Amerigroup Insurance Coverage for Drug Rehab
As one of the nation’s leading health insurance providers, Amerigroup serves millions of members across the United States. The insurer is dedicated to making health care simpler for individuals enrolled in Medicaid and other state-sponsored health programs. The company also serves those who are eligible for Medicare.
Amerigroup has partnerships throughout the country with state agencies, providers, and the communities it serves. Amerigroup currently provides coverage in the following states:1
- New Jersey
- New Mexico
Amerigroup plans vary state, so your coverage is determined by your location. The insurance provider offers a variety of coverage options for a wide range of healthcare needs, including treatment for substance use disorder (drug and alcohol addiction).
If Amerigroup is your healthcare insurance provider, your policy likely covers some of the costs of drug and alcohol rehabilitation. Call the number on the back of your insurance card for more information about what your specific plan covers regarding drug and alcohol rehab and treatment. Alternatively, you can call us at 1-888-851-2649 Who Answers? to speak to an admissions specialist who can check your coverage while you’re on the phone.
Amerigroup Insurance Coverage
As with other health insurance providers, Amerigroup insurance coverage includes treatment for mental health conditions (e.g., depression, anxiety, mood disorders) and the treatment of substance use disorder.
Amerigroup works with treatment centers throughout the country to provide services to those seeking rehab for drug and alcohol addiction. Your plan determines what is covered and what is out-of-pocket in your state, so it’s important to check with your insurance provider before committing to a rehab program.
Addiction treatment services that Amerigroup policies may cover include:
- Medically-assisted detox.
- Inpatient treatment.
- Medication-assisted treatment.
- Dual-diagnosis treatment programs.
- Outpatient detox.
- Partial hospitalization programs (PHPs).
- Outpatient treatment.
The following are some of the more common types of drug and alcohol treatment services that Amerigroup may cover:
Medical detox: Depending on the type(s) of substances abused and how long they have been used, you may require the help of medical detox to safely withdraw from substance use disorder. Medical detox involves the use of medications during the withdrawal process to help you or your loved one safely withdraw. Supervision is provided by trained staff 24/7 while the person undergoes medical detox. Amerigroup plans may cover this type of treatment. Pre-authorization may be required to prove that medical detox is necessary before coverage is approved.
Inpatient treatment: Inpatient rehab requires an individual to live in a rehab facility 24 hours a day, 7 days a week for a prescribed duration of time, most often from 30-90 days. While in inpatient treatment, individuals attend 1:1 counseling as well as group therapy to help overcome addiction and learn the healthy coping mechanisms they’ll need to get and stay sober. Many Amerigroup covers inpatient treatment, although some plans may not cover all services. In some cases — again, depending on the state you live in and what particular plan you have — you may need a pre-authorization before coverage kicks in. You may also need to meet a deductible before Amerigroup covers any costs and be responsible for copays. Some plans offer full coverage for a specified number of days each year.
Outpatient treatment: Outpatient programs are ideal for individuals who have completed an inpatient treatment program and require more support on the path to sobriety, but can’t or don’t want to enter inpatient rehab. Day programs — such as partial hospitalization programs and intensive outpatient programs — are also considered to be outpatient treatment. Depending on the program, a person may be required to attend treatment for a certain number of hours a day, anywhere from 2-7 days a week.
Drug and alcohol counseling: Drug and alcohol counseling is an important part of recovery. Individuals who go through treatment — whether inpatient or outpatient — must attend counseling sessions, both one-on-one with a counselor and in group settings. Counseling can help identify reasons and triggers for addiction and provide important life skills and coping mechanisms to prevent future relapse.
It’s important to know what costs will be covered by your Amerigroup health insurance plan prior to committing to a program. Knowing what you are financially responsible for will provide peace of mind without worrying about the financial impact of seeking help for sobriety.
For more information on Amerigroup insurance plans and to check what your plan covers, call the number on the back of your insurance card or call us at 1-888-851-2649 Who Answers? . An admissions representative will determine what is covered, all while you’re on the phone. We’d be happy to help.
Mental Health Treatment Provided by Amerigroup
In many cases, substance use disorder and other mental health conditions go hand-in-hand. Anxiety, depression, mood disorders, and other mental health disorders are common, particularly amongst those with substance use disorder. More than 8 million adults aged 18 and older have mental illness and substance use disorder at the same time.2 This is known as a co-occurring disorder or dual diagnosis.
