Finding Hope With Amerigroup Insurance: Rehab Centers That Can Help
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that approximately 48.5 million individuals in the United States are affected by substance use disorders (SUD), which accounts for 17.1% of the population aged 12 and older. Unfortunately, many of these individuals do not receive the necessary professional help to overcome addiction, primarily due to the high costs of treatment, especially for those from low-income backgrounds. However, rehabs that take Amerigroup Insurance can help individuals use their plans to cover some or all expenses related to addiction treatment and rehabilitation.
Amerigroup is a well-known health insurance provider that focuses on Medicaid and Medicare plans. It offers coverage for a variety of behavioral health services, including SUD treatment. From detoxification and inpatient rehabilitation to outpatient counseling and aftercare services, many rehabs accept Amerigroup insurance, alleviating the financial strain of high-quality addiction treatment.
These facilities create tailored treatment plans aimed at addressing the underlying issues of addiction and equipping individuals with effective coping mechanisms for sustained sobriety. Awareness of the types of addiction rehab services insurance will cover, potential out-of-pocket expenses, and what to seek in reputable rehab centers can empower you to make well-informed choices regarding your health.
Does Amerigroup Cover Inpatient and Outpatient Rehab Programs?
Amerigroup may cover many rehabilitation services, including inpatient and outpatient SUD programs when deemed medically necessary. Most insurers define medical necessity in their policies.
Still, it generally means that the service or treatment meets accepted standards of medical practice and is the least intensive or most cost-effective option that still achieves the desired outcome. Through comprehensive evaluations, healthcare practitioners will determine your care level and what your insurance plan covers.
Inpatient or residential treatment is the most intensive form of rehab. It requires patients to reside at the treatment facility full-time, where they receive around-the-clock care from a team of medical professionals and addiction specialists. Prior authorization is often required for insurance to cover addiction treatment inpatient services, and coverage depends on medical necessity as determined by your healthcare provider.
Individuals who may qualify for inpatient rehab have a severe substance use disorder, are at risk for dangerous withdrawal symptoms, have a serious co-occurring disorder, have relapsed at lower levels of care, or lack a safe, supportive, or sober living environment. Additionally, the length of stay covered can vary based on your specific plans, as some plans may limit the number of days covered per year.
Amerigroup plans also cover various outpatient addiction treatment services, including:
- Individual and group therapy
- Intensive Outpatient Programs (IOPs)
- Partial Hospitalization Programs (PHPs)
- Medication-Assisted Treatment (MAT) on an outpatient basis
Outpatient rehab offers more flexibility while providing structured recovery support than inpatient treatment. These programs require individuals to reside at home or a sober living facility while in treatment, allowing individuals to continue managing personal, work, or school commitments.
Outpatient rehab is best suited for those with mild to moderate substance use disorders, who have a stable home environment, are highly motivated, do not require 24/7 supervision or medical detox, or are transitioning from inpatient rehab and need ongoing support.
Similar to inpatient treatment, prior authorization might be required for certain outpatient services, especially more intensive programs like IOPs or PHPs. Outpatient services usually have different copay structures compared to inpatient care but may be more affordable.
How Much Will Rehab Cost With Amerigroup Insurance?
The typical expense for addiction rehabilitation without insurance can be pretty high. For instance, the National Drug Helpline reports that in 2023 the average cost for a 30-day Intensive Outpatient Program (IOP) was around $3,100, while residential treatment could soar to $80,000.
Although having Amerigroup health insurance can help reduce these expenses, various out-of-pocket costs related to deductibles, copays, and coinsurance may still exist, depending on your specific plan, whether it’s a Medicaid, Medicare Advantage, or marketplace plan. Furthermore, the type of care required can also influence the overall rehab cost after insurance.
Generally, individuals with Medicaid plans experience minimal out-of-pocket expenses for covered services, often only facing small copays for specific treatments. Conversely, those with Medicare Advantage plans may encounter copays for inpatient and outpatient services, deductibles, and coinsurance.
