Do Drug and Alcohol Rehab Centers in Texas Take Ambetter

Your Ambetter from Superior HealthPlan rehab coverage may partially or fully cover your costs for addiction treatment. Below is information about Ambetter from Superior HealthPlan’s health insurance coverage for drug and alcohol rehabilitation in Texas, along with instructions on confirming which services are covered by your particular plan.

What is Texas Known For?

Texas is the second most inhabited state, with over 30 million citizens.1 85% of the state's population resides in Dallas, Houston, and San Antonio. Various indigenous cultures had inhabited the region before the arrival of the Europeans.2 The 28th state proclaimed its independence from Mexico in 1836.

When it comes to entertainment, San Antonio’s Alamo is a must-see, while Dallas is home to Highland Park Village, America’s first shopping center.3 At this iconic, eighty-year-old location, exclusive stores and barbecues come together for the ultimate Texan experience. Additionally, don’t miss Austin, the Lone Star State’s capital and music haven.

Texas's economy mainly relies on oil and gas production as it is the top producer of crude oil in the United States. Other important industries include manufacturing, technology, healthcare, and agriculture. Texas also has many ports along the Gulf of Mexico coast, making it a significant player in international trade.

Texas has a strong and long-standing investment in college football. Some of the best colleges for football in the state are the University of Texas,  Texas A&M University, and Texas Christian University. Additionally, Texas boasts three highly-regarded professional sports teams: the San Antonio Spurs, Houston Astros, and Dallas Cowboys. The Cowboys play their home games in the AT&T Stadium, the largest dome in the world.4 The adage "everything's bigger in Texas" applies here.

Who is Ambetter?

Centene Corporation, a Fortune 500 company specializing in health solutions, operates the Ambetter health insurance brand. Centene is one of the largest managed healthcare companies in the United States and has been in the managed care sector for over 30 years, with a diverse and varied portfolio.5
 AmbetterHealth Logo
Ambetter has more than 2 million members across the country and provides various healthcare services, including HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), and EPO (Exclusive Provider Organization) plans.6 These are offered through the Health Insurance Marketplace. The plans follow Affordable Care Act (ACA)7 guidelines, providing essential health benefits as the law requires. These benefits include the following:
  • Emergency Care
  • Outpatient or Ambulatory Care
  • Preventive Care Services
  • Health and Wellness Programs
  • Maternity & Newborn Care
  • Pediatric Care
  • Mental Health & Substance Abuse Care
  • Laboratory Services
  • Prescription Drug Coverage
  • Therapy Services
  • Hospitalization

Check Your Ambetter from Superior HealthPlan Insurance for Addiction Treatment

You can check your Ambetter from Superior HealthPlan insurance coverage levels for drug or alcohol addiction rehab by calling us on 866-461-3339 or by using the form below.

Our admissions coordinators will interact directly with your insurance provider on your behalf, removing from your shoulders the burden of figuring out if your insurance will pay for your addiction treatment.

What is Superior HealthPlan?

Superior HealthPlan is a managed care organization (MCO) providing health insurance services to millions in Texas. Centene Corporation's subsidiary collaborates with the Texas Health and Human Services Commission (HHSC) to offer Medicaid, Children's Health Insurance Program (CHIP), and other healthcare programs to eligible individuals and families.8

The primary goal of Superior HealthPlan, headquartered in Austin, Texas, is to improve the health outcomes of its members by coordinating and managing their healthcare needs. The organization offers various services, including preventive care, doctor visits, hospital stays, prescription medications, behavioral health services, and more.9

Established in 1999 in El Paso, Superior HealthPlan provides comprehensive and cost-effective healthcare options, emphasizing preventive care and early intervention. Through its provider network, it aims to deliver high-quality and affordable healthcare services to its members, promoting wellness and improving overall health outcomes.

What is Ambetter from Superior HealthPlan?

Ambetter from Superior HealthPlan is a health insurance product offered by Centene Corporation through the Health Insurance Marketplace. The goal of Ambetter is to enhance the health of its members by providing compassionate, coordinated, and personalized care. Ambetter believes that quality healthcare is best delivered locally and strives to uphold this core belief in its approach.10

Ambetter from Superior HealthPlan consists of HMO (Health Maintenance Organization) plans underwritten by Superior HealthPlan, Inc. and EPO (Exclusive Provider Organization) products underwritten by Celtic Insurance Company, both of which are qualified health plan issuers in the Texas Health Insurance Marketplace.

