in New Jersey. It provides both individual insurance plans and employer-based insurance plans. The company offers insurance to over 260,000 members in the state of New Jersey alone. AmeriHealth’s network of service providers includes thousands of physicians and 76 hospitals in this area, but it notably also includes countless service providers throughout the United States. This means that individuals across the country in Los Angeles have access to high quality rehabs covered by AmeriHealth.
AmeriHealth values its members, including those who suffer from mental health disorders and addictions. To help them cope and develop healthier lifestyles, AmeriHealth operates several wellness programs that are free to members. These services include health coaching, consultations with nurse wellness specialists, and workplace wellness support. While people with drug or alcohol addictions generally need clinical support in the initial stages of recovery, these wellness services offered by AmeriHealth can help people reintegrate into the outside world afterwards.
Addictions Covered by AmeriHealth
AmeriHealth offers comprehensive support and coverage for all types of addictions. The company does not deny treatment to individuals based on their substance of choice. If a member has been diagnosed with a substance use disorder, they can expect their rehab services to be covered by AmeriHealth. Addictions covered by AmeriHealth include:
- Benzodiazepines, including Xanax and Klonopin
- Opioid painkillers, such as oxycodone and fentanyl
- Prescription stimulants, such as Adderall and Vyvanse
- Crystal meth
Many treatment programs covered by AmeriHealth recognize that many people with addictions actually abuse multiple substances. Treatment for polysubstance addiction is widely available. AmeriHealth also offers coverage for more specialized treatment facilities that are designed to treat specific types of substance use disorders.
How Can I Get Treatment with AmeriHealth?
Before beginning a treatment program, AmeriHealth generally requires an initial evaluation. Their goal is to assess whether addiction treatment is medically necessary for you. However, there is little to fear here: AmeriHealth recognizes that even individuals in the earliest stages of addiction deserve treatment, since substance use disorders tend to become progressively worse over time if left untreated. By catching a problem early, AmeriHealth saves money!
Preauthorization for treatment generally occurs before an individual enrolls in a rehab or treatment program. However, in some cases it can occur shortly after, especially when emergency circumstances require an individual to get medical help immediately.
Once you have been preauthorized, AmeriHealth will work with you to devise a treatment plan. Treatment plans with AmeriHealth generally make use of a wide variety of addiction treatment modalities, and the nature of these plans is liable to change over time as an individual progresses in their recovery journey.
Keep in mind, however, that the nature of a person’s coverage depends in large part on their specific plan with AmeriHealth. Different plans provide coverage for different lengths of time, different levels of flexibility, and different out-of-pocket expenses.
Outpatient Treatment with AmeriHealth
AmeriHealth insurance plans cover a wide variety of outpatient programs. Outpatient rehabs offer addiction treatment once or several times a week. Unlike residential rehabs, they do not require that participants live at the treatment center. These programs are designed to be flexible so that clients can easily integrate them into their lives. Outpatient rehabs utilize a wide variety of treatment modalities so that clients can address underlying issues, develop new coping skills, and come to a better understanding of themselves and their addictions.
Outpatient programs are suitable for people at all levels of addiction severity. Because they have no residency requirement, they are often recommended to individuals with families or work commitments. These flexible programs make it easy for anyone to gain a stronger foundation of sober tools while continuing to live their lives outside of rehab. Moreover, outpatient programs are frequently utilized as part of an aftercare plan for recent graduates of inpatient treatment programs. By offering support and increasing flexibility, outpatient rehabs allow graduates of acute programs to continue strengthening their recovery while getting help meeting the inevitable challenges of early sobriety.
Levels of care offered by AmeriHealth in-network outpatient rehabs include:
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Outpatient programs (OPs)
- Aftercare planning
AmeriHealth is generally willing to cover outpatient treatment on a long term basis. This is partly because outpatient care is more affordable than inpatient treatment. However, research also indicates that individuals who remain enrolled in clinical addiction treatment programs for longer have significantly lower chances of relapsing. Allowing clients to progress from more acute treatment programs to less acute ones allows them to gradually rebuild their lives and develop autonomy while remaining supported.
