Amerigroup is one of the nation’s leading health insurance providers, serving millions of members in the United States. Amerigroup insurance provides some coverage for drug and alcohol addiction treatment. The amount of coverage depends on your specific plan.
Amerigroup partners with a network of healthcare providers, state agencies, and the communities they serve to provide members with a wide variety of choices for healthcare providers—including rehab. Amerigroup currently provides insurance coverage in the following states:1
- New Jersey
- New Mexico
While plans vary from state to state, Amerigroup offers a wide range of coverage options for your healthcare needs, including treatment for substance use disorder.
If Amerigroup is your healthcare insurance provider, your policy covers some or most of the costs of drug and alcohol rehabilitation, depending on the plan you have. Call the number on the back of your insurance card for more information about your plan’s coverage for drug and alcohol rehab and treatment.
Amerigroup Insurance Coverage
Amerigroup provides insurance coverage for mental health conditions, including substance use disorder. The company works directly with treatment centers throughout the country to cover rehab expenses related to drug and alcohol addiction. Your plan determines what expenses are covered and what you will have to pay out-of-pocket. Checking with your insurance provider ahead of time to see what is covered is an important step before committing to a rehab program.
Addiction treatment services that Amerigroup policies may cover include:
- Medical detox: Some people require the help of medical detox when they stop using drugs and alcohol. Medical detox involves using medications to help you or your loved one withdraw from the abused substances safely, under the supervision of medical staff. Medical detox generally lasts 2-4 days, depending on the substances used and how long a person has been using them. Amerigroup insurance plans may cover medical detox when deemed medically necessary. In some cases, pre-authorization may be required to prove that medical detox is necessary before moving onto the next step of recovery (usually inpatient or outpatient rehab).
- Inpatient treatment: Inpatient rehab involves living in a rehab treatment facility 24 hours a day, 7 days a week, typically for 15-90 days. You attend group therapy and 1:1 counseling to help overcome your addiction and learn healthy coping mechanisms to stay sober. Many Amerigroup plans cover at least some of the costs of inpatient treatment. You may require pre-authorization from a medical professional demonstrating that inpatient rehab is medically necessary. Some plans may expect you to meet a deductible before coverage kicks in. You may also need to pay copays for certain services. Some plans offer full coverage for a specific number of days per year.
- Outpatient treatment: Outpatient programs are best for people who have completed inpatient treatment and are ready for the next step in their recovery. Outpatient programs allow patients to live at home and attend therapy for 10-12 hours a week.
- Partial hospitalization programs and intensive outpatient programs: These programs are similar to outpatient treatment in that you can live at home. Depending on the program, you are required to attend treatment either during the day or evenings for 3-7 days per week. These programs are ideal for people who need ongoing support and/or cannot or do not want to enter inpatient treatment.
- Drug and alcohol counseling: Counseling for drug and alcohol addiction is an important part of recovery. It comprises 1:1 sessions with a counselor, group therapies, and family therapy. Counseling can help people get to the root of their addictions and provide important life skills and coping mechanisms to prevent future relapse and support ongoing recovery.
Knowing ahead of time what is covered by your Amerigroup policy can help you focus on what matters when you enter treatment: getting and staying sober.
For more information on what your Amerigroup insurance plan covers, call the number on the back of your insurance card or log in to the member portal on Amerigroup’s website. Alternatively, you can call us at (888) 968-0834. We’ll check your insurance benefits for you while you’re on the phone.
Mental Health Treatment Provided by Amerigroup
For many people, substance use disorder and other mental health conditions go hand-in-hand. Depression, anxiety, PTSD, and mood disorders are particularly common in 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.
Treating a person’s mental health disorder and substance use disorder simultaneously is imperative for getting and staying sober. In most cases, the conditions impact one another, so treating them both at the same time helps you get the most out of treatment.
The Affordable Care Act mandated that insurance providers must provide coverage for mental health care and addiction treatment. This includes both co-occurring disorder treatment and stand-alone rehab for drug and alcohol addiction.
Amerigroup understands the importance of mental health and facilitates integrated physical and behavioral health services for its members. Most Amerigroup plans cover treatment for co-occurring disorders while you are in rehab, helping you get the most out of your time in treatment.3
Rehab Duration Provided by Amerigroup
When you’re living with addiction, seeking treatment is an important step. We are glad you’re considering it. Chances are, you’re wondering about the costs and how long you’ll be in treatment. Every person’s situation and needs are unique, so there is no single optimal length of time for treatment.
Typical treatment programs include the following:
- 30-day program
- 60-day program
- 90-day program
- Extended programs, including halfway houses and sober living facilities
Generally, the more time spent in treatment, the better your chances are at long-term recovery. Research shows that a longer treatment (anywhere from 3-6 months) followed by structured continuing care—such as outpatient treatment and counseling—is associated with better outcomes for long-term sobriety.4
While your insurance plan may provide coverage for a specified number of days each year, it’s important to stay in treatment for as long as you need. Your health, sobriety, and long-term wellness are most important. Amerigroup’s variety of plans and tiers of coverage means that some plans cover longer stays than others.
Regardless of your specific plan, Amerigroup will cover some costs of drug and alcohol addiction treatment. Call the number on the back of your insurance card to learn what is covered. You can also look up your plan on the members portal on Amerigroup’s website to determine exactly what your plan covers, and for how long.
What if My Amerigroup Insurance Policy Does Not Cover Rehab?
Getting treatment now can save your life and help you get on the road to sobriety sooner. If your Amerigroup policy does not cover all of your rehab expenses, there may be other options to help pay for your out-of-pocket costs, including:
- A payment plan arrangement with the rehab facility.
- Scholarships/grants offered by some rehab facilities.
- Employee benefit programs (available through your workplace).
Amerigroup In-Network vs. Out-of-Network Drug Rehab Centers
In your search for a rehab facility for yourself or a loved one, you have likely come across some “in-network” and “out-of-network” wording. Understanding what these terms mean can make a big difference in knowing how much of your rehab expenses you are financially responsible for.
An in-network rehab facility has an agreement with Amerigroup to provide rehab treatment at a discounted rate to Amerigroup members. American Addiction Centers has a partnership with Amerigroup at many of our treatment facilities throughout the country. This means we can provide treatment to Amerigroup members at a lower price than other rehab centers.
Out-of-network simply means that the rehab center does not have an agreement with Amerigroup. If you choose a facility that is out-of-network, you will have higher out-of-pocket costs. Choosing an out-of-network facility may mean that your Amerigroup plan will cover little to none of the costs associated with treatment.
There can be a significant difference in out-of-pocket costs when you get treatment outside your network. If you can, choose an in-network facility to keep your costs lower. However, there are certain circumstances when Amerigroup may cover an out-of-network facility. For example, you may live in a rural area and be unable to access an in-network facility.
Check Amerigroup Coverage for Addiction Treatment
It is important to check with Amerigroup before selecting a treatment facility or rehab center for yourself or a loved one. You’ll want to know ahead of time what your deductible and copays will be (if any) to avoid any financial-related stress. Getting sober is what matters most.
To learn about what your plan covers, call the number on the back of your insurance card to speak with a customer service agent or log in to the member portal on Amerigroup’s website. If you prefer, you can call us at American Addiction Centers. We can verify your insurance coverage for you while you’re on the phone. Call our helpline at (888) 968-0834. We’re happy to help.
- The States We Serve.
- Center for Behavioral Health Statistics. 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).
- 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