Ambetter from Superior HealthPlan is offered in 149 counties in Texas, covering major metropolitan areas such as Austin, Corpus Christi, Dallas, El Paso, Fort Worth, Houston, and San Antonio.11

What is Ambetter from Superior HealthPlan Rehab Addiction Recovery Insurance Coverage?

Ambetter from Superior HealthPlan’s rehab insurance for addiction recovery refers to benefits usually found under behavioral health services. These healthcare benefits include coverage for substance abuse treatment.12 While each member’s substance abuse coverage needs and resources will vary, some of the services that your policy may cover include the following:

Does Ambetter from Superior HealthPlan cover Rehab for Substance Abuse?

This is a common question. Ambetter from Superior HealthPlan does provide coverage for substance abuse treatment for drug and alcohol addiction. However, the extent of coverage for Ambetter from Superior HealthPlan alcohol rehab and Ambetter from Superior HealthPlan drug rehab will vary according to several factors, such as your location and particular policy.

It is essential to know your plan and coverage options for a successful recovery from drug and alcohol addiction. You can call 866-461-3339 to learn about your Ambetter from Superior HealthPlan policy's coverage levels for substance abuse rehabilitation. Our caring team can help you verify insurance benefits and address any questions or concerns you may have.

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Does Ambetter from Superior HealthPlan Rehab Insurance Cover Mental Health Rehab?

Yes. Mental health and substance abuse services are essential health benefits under an Ambetter from Superior HealthPlan insurance policy.13 The mental health rehab services may include therapy, hospitalization, and more. Your coverage levels will vary according to many factors, including the type of services required.14

Insurance plans often have restrictions and exclusions, such as only covering  necessary medical services and requiring approval for specific treatments. To fully understand your policy, it is recommended that you become familiar with its details. Please call 866-461-3339 - we can help you review your insurance information now.

Inpatient and Outpatient Addiction Recovery Centers in Texas That Take Ambetter from Superior HealthPlan Rehab Insurance

We at Virtue Recovery Center provide customized inpatient and outpatient programs for drug and alcohol addiction and mental health treatment to assist individuals in attaining long-term sobriety. Our team values personalized care and utilizes contemporary, evidence-based techniques to address substance abuse, acknowledging that every individual has a distinct situation.

We can offer you or a loved one the best care, starting with a remote, free assessment. In addition, call us at 866-461-3339 to learn more about the rehab admissions process and begin your road to recovery today. You can rest easy knowing that all information provided and exchanged is 100% Confidential.

Click on the links below to learn more about our Texas-based accredited treatment facilities that are in-network with Ambetter from Superior HealthPlan and may accept your particular policy:

 near me facility texas

How Much is Rehab with Ambetter from Superior HealthPlan Insurance?

An individual patient undergoing outpatient rehab in Texas can expect to pay an average of $1,698.15 However, costs vary widely and are influenced by several factors, including your location, specific policy, and the treatment facility. Call 866-461-3339 to receive the details on addiction recovery costs with your Ambetter from Superior HealthPlan rehab insurance policy, including any potential out-of-pocket expenses. We know the complexity of rehab admissions process can be a hurdle keeping you or a loved one from seeking the help needed, but our team is standing by to ensure that costs do not stop those seeking treatment from starting their journey.

How To Check My Ambetter from Superior HealthPlan Rehab Insurance Coverage Levels for Addiction Recovery

If you want to know the extent of your Ambetter from Superior HealthPlan medical coverage for addiction recovery, call 866-461-3339. You will be connected with our admissions coordinator, who can help verify your insurance information and address any concerns you may have about addiction treatment and insurance. Our coordinators are empathetic, non-judgmental, and flexible in their approach.

You can also complete our online insurance verification form below. There are no obligations, and your information will be kept confidential.

How To Get Ambetter from Superior HealthPlan Rehab Insurance to Pay for Addiction Recovery in Texas

The steps for getting Ambetter from Superior HealthPlan to cover your addiction recovery in Texas can vary from plan to plan. However, first and foremost, it's essential to review your policy to get a clear picture of what's covered and what's not. This includes taking note of in-network providers, deductibles, copayments, and any limitations or exclusions that may be applicable.

Simply call us at 866-461-3339, and we'll be more than happy to assist you.