AmeriHealth and the Affordable Care Act
AmeriHealth’s insurance practices are consistent with the Affordable Care Act. The Affordable Care Act, or ACA, ensures that no one can be denied insurance coverage. In the past, health care companies often denied people with substance use disorders coverage; they would argue that addictions were potentially expensive “pre-existing conditions.” ACA stipulates the addictions cannot be classified as pre-existing conditions, meaning that no matter how severe one’s substance use disorder is, getting quality health care coverage is always possible.
The Affordable Care act also recognizes addiction treatment and mental health services as “essential health benefits.” In essence, this means that these services have been deemed absolutely necessary elements of all health insurance plans. Health insurance companies such as AmeriHealth are legally obligated to provide coverage for addiction treatment.
AmeriHealth also covers mental health treatment at outpatient programs. Most quality outpatient rehabs, including NuView Treatment Center, offer integrated treatment programs for dual diagnosis patients. Addressing underlying mental health conditions is an essential aspect of recovery. According to the National Institute on Drug Abuse, roughly half of all people with addictions suffer from mental illness. Given how mutually reinforcing addiction and mental health conditions are, it is no surprise that treatments for both are essential health benefits.
How Much Will Treatment Cost with AmeriHealth?
The specific fees associated with receiving addiction treatment depend on a range of factors. Factors that can affect out of pocket expenses include the client’s location, their specific health plan, the rehab facility they attend, and how long they receive treatment. In general, choosing a rehab that is within AmeriHealth’s network, such as NuView Treatment Center, is likely to be more cost-effective. Coverage for out of network rehabs is generally minimal. With some AmeriHealth plans, out of network rehabs are not covered at all.
The three costs that most people encounter when beginning treatment are deductibles, coinsurance, and copays. Deductibles are set amounts of money that individuals are expected to pay before their AmeriHealth coverage begins. After a person has met their deductible, AmeriHealth will begin covering the costs of treatment. Copays are fixed quantities of money that an individual is expected to pay per treatment, while coinsurance fees are small percentages of the cost of treatment. With many plans, these fees are waived entirely, in the event that a person has reached their “out of pocket maximum.”
Checking Your AmeriHealth Rehab Coverage
AmeriHealth offers many distinct health insurance plans with different benefits. To determine what your coverage levels are and investigate your treatment options, it is often advised that you contact your health insurance representative. Their phone number is generally listed on the back of your AmeriHealth insurance card. A representative can answer questions, help get you evaluated, and send you a list of in-network providers.
However, it is often even more helpful to have someone working with you on a more personal level to get you the help you need. NuView Treatment Center, Los Angeles’ preeminent outpatient rehab, is here to be your advocate. We are familiar with the inner workings on insurance companies like AmeriHealth. Our staff members understand the process of addiction recovery. During a consultation with us, we will evaluate your unique circumstances and needs to set you up with an affordable addiction treatment plan that addresses them. Our outpatient programs are within AmeriHealth’s network, but even if our program is not suitable for you at this time, we will ensure you are connected to any services that you need. Call us today at (310) 984-1730 for a free and confidential consultation.
Addiction Recovery at NuView Treatment Center
NuView Treatment Center is an outpatient rehab facility located in West Los Angeles. We offer a wide variety of evidence-based treatment programs covering all levels of addiction severity, including partial hospitalization programs, intensive outpatient programs, outpatient programs, and aftercare planning. Our goal is to help people in recovery progress at a comfortable pace as they develop coping tools, life skills, and strong social support systems.
We recognize that everyone comes to recovery with a unique story and background. With that in mind, our staff work hard to create individualized treatment plans for every single client. Whether a person has underlying mental health disorders that require treatment, communication difficulties with family members and loved ones, or even financial hardships, our staff aim to address these needs. Recovery is never one-size fits all.
If you are ready to make a change, our in-network outpatient rehab has a space for you. Contact NuView Treatment Center today for a free and confidential consultation.