AmeriHealth for Rehab

Using AmeriHealth Insurance for Substance Treatment

If you need help for drug or alcohol problems, you should seek treatment as soon as possible. But you must have a way to pay for that treatment. Health insurance is often used to help cover the costs of rehab. However, the list of covered costs is not always the same from one insurer to another. This means that you must determine if your plan provides rehab coverage. You must also determine which specific kinds of services are paid for under your insurance plan.

AmeriHealth is a popular choice for affordable healthcare insurance. This multi-company organization offers a variety of services, including coverage for substance and mental health treatment. If you have an AmeriHealth plan, your policy will likely cover at least a portion of your rehab expenses.

What Is AmeriHealth Insurance

AmeriHealth is the common name for several companies that provide health insurance coverage. These companies are:

• AmeriHealth New Jersey
• AmeriHealth Pennsylvania
• AmeriHealth Caritas

As its name indicates, AmeriHealth New Jersey provides insurance services to residents and employers in that state. AmeriHealth Pennsylvania provides equivalent services for Pennsylvania residents.

AmeriHealth Caritas specializes in providing insurance coverage through the federal Medicaid program. It also offers a number of additional, supportive services. In addition to New Jersey and Pennsylvania, AmeriHealth Caritas operates in:

• New Hampshire
• Florida
• Louisiana
• North Carolina
• South Carolina
• Michigan
• Minnesota
• Missouri
• California
• Washington, D.C.

In addition to offering coverage to in-state residents, AmeriHealth offers national access through approved providers.

The AmeriHealth umbrella also includes two additional companies. The first, AmeriHealth Administrators, provides administrative services to various segments of the healthcare industry. The second, AmeriHealth Casualty Services, specializes in workers’ compensation insurance.

AmeriHealth Insurance for Behavioral Health

Behavioral health is a term that refers to the effects of your behavior on your sense of well-being. It can be used in a variety of contexts. That includes the connection between your behavior and drug and alcohol problems. It also includes the connection between your behavior and other kinds of mental health issues.

Does AmeriHealth insurance cover behavioral health issues? The general answer to this question is yes. The specific company providing this coverage is AmeriHealth Caritas. However, under Caritas, each state sets its own specific rules for coverage. This means that the terms of your policy may depend, in part, on where you live.

AmeriHealth Caritas Pennsylvania serves as an example. In Pennsylvania, each individual county determines which kinds of plans are available. All plans must meet certain standards. But variations from county to county are possible.

Common Features of AmeriHealth Healthcare Policies

AmeriHealth Caritas provides behavioral health coverage through a separate managed care company. The name of this company is PerformCare. All PerformCare policies focus on holistic healthcare. This kind of care does not just address a specific illness like addiction. It addresses that illness in relation to your overall needs as a person. This means that policyholders have access to additional services that support their covered treatment. Examples of these services include:

• Addiction interventions
• Screening tests for addiction
• Help for people affected by intellectual or developmental disabilities
• Housing assistance
• Suicide prevention

Will AmeriHealth Cover Drug and Alcohol Treatment

Features of In-Network AmeriHealth Treatment Centers

Can you use AmeriHealth for rehab insurance? Yes, you can. Caritas plans cover a variety of rehab services, including:

• Drug and alcohol detox
• Inpatient drug and alcohol treatment
• Outpatient drug and alcohol treatment
• Screening, diagnosis and treatment for people aged 21 or younger

Detox programs provide the support you need to make an initial break from substance use. They also help you complete drug or alcohol withdrawal and reach a sober state. In addition, they help you prepare for inpatient or outpatient treatment.

All substance treatment programs help you learn how to stay sober long-term. Some people need more support to achieve this objective than others. Inpatient treatment provides the most extensive support. It requires you to live at your facility while undergoing needed care.

Outpatient care allows you to keep living at home. It comes in three forms:

• Standard programs
• Intensive outpatient programs, or IOPs
• Partial hospitalization programs, or PHPs

Of these three, PHPs provide the most outpatient treatment per week. They also require the greatest time commitment. Standard programs provide the least amount of weekly treatment. They also require the smallest time commitment. IOPs are less extensive than PHPs, but more extensive than standard programs.

Which level of treatment should you choose when using AmeriHealth for rehab? That depends on the seriousness of your drug or alcohol problems. Your doctor will help you determine the right setting for you.

Medication-Assisted Treatment With AmeriHealth Coverage

If you are affected by opioid addiction, you will likely need medication-assisted treatment, or MAT. MAT combines medication with psychotherapy. It is intended to address the symptoms of your addiction while also providing more general recovery support.