In addition, below are a few other things to keep in mind for your best chances at getting Ambetter from Superior HealthPlan rehab insurance to cover treatment:

  • Verify In-Network Providers: Before choosing an addiction recovery treatment facility or provider, checking if they are in-network with Ambetter from Superior HealthPlan is essential. In-network providers typically lead to lower out-of-pocket costs.
  • Obtain Prior Authorization: Certain services may require prior authorization. This means you must get approval from the insurance company before beginning treatment.
  • Medical Necessity Documentation: To determine if addiction recovery services are necessary for your medical needs, it's crucial to collaborate with your healthcare provider. You might be required to provide proof or documentation to support the specific treatment or level of care needed.
  • Follow Treatment Plan: It’s essential to adhere to the treatment plan prescribed by your healthcare provider. This includes attending scheduled therapy and group sessions, taking prescribed medications, and following other recommended interventions.
  • Submit Claims Promptly: It is crucial to submit all claims promptly and accurately. Keep copies of all relevant documents, such as bills, receipts, and treatment records.

How Many Times Will Ambetter from Superior HealthPlan Rehab Pay for Addiction Recovery?

The extent of coverage for addiction recovery services under Ambetter from Superior HealthPlan is subject to variation depending on Texas state regulations, your specific plan, and other factors. The number of times they’ll cover the treatment is typically determined by factors such as medical necessity, the type of treatment, and your specific needs.

Typically, health plans offer coverage for addiction recovery services based on the medical necessity of the treatment, as determined by healthcare professionals. The specific coverage details, including any restrictions on the number of treatment sessions or duration of coverage, can be determined by calling 866-461-3339.

Addiction Recovery Treatment and Insurance Statistics

  • Superior HealthPlan has over 90,000 healthcare providers available throughout all 254 counties in Texas.16
  • 6% of noninstitutionalized American civilians lacked health insurance in 2021.17
  • Texas has the highest uninsured rate in the country, with approximately 18% of its population lacking health insurance in 2021.18
  • Although Texans account for only 9% of the total U.S. population, they make up 19% of the uninsured population in the country.19
  • In 2021, around 930,000 children in Texas did not have health insurance, and according to the Census, roughly 495,000 came from households with incomes below twice the Federal Poverty Income Level.
  • In 2021, Texas reported 2,770 deaths due to opioid overdose, which made up 56% of all drug overdose deaths in the state.20
  • Adults with mental illness enrolled in large employer health plans had higher out-of-pocket spending in Texas than those without mental illness in 2021. The average out-of-pocket spending for all services for those with mental illness was $1,476, while the average for those without mental illness was $730.
  • Even though there are effective treatments for common substance use disorders, many American adults struggling with these conditions do not receive treatment.21
  • Before the Affordable Care Act (ACA) Medicaid expansion in 2014, low-income people who needed treatment for substance use disorder were not eligible for Medicaid coverage22
  • Around one-third of the population or approximately 64.5 million non-elderly adults, were impacted by mental illness and substance use disorders in 2020. This was more prevalent among young adults and white individuals, while people of color may have lower rates due to underdiagnosis within their communities.23

Check Your Ambetter Insurance Coverage With Virtue Recovery Center

If you’re committed to recovery, submit a request to one of our professional admission coordinators today using the form below. Before discussing the next steps, a coordinator will address any inquiries regarding our programs, including interacting directly with Ambetter Rehab on your behalf to check your insurance coverage levels for drug or alcohol addiction rehab.

STEP 1

Using your Health Insurance Card, fill out all of the fields on the confidential form.

STEP 2

A member of our staff will contact your insurer to verify if your policy will cover your treatment

STEP 3

We will contact you promptly with the results of the verification and discuss the next steps

*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note that this is only a quote of benefits and/or authorization. We cannot guarantee that payment or verification eligibility will be accurate and complete as conveyed by your health insurance provider. Payment of benefits is subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. Your health insurance company will only pay for services it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. Suppose your health insurance company determines that a particular service is not reasonable and necessary or that a specific service is not covered under your plan. In that case, your insurer will deny payment for that service, and it will become your responsibility.

Your Name*
Who is seeking treatment?*
Name of Patient
MM slash DD slash YYYY
Insurance Company's Name*
May we text you?

*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.