Policyholders typically pay a deductible for each benefit period for inpatient rehab under Medicare. After meeting the Part A deductible, costs are usually $0 for the first 60 days of a benefit period, but from days 61 to 90, a daily coinsurance fee applies.
Lastly, individuals with Marketplace/ACA plans will find that coverage varies significantly based on whether they have Bronze, Silver, Gold, or Platinum plans. Each plan offers different premiums, copays, and coinsurance rates. Plans with lower premiums often come with higher out-of-pocket expenses when seeking care.
Does Amerigroup Cover Virtual Rehab Programs?
Amerigroup insurance acknowledges the significance of telehealth and typically includes virtual rehabilitation programs within its behavioral health offerings. Many of its plans support virtual consultations through secure audio and video channels. Virtual rehab is generally categorized as outpatient care, encompassing individual therapy, group therapy, intensive outpatient programs (IOPs), and remote medication management.
These virtual rehab programs offer numerous benefits, such as reaching individuals in rural locations or those lacking reliable transportation. Clients can receive high-quality therapy and treatment from the comfort and privacy of their homes, making it easier to fit treatment into their busy lives.
Furthermore, these programs can be more cost-effective, reducing out-of-pocket expenses for Amerigroup insurance holders. Virtual services can also complement your ongoing care plan following an in-person rehab.
What Should I Look for in a Rehab?
Using insurance for addiction treatment and choosing the right rehab is one of the most crucial decisions in the journey towards recovery. With so many options available, it’s easy to feel overwhelmed and wonder which facility will offer the best program.
SAMHSA suggests that those with insurance contact their provider to inquire about coverage and preferred networks. High-quality treatment facilities will deliver a comprehensive array of evidence-based services and customized treatment plans tailored to each individual’s specific needs.
Here are some essential factors to consider when evaluating an addiction rehab center:
- Ensure the facility is accredited by reputable organizations such as the Joint Commission and holds a valid state license.
- Seek out centers staffed with licensed therapists, addiction counselors, medical professionals, and experienced support personnel who specialize in treating SUD.
- Ask whether the center offers proven therapies such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).
- For those facing co-occurring mental health issues, it is vital to choose a rehab that offers dual diagnosis treatment programs.
- Facilities that engage family members in the recovery journey through therapy and educational initiatives tend to achieve better long-term recovery results.
- Check if the center accepts Amerigroup insurance or is part of their network to help minimize out-of-pocket expenses.
Start Your Recovery Today with WhiteSands Treatment – One of the Leading Rehabs That Take Amerigroup Insurance
If you or someone you care about is facing addiction, selecting the right rehabilitation center can be a crucial step towards a healthier, drug-free life. At WhiteSands Treatment, we provide the compassionate and expert care you need through tailored, evidence-based treatment plans.
Recognized as one of Florida’s leading rehabs that take Amerigroup insurance, we strive to make high-quality treatment accessible and affordable. Our experienced team will collaborate with your Amerigroup insurance to ensure you receive the necessary care while keeping your out-of-pocket expenses low. For those without insurance, we also offer financing options, guaranteeing that cost is never a barrier to treatment.
Contact WhiteSands Treatment in Florida today at 877-855-3470 to verify your Amerigroup insurance coverage and speak with an admissions specialist who can guide you through the next steps.
External Sources
- Substance Abuse and Mental Health Services Administration (SAMHSA) – Highlights for the 2-23 National Survey on Drug Use and Health
- National Drug Helpline – The Cost of Drug and Alcohol Rehab in 2023
- Substance Abuse and Mental Health Services Administration (SAMHSA) – Struggling with Addiction? Tips on Finding Quality Treatment
If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.
About the Author
Jackie has been involved in the substance abuse and addiction treatment sector for over five years and this is something that she is truly eager about. She has a passion for writing and continuously works to create informative pieces that not only educate and inform the public about the disease of addiction but also provide solutions for those who struggle with drug and alcohol abuse.
