HomeWho Accepts Ambetter Health Insurance

Who Accepts Ambetter Health Insurance

Does Ambetter Cover Methadone Or Suboxone Treatment

A Partner in Lifelong Healing Ambetter Member Testimonial

Opioid addiction treatment can be covered by a health insurance program. This type of addiction can be treated, in part, with medications and prescription drugs. These medicines reduce the severity of symptoms associated with opioid use disorder.

Read more about Treatment Options For Opioid Addiction

Does Ambetter Cover The Cost Of Suboxone

Suboxone is a medication that is part of many opioid treatment programs. Medication-assisted treatment helps many people with opioid use disorders quit the use of addictive drugs and enter recovery.

Suboxone may be covered by Ambetter insurance plans, but since this medication is typically part of a long-term treatment plan, its a good idea to know whether its covered before electing this treatment route.

All essential benefit healthcare plans include pharmacy benefits or medication coverage. However, Ambetter coverage for Suboxone may come with a co-pay. Speaking with an insurance representative can help you be prepared for your out-of-pocket costs if you need MAT with Suboxone.

Are Video Visits With A Primary Care Doctor Online Covered By Ambetter

Most insurers provide coverage for video visits at the same cost as in-person visits. You can search on Zocdoc specifically for Doctors who accept Ambetter for video visits by selecting your carrier and plan from the drop-down menu at the top of the page. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits.

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Types Of Plans Offered

Its somewhat difficult to access specific information about the types of health plans Ambetter has. Their website primarily just explains the metal tiers for their plans, as well as how essential health benefits are covered by every plan. But to find out what kinds of plans these are , not to mention what prices and benefits you qualify for, youll have to contact a representative. Up front, its important to know that Ambetter is part of the Health Insurance Marketplace . Its Centenes option for HIM plans, which is intended for people who dont have health insurance and maybe dont qualify for typical plans. In HIM territory, Medicare isnt an option, for example, because if you qualify for Medicare, thats the legal option for you to get rather than taking advantage of a plan like Ambetters. Medicaid and CHIP are HIM plans, though. Ambetter has PPOs, HMOs, and EPOs.

They dont offer HSAs though. Theyve divided their plans into three metal tiers: Bronze, Silver, and Gold. All three of these tiers cover essential health benefits, Ambetters term for services like preventative and emergency care, therapy, behavioral health help, medications, maternity, and hospitalization. But the difference in the tiers comes in the costs for premiums and out-of-pocket expenses. Bronze plans have the lowest premiums but the highest OOP costs, and Gold has the highest premiums but the lowest OOP costs. Silver, of course, is the in the middle.

About Ambetter Health Insurance

Ambetter Sunshine Chiropractic Coral Springs

Ambetter has been offering health insurance plans across the U.S. since 2014, and now serves more than 2 million members.1 Ambetter insurance offers Marketplace insurance plans, and all plans under the Health Insurance Marketplace cover mental health & substance abuse care to some extent.2 Plans vary by deductibles, premium payments, and out-of-pocket costs to match your needs.

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Many Care Options For Minor Injuries

If your injury is minor and not life threatening , your first choice should be to call your primary care provider . Or choose Ambetter Telehealth* for convenient video doctor visits!

If you cant wait for an appointment with your PCP, visit an urgent care center for injuries that need faster attention. That might be a minor sprain or a small cut. Be sure to choose an in-network urgent care center to save on costs. Use our Find a Provider tool to find an Urgent Care near you.

Does Ambetter Cover The Cost Of Intensive Outpatient Programs

Once a person no longer requires medical care or intensive day treatment, they are ready for intensive outpatient programs which are covered by Ambetter health plans.

How much Aetna pays toward intensive outpatient treatment can depend on whether you have completed residential treatment, completed an IOP before, and whether the program you choose is in-network with your Ambetter insurance.

Intensive outpatient programs involve counseling, therapy, and case management and are similar in length to PHPs. Treatment sessions may be shorter though, with therapy and counseling totaling one to three hours per day, two to three days per week.

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Where To Go For Care

Watch the video to learn more about your choices for care when youre sick or hurt. View Video.

* $0 cost share applies for in-network telehealth services through Ambetter Telehealth. $0 Ambetter Telehealth cost share does not apply to HSA plans until the deductible is met. Ambetter does not provide medical care.

Are Video Visits With A Neurologist Online Covered By Ambetter

A Partner in Heart Health Ambetter Member Testimonial

Most insurers provide coverage for video visits at the same cost as in-person visits. You can search on Zocdoc specifically for Neurologists who accept Ambetter for video visits by selecting your carrier and plan from the drop-down menu at the top of the page. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits.

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Sgmc Announces Ambetter As Hie Partner

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South Georgia Medical Center announces its Health Insurance Exchange partner for 2021 is Ambetter from Peach State Health. The HIE connects patients with affordable, quality healthcare plans across communities served by SGMC, SGMCs physician network and its affiliates in Lowndes, Berrien and Lanier counties.

Although the current health exchange website may identify SGMC in other product networks, Pathways notified SGMC that it will not be an in network provider for its Pathways product for the calendar year 2021.

Consumers choosing a health insurance product that is not in network could experience higher out of pocket costs when using SGMC services or physicians.

The Open Enrollment period for 2021 is Nov. 1 through Dec. 15, 2020 and can be completed by visiting healthcare.gov. Coverage begins Jan. 1, 2021.

SGMC encourages consumers to research health insurance options carefully to ensure the health insurance product they choose has in network providers in or near the communities where they seek healthcare.

Each year, insurance companies decide what hospitals and physicians will be in their network for the upcoming calendar year. When a change occurs by an insurer, this may leave consumers without convenient in network options in their community. The result often time results in higher out of pocket expenses should the consumer choose an out of network hospital or physician for their care.

