AmeriHealth Detox & Rehab Benefits Guide
AmeriHealth insurance is a privately owned insurance company with roots in New Jersey and Pennsylvania. AmeriHealth provides a variety of healthcare solutions and coverage for more than 250,000 members.1,
Knowing your insurance options is critical, especially if you need detox and rehab services. Dealing with an addiction does not have to be something you suffer through alone. If you’ve wondered—does health insurance cover detox—you can find your answers through this helpful AmeriHealth guide.
Often, people don’t move forward with essential addiction services because they wonder—is detox is covered by insurance? This information will show you how to understand and access your insurance for alcohol and drug addiction detox programs.
Does AmeriHealth Cover Detox?
If you are struggling with a drug or alcohol addiction, detox treatment is necessary for your well-being and peace of mind. You might be wondering whether AmeriHealth detox coverage exists or if this is something you need to manage on your own. Before discussing AmeriHealth’s specific drug rehab insurance coverage, you should be aware that all marketplace plans must provide mental health and substance abuse services. 6 This is an essential healthcare service and benefit. It’s not considered an elective treatment or extraordinary care. Just as your provider wouldn’t turn you away if you needed treatment for a broken leg, they won’t deny insurance coverage for rehab services. Of course, you must consult your plan to see how much you will need to pay when it comes to your deductible. Your plan may not cover the entire portion of services.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, a substance use disorder is classified as a mental health disorder. 7 For this reason, addiction rehab is categorized by insurance providers as behavioral and mental healthcare services.
AmeriHealth Caritas provides behavioral mental health services for people who need detox and rehab services. You can find out more about your area’s coverage by selecting the location you live in on the website here and following the steps. This will provide you more detailed information about AmeriHealth Rehab insurance coverage.
AmeriHealth Caritas Louisiana
As an AmeriHealth member, you have access to AmeriHealth detox coverage. You are eligible to get substance abuse and mental health services no matter what metallic level plan you have. Each state may offer slightly different types of substance abuse services. Louisiana’s AmeriHealth plan, for example, assists members with the following issues: 8
- Substance use disorder
- Addictive disorder
- Drug and alcohol issues
- Mental illness
- Dual diagnosis
The addiction and rehab services they offer include the following:
- Addiction services
- Applied behavioral analysis
- Mental health and/or substance use services, such as psychosocial rehabilitation, assertive community treatment, and permanent supportive housing
- Inpatient hospitalization
- Outpatient services
- Group home services
If you’re wondering, does AmeriHealth cover therapy, you’ll be relieved to know that they offer the following therapy regimens:8
- Individual therapy
- Group therapy
- Family therapy
- Substance use disorder therapy
Furthermore, for families with children under 18 years old, a family-based therapy program, multi-system therapy, provides at-home support from qualified therapists. 8
If you’d like to check to see if you qualify for any of these services, you can call member services at 1-888-935-1318.
AmeriHealth Caritas Pennsylvania
The Pennsylvania division of AmeriHealth covers both inpatient and outpatient drug and alcohol treatment services. These treatments could include detoxification and/or rehabilitation therapies. 9
In addition, family members under 21 years of age can receive early and periodic screening, diagnosis, and treatment, and behavioral rehabilitation services.9
County-specific plans provide behavioral health and addiction detox services in Pennsylvania. For more information on your county, you can check the Amerihealth insurance plans by county here. 10
AmeriHealth New Jersey
AmeriHealth New Jersey offers an integrated behavioral health services program, including the use of medications, where appropriate, for addiction disorders. 3In addition, their plan allows for the following services:
- Inpatient treatment
- Outpatient treatment
- Rehabilitation and therapy services
These services are targeted at those with behavioral health and substance use disorders and will require precertification. You can talk to your primary care physician to get the necessary referral.