Simultaneous treatment of mental health disorders and substance use disorder is optimal for getting and staying sober. Treating only one issue can lead to challenges down the road. To get the most out of treatment, both disorders must be treated at the same time.
Thanks to the Affordable Care Act, insurance providers are required to provide coverage for mental health care and treatment. Both co-occurring disorder treatment and stand-alone rehab for drug and alcohol addiction fall under this mandate.
Amerigroup knows that mental health is a vital part of healthcare, and facilitates integrated physical and behavioral health services for their members. Most Amerigroup plans cover mental health treatment while in rehab to ensure improved quality of life and outcomes.3
Rehab Duration Provided by Amerigroup
When you’re living with addiction, seeking treatment can feel daunting. You may be wondering what the cost will be and how long you will be in treatment. Each person has different needs; there is no single optimal length of time for treatment for everyone.
Generally speaking, the more time spent in treatment, the better your chances are at long-term recovery. Research shows that longer stays in treatment lead to fewer instances of relapse and better rates for long-term sobriety. One study found that a longer duration of treatment (3-6 months) combined with continuing structured care post-treatment (such as outpatient treatment and counseling) is associated with better outcomes, such as long-term sobriety and wellness.4
The typical length of treatment varies according to the individual’s needs. Options generally include:
- 30-day programs.
- 60-day programs.
- 90-day programs.
- Extended programs, including halfway houses and sober living facilities.
The duration of your stay should not depend on what is and isn’t covered by your insurance plan; your sobriety and life are most important. That said, the variety of plans and various tiers of coverage mean that some plans cover longer stays than others.
Amerigroup does cover some costs of drug and alcohol addiction treatment. Call the number on the back of your insurance card or look up your plan on the members portal on Amerigroup’s website to determine exactly what will be covered, and for how long.
What if My Amerigroup Insurance Policy Does Not Cover Rehab?
Cost should never keep anyone from living a sober life. Getting treatment immediately can save your life and get you on the path to sobriety sooner. If your Amerigroup insurance policy doesn’t cover rehab, there are financial options available. Most treatment facilities offer payment plans. Some even offer scholarships to help offset the costs of treatment for yourself or your loved one.
In Network vs. Out of Network Rehab Centers
Searching for a drug and alcohol rehab facility can be intimidating, especially when you see “in-network” and “out-of-network” and aren’t sure which is which.
An in-network facility means that the rehab center has an agreement with a health insurance provider. American Addiction Centers has a partnership with Amerigroup for many of our treatment facilities throughout the country. This allows us to offer treatment and care at a lower rate than other providers.
Out-of-network simply means that the rehab center does not have an agreement with a particular insurance company. Amerigroup may cover little to none of the cost associated with rehab at an out-of-network facility, so you will likely have to pay higher out-of-pocket costs.
The difference in cost of an in-network facility versus one that’s out-of-network can be quite significant. Some insurance companies may not provide any coverage at all for out-of-network treatment. When possible, choose an in-network facility to decrease your out-of-pocket expenses. Amerigroup may cover an out-of-network treatment facility in some cases, such as if you live in a rural area and need to travel elsewhere to get treatment.
Check Your Benefits
Before selecting a treatment facility or rehab center for you or a loved one, it’s important to check with Amerigroup to determine what costs will be covered by your specific plan and which will be out-of-pocket. It is good to know ahead of time what your deductible and copays will be (if any) to avoid any surprises.
Call the number on your insurance card or log in to your account on Amerigroup’s website to learn what is covered by your plan. Alternatively, American Addiction Centers can verify your insurance coverage for you. Call our helpline at 1-888-851-2649 Who Answers? and speak to an admissions representative who can check your benefits while you’re on the phone.
Let’s verify your coverage for treatment at an American Addiction Centers location. Your information is kept 100% confidential.
 Amerigroup. The States We Serve.
 Center for Behavioral Health Statistics. SAMHSA – Substance Abuse and Mental Health Services Administration Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. (2017).
 Amerigroup. Behavioral Health.
 Eastwood B, Peacock A, Millar T, et al. Effectiveness of inpatient withdrawal and residential rehabilitation interventions for alcohol use disorder: A national observational, cohort study in England. J Subst Abuse Treat. 2018;88:1-8. doi:10.1016/j.jsat.2018.02.001