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Sources and Citations
  1. [1] “Texas Population, 2023.” World Population Review, 2023 https://worldpopulationreview.com/states/texas-population
  2. [2] Kiffel-Alcheh, Jamie. “Texas.” National Geographic Kids, 23 June 2021, kids.nationalgeographic.com/geography/states/article/texas.
  3. [3] “The Highland Park Village Legacy”, Highland Park Village, 2023. https://hpvillage.com/legacy/
  4. [4] “AT&T Stadium Tours presented by SeatGeek” Dallas Cowboys, 2023. https://attstadium.com/tours/
  5. [5] “Who We Are.” Centene Corporation, www.centene.com/who-we-are.html. Accessed 1 July 2023
  6. [6] “Ambetter – About Us.” Centene Corporation, 2022, https://www.ambetterhealth.com/about-us.html
  7. [7] “What Is the Affordable Care Act (ACA)? | healthinsurance.org.” healthinsurance.org, 13 Mar. 2023, www.healthinsurance.org/glossary/affordable-care-act.
  8. [8] Centene Corporation. “About Superior HealthPlan.” Superior HealthPlan, www.superiorhealthplan.com/about-us.html. Accessed 2 July 2023.
  9. [9] “Ambetter From Superior HealthPlan Health Insurance Plans.” eHealth Insurance, www.ehealthinsurance.com/health-insurance-companies/ambetter-from-superior-healthplan-texas. Accessed 2 July 2023
  10. [10] “Health Insurance Providers in Texas | About Ambetter From Superior HealthPlan.” Ambetter, ambetter.superiorhealthplan.com/about-us.html. Accessed 2 July 2023.
  11. [11] Centene Corporation. “Ambetter From Superior HealthPlan Coverage Available in 149 Texas Counties.” Superior HealthPlan, 11 Jan. 2022, www.superiorhealthplan.com/newsroom/ambetter-from-superior-healthplan-coverage-available-in-149-texa.html.
  12. [12] Centene Corporation. “Essential Health Benefits.” Ambetter From Superior HealthPlan, ambetter.superiorhealthplan.com/benefits-services/health-benefits.html. Accessed 2 July 2023
  13. [13] “Essential Health Benefits.” Ambetter From Coordinated Care, ambetter.coordinatedcarehealth.com/benefits-services/health-benefits.html. Accessed 1 July 2023
  14. [14] “Important Mental Health and Substance Use Disorder Treatment Information.” Ambetter From Coordinated Care, ambetter.coordinatedcarehealth.com/resources/mental-health-resources.html. Accessed 1 July 2023
  15. [15] Stilkind, Joseph. “Average Cost of Drug Rehab [2023]: By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab.
  16. [16] Centene Corporation. “Just the Facts.” Superior HealthPlan, www.superiorhealthplan.com/about-us/just-the-facts.html. Accessed 2 July 2023.
  17. [17] USAFacts. “US Health Statistics and Data Trends: Life Expectancy, Health Insurance, and More.” USAFacts, Jan. 2023, usafacts.org/topics/health.
  18. [18] Texas. “Why 5 Million Texans Are Uninsured: New Study.” Texas 2036, Oct. 2022, texas2036.org/posts/why-5-million-texans-are-uninsured.
  19. [19] Dunkelberg, Anne. “2021 Census Data Provides Insight Into the Uninsured Population of Texas.” Every Texan, Feb. 2023, everytexan.org/2022/10/28/2021-census-data-provides-insight-into-the-uninsured-population-of-texas
  20. [20] “Mental Health in Texas.” KFF, 20 Mar. 2023, www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/texas.
  21. [21] Grant, Bridget F., Tulshi D. Saha, et al. “Epidemiology ofDSM-5Drug Use Disorder.” JAMA Psychiatry, vol. 73, no. 1, American Medical Association, Jan. 2016, p. 39. https://doi.org/10.1001/jamapsychiatry.2015.2132.
  22. [22] Tolbert, Jennifer, et al. “Key Facts About the Uninsured Population.” Kaiser Family Foundation, 19 Dec. 2022, www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population.
  23. [23] Saunders, Heather, and Rudowitz Robin. “Demographics and Health Insurance Coverage of Nonelderly Adults With Mental Illness and Substance Use Disorders in 2020.” Kaiser Family Foundation, 6 June 2022, www.kff.org/medicaid/issue-brief/demographics-and-health-insurance-coverage-of-nonelderly-adults-with-mental-illness-and-substance-use-disorders-in-2020.  

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