H2: Check Your Amerihealth Plan Benefits
To check your specific Amerihealth drug rehab coverage, AmeriHealth offers a member portal, AmeriHealthExpress.com. You must register an account online, and then you can access all your information about benefits and claims. Begin the registration process here. 11
Once you are registered and want to access your benefits information quickly, you can log in here.12
In addition, if you are currently in the process of obtaining AmeriHealth, you can look for a healthcare plan near you by accessing this page.13
If you prefer to speak to a representative or have additional questions that aren’t addressed by the online information, you can call 1-888-935-1318. 14
Types of AmeriHealth Plans
AmeriHealth offers members and employers an array of different plan options for healthcare needs. Because of our many affiliates who use the AmeriHealth name, the plan structure may vary by location, so it’s always best to check the details of your specific plan for clarity.
Some plans may require a referral from your primary care doctor for certain services. AmeriHealth plans are as follows: 2
- Health maintenance organization (HMO)—Your primary care doctor will manage your care for you, referring you to specialists, as needed, who are within the network. HMO plans only cover network doctors.
- HMO (plus)—This is similar to a standard HMO, except you can choose the doctor or hospital without a referral. However, you must choose one within the network.
- Point-of-service (POS)—With a POS plan, your physician will coordinate all your care for you. You can choose where you go, and it can be with an in- or out-of-network provider.
- POS (plus)—With a POS plus plan, you’ll get all the benefits of the POS plan, but you won’t need a referral for care.
- Preferred provider organization—You’ll have an expansive network of doctors and specialists from which to choose. They can be in- or out-of-network, and you don’t need a referral.
- Exclusive provider organization—This plan allows you to see any doctor or specialist you want without a referral, but you’ll need to stay within the network.
Within these major plans are different levels by which the plans are categorized. 3 These are as follows:
The different categories help define the costs you are responsible for. They are not a reference to the quality of services or type of medical access you have. 4 If you have the “lower-level” Bronze plan, you will pay less monthly but pay more when you need care. You also will have a higher co-pay. If you opt for the Gold plan, you will pay more every month but less when you receive services. The Silver plan is in the middle, with moderate costs both monthly and at the time of service. 4 For someone who will need frequent or costly services, it may make sense to purchase a plan with less out-of-pocket costs at the time of service, like the Gold or Platinum plans.
AmeriHealth Caritas also provides underserved and vulnerable populations with quality healthcare plans by offering solutions through Medicaid and Medicare managed care. 5 These solutions provide critical medical resources.
Two special programs offered through their dual-eligible program include:
- Medicare dual-eligible special-needs plans
- Medicare-Medicaid plans
These programs provide services for people who have special needs, disabilities, and circumstances presenting independent living challenges. 5 Every state offers a different level of assistance, so it’s best to check with your AmeriHealth representative to see if these services apply to you.
AmeriHealth at American Addiction Centers
If you feel overwhelmed by a substance use issue, you have options. At American Addiction Centers, we’ve helped thousands of people just like you all across the nation. Located throughout the United States, we work with several different insurance providers, including AmeriHealth, to ensure our clients are well cared for.
American Addiction Centers operates with the highest medical standards, using research-based treatments. Our centers are staffed by addiction professionals, registered nurses, licensed social workers, psychologists, physicians, and psychiatrists. You can rest easy, knowing you are in capable hands when you connect with American Addiction Centers.
Reach out to our helpline today by calling 1-888-935-1318. You’re only one step away from a new future.
- (2020). About AmeriHealth.
- (2020). AmeriHealth New Jersey: Plan types & referrals.
- AmeriHealth New Jersey. (2020). 2021 benefits at a glance.
- (2020). AmeriHealth New Jersey: Metallic categories.
- AmeriHealth Caritas. (2020). Medicare health plans and dual-eligible solutions.
- gov. Mental health & substance abuse coverage
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association.
- AmeriHealth Caritas Louisiana. (2020). Covered mental health and substance use treatment services.
- AmeriHealth Caritas Pennsylvania. (2020). Behavioral health and substance abuse resources.
- AmeriHealth Caritas Pennsylvania. (n.d.) Pennsylvania behavioral health managed care
- (2020). Welcome to the AmeriHealth member site!
- (2020). Welcome to AmeriHealthexpress.com.
- AmeriHealth Caritas. (2001-2020). Find a health plan.
- (2009). Everything you need to know about your health plan.