Find Alcohol & Drug Rehabs that Accept Amerigroup Insurance

AmeriGroup members can access a network of licensed clinicians, accredited rehab centers, and mental health professionals. The specific coverage options depend on your plan, but many members may receive support for:

• Medically-supervised detoxification: Safe withdrawal from substances under professional supervision, often the first step in recovery.
• Residential or inpatient rehabilitation: 24/7 structured care for people with moderate to severe substance use disorders.
• Partial Hospitalization Programs (PHP): Intensive day programs without overnight stays, offering structured therapy and support.
• Intensive Outpatient Programs (IOP): Frequent therapy sessions while maintaining daily responsibilities, designed for moderate support needs.
• Outpatient therapy and counseling: Individual, group, and family sessions for ongoing recovery support.
• Medication-Assisted Treatment (MAT): Use of FDA-approved medications combined with therapy to support recovery from opioid, alcohol, or other substance use disorders.
• Co-occurring disorder treatment: Integrated care for individuals managing both substance use and mental health conditions.

It’s important to remember that coverage can vary widely depending on your specific plan and state of residence. What is medically necessary and whether a provider is in-network are key factors in determining coverage.

AmeriGroup evaluates addiction treatment based on several factors:

• Medical necessity: Higher levels of care, such as inpatient rehab or detox, typically require documentation showing that treatment is clinically necessary.
• Prior authorization requirements: Some services may need approval from AmeriGroup before you can begin treatment.
• Network status: In-network providers usually have agreements with AmeriGroup that can reduce your out-of-pocket costs, whereas out-of-network services may be partially covered or require higher payments.
• Plan type and state-specific rules: AmeriGroup offers different plans across states, and coverage can differ depending on Medicaid, Medicare, or commercial plan enrollment.

Because these factors vary, it’s essential to verify benefits before committing to a program.

Every AmeriGroup plan differs, but here are common cost structures members may encounter:

• Deductibles: Many plans require members to meet an annual deductible before coverage begins.
• Copays and coinsurance: After the deductible, you may be responsible for a portion of treatment costs.
• Plan tier impact: The type of plan (Bronze, Silver, Gold, or Platinum) can influence how much you pay.
• State-specific regulations: Medicaid and Medicare rules vary by state and can affect coverage limits.

Working with Better Addiction Care can help you estimate potential costs under your plan and guide you toward cost-effective treatment options.

Before certain services are authorized, AmeriGroup may require:

• A clinical assessment confirming the presence of a substance use disorder.
• Referrals or recommendations from a primary care physician or mental health professional.
• Documentation of medical necessity to justify the type and level of care.
• Use of licensed or approved facilities and providers that meet network standards.

These requirements are designed to ensure treatment aligns with clinical guidelines and network policies.

For individuals with opioid or alcohol use disorders, AmeriGroup may provide coverage for MAT. This typically includes:

• Medications prescribed by licensed providers to reduce cravings or withdrawal symptoms.
• Accompanying therapy sessions to support long-term recovery.
• Coverage limits or prior authorization requirements that vary by plan.

Because not all medications or treatment combinations are included in every plan, confirming coverage beforehand is essential.

Many people seeking addiction treatment also struggle with mental health conditions such as depression, anxiety, or bipolar disorder. AmeriGroup can provide integrated care options that address both substance use and mental health simultaneously.

Coverage depends on plan specifics and may include therapy sessions, medication management, or coordinated care across multiple providers.

Understanding your insurance benefits before seeking treatment can save time and stress. Here’s what you can do:

1. Locate your AmeriGroup ID card and plan documents.
2. Call the member services number and ask specifically about behavioral health and substance use disorder coverage.
3. Confirm the provider network: Ask whether your preferred treatment facility is in-network.
4. Check prior authorization requirements: Certain services, especially inpatient or detox, may need approval before treatment begins.
5. Clarify your cost responsibility: Ask about deductibles, copays, coinsurance, and any plan limits.

Work with Better Addiction Care: Our team can verify benefits, coordinate with AmeriGroup, and help match you with accredited in-network facilities.