People in MAT typically receive an opioid medication as part of their detox plans. This medication is weaker than the substances that commonly serve as sources of addiction. Therefore, it does not help you get “high.” Instead, it provides enough of an opioid effect to help you halt your uncontrolled drug use. It also makes it easier for you to bring all opioid use to an end and establish sobriety. Additional, non-opioid medication will help you stay drug-free. Once you reach a sober state, therapy provides the skills and abilities you need to maintain it.

AmeriHealth Caritas takes a broad-spectrum approach to opioid addiction. This approach includes the appropriate use of medication-assisted treatment. Caritas is also working to increase access to MAT programs.

Aftercare Planning With AmeriHealth

Aftercare is a general term for sobriety support that follows your time in rehab. You may also see this support referred to as continuing care. Aftercare is important because you are not done dealing with addiction when your main treatment ends. Addiction is a chronic disease. And like all chronic diseases, it requires ongoing care and management. If you do not take the steps to meet these needs, you increase your chances of relapsing back into substance use.

Aftercare gives you continued access to core sobriety resources. Doctors and other medical professionals provide much of the needed support. Enrollment in a mutual self-help group can also supply you with significant, additional benefits.

AmeriHealth Caritas offers several kinds of aftercare resources. The specific resources available to you may depend on your location. For example, options available in Washington, D.C. include:

• A 24/7 nurse call line
• An outreach team that helps you set up timely appointments for needed help
• Case management services that track and coordinate your aftercare

Does AmeriHealth Cover Sober Living

A sober living program helps you transition from your treatment program to your normal daily routine. In this kind of program, you live in a house with other people who have recently completed treatment. While there, you receive sobriety support from these residents, as well as staff members. You also share responsibility for the operation of the home. During the day, you can take care of any obligations you have outside of the facility.

Does AmeriHealth for rehab cover the costs of sober living? As a rule, it does not. Sober living homes typically operate as independent entities. For this reason, they do not accept insurance as payment. This is true whether you have private insurance or a Medicaid-based AmeriHealth plan. Check with your specific provider to determine their exact guidelines on sober living coverage.

Making the Most of Your AmeriHealth Healthcare Coverage and Benefits

No matter who provides your insurance coverage, knowledge is key. To take full advantage of your policy, you must understand its contents. That includes information regarding your rehab-related coverage and benefits. Make sure to closely examine these sections of your policy. If you need help interpreting what they say, talk to an AmeriHealth representative. You can also ask specific rehab programs about the services they cover through AmeriHealth.

Alternative Ways Pay for Addiction Treatment

Hopefully, AmeriHealth or another insurer will help you pay for your addiction treatment. However, some of the services you need may not be included in your policy. In addition, you may lack insurance altogether.

Is it possible to pay for treatment in these kinds of situations? The answer to this question is often yes. Many rehab programs make accommodations for people who lack adequate insurance coverage. These accommodations allow you to pay for needed treatment in regular installments. That way, you can avoid the full, upfront cost of any needed care. Ask any programs you plan to enter about their alternative payment options.

Emerald Isle Health & Recovery: In-Network With AmeriHealth

Need to use your AmeriHealth insurance while in Arizona? Emerald Isle is an in-network provider for AmeriHealth members out of range of their home state. This means that you can get the full benefits of your policy and keep your costs as low as possible.

Emerald Isle offers a full slate of resources for drug and alcohol recovery. Regardless of the level of help you need, we have high-quality plans that suit your needs. Our expertise also extends to other forms of mental health treatment. We have the resources to help you recover from any separate mental illness. In addition, we support recovery from the combined effects of addiction and other mental health issues. For more information on using AmeriHealth for these and other services, just call us today.

References:

1. AmeriHealth: AmeriHealth Companies   
2. AmeriHealth Caritas: Our National Footprint
3. AmeriHealth Caritas Pennsylvania: Behavioral Health and Substance Abuse Resources
4. AmeriHealth Caritas: PerformCare Behavioral Health Care
5. IAP – Medicaid Innovation Accelerator Program: Overview of Substance Use Disorder (SUD) Care Clinical Guidelines – A Resource for States Developing SUD Delivery System Reforms
6. Substance Abuse and Mental Health Services Administration: Medication-Assisted Treatment (MAT)
7. AmeriHealth Caritas: The Opioid Crisis – Protecting Medicaid Members
8. Journal of Substance Abuse Treatment: Continuing Care Research – What We’ve Learned and Where We’re Going
9. AmeriHealth Caritas District of Columbia: Stay Healthy After Your Hospital Stay
10. Journal of Psychoactive Drugs: A Clean and Sober Place to Live – Philosophy, Structure and Purported Therapeutic Factors in Sober Living Houses