To speak with someone at SGMC regarding this change, call 229-433-1040.

Ambetter Insurance At Kenmar Dental Marietta

You may be looking for an alternative or low-cost dental insurance solution or dentists near you that accept Ambetter insurance. We are proud to announce that Kenmar Dental is currently accepting new and existing Ambetter dental insurance holders. Financial worries shouldnt hold you back from good oral health and the team at Kenmar Dental are happy to work with you for the most affordable outcome.

What is Ambetter Insurance and Does my Dentist Accept it?

Ambetter insurance might be a good option for you if you need a lower-cost healthcare insurance plan. Its a marketplace provider, offering different insurance plans at different coverage levels and is an alternative to Medicaid. If youre in Georgia searching for a local dentist that accepts Ambetter in 2021, Dr. Chirag Patel at Kenmar Dental is an in-network Ambetter dental provider. Please note that while pediatric dental care is covered by all Ambetter plans, adult dental care may vary so please confirm coverage with your insurance provider.

Ambetter Accepted in Marietta, GA

Ambetter plans are not available in every state but they are accepted in Georgia and Kenmar Dental is your Ambetter Marietta dental provider. Kenmar Dental also accepts a wide variety of other insurance and healthcare plans so check our patient information to see if yours is on the list. If it isnt or you have any other questions, just give us a call on -427-4778 for further information.

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Finding A Provider In The Ambetter Network


The Ambetter from Superior HealthPlan network includes all provider types to support your health care benefits, including local providers and pharmacies that you know and trust.

Use Ambetters Find a Provider tool to search the full list of providers available in the Ambetter network. It includes details like provider specialties, providers accepting new patients, languages spoken, office hours, contact information and directions to the providers location.

You can also contact Ambetter Member Services through the Online Member Portal, by email at or by calling from 8 a.m. to 8 p.m. CT, Monday through Friday. Member Services can help you:

  • Find an in-network provider.
  • Request a current non-electronic listing of all Ambetter in-network providers at no cost.
  • Answer your questions.

Does Ambetter Cover The Cost Of Methadone

Doctors That Accept Ambetter

Methadone is another form of medication-assisted treatment that offers long-term treatment for opioid addiction and is covered by Ambetter insurance policies.

Methadone maintenance therapy is often combined with other treatments, like individual counseling, group therapy, and behavioral therapy. For the best recovery results, methadone is taken daily or monthly to help recovered individuals stay sober.

As with other medications, the cost of methadone may be covered by Ambetter, but your co-pay amount may vary by plan and by the type of methadone youre taking.

For a more thorough overview of your addiction treatment coverage through Ambetter talk to your insurance company or a treatment representative prior to finding your rehab program.

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Find Ambetter Coverage In Your State

Ambetter has you covered, with plans available in 20 states nationwide. Select your state below to see plans in your area.Don’t see your state listed? Contact us.If you live in CA or NY, you can enroll in coverage with Health Net or Fidelis Care .

Statistical claims and the #1 Marketplace Insurance statement are in reference to national on-exchange marketplace membership and based on national Ambetter data in conjunction with findings from 2019 Issuer Level Enrollment Data from CMS, 2019 State-Level Public Use File from CMS, 2019 Covered California Active Member Profile data, state insurance regulatory filings, and public financial filings.

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*For some plans

Healthcare is essential. Ambetter can help.

You can count on us to share helpful information about COVID, how to prevent it, and recognize its symptoms. Because protecting peoples health is why were here, and its what well always do.

Statistical claims and the #1 Marketplace Insurance statement are in reference to national on-exchange marketplace membership and based on national Ambetter data in conjunction with findings from 2019 Issuer Level Enrollment Data from CMS, 2019 State-Level Public Use File from CMS, 2019 Covered California Active Member Profile data, state insurance regulatory filings, and public financial filings.

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Customer Reviews And Complaints

If you are looking for the cheapest rates for health coverage, then Ambetter Health Insurance is a great option. However, customer reviews for Ambetter Health Insurance are below average to poor. Many policyholders complain about long phone call wait times when dealing with Ambetter employees, along with providers not being paid for medical services. Furthermore, many members reported getting billed incorrectly and not being able to find providers that accept Ambetter insurance in their areas.

These customer reviews are substantiated by the ratings that Ambetter Health Insurance has received. The Better Business Bureau has given the company a “D” rating, meaning they rarely interact with customers or respond to complaints in a timely manner. Ambetter also received an NAIC complaint ratio of 1.12âmeaning the company has received more than the median number of complaints based on its size.

Ambetter Health Insurance is a marketplace plan that is operated by CeltiCare Insurance, a subsidiary of the Centene Corp. When you purchase an Ambetter policy, your point of contact for questions would be Celticare. For example, in Florida, Ambetter plans are marketed as Ambetter by Sunshine Health but are operated and underwritten by CeltiCare Insurance.

Editorial Note: The content of this article is based on the authorâs opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.

How Can I Make A Same

Ambetter How To: Why Do I Need a Primary Care Provider?

On average, patients who use Zocdoc can search for a Primary Care Doctor who takes Ambetter insurance, book an appointment, and see the Primary Care Doctor within 24 hours. Same-day appointments are often available, you can search for real-time availability of Doctors who accept Ambetter insurance and make an appointment online.

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How To File A Claim With Blue Cross Blue Shield And Ambetter Insurance

Blue Cross Blue Shield

If you use a network doctor or hospital, your claims will be submitted by that provider. If you see an out-of-network provider, you need to submit the claim yourself. You must submit a completed claim form or alternative documentation via fax or mailing address. As an alternative to sending a claim form, supply a description of services, a bill of charges from the provider and any medical documents you received from your provider.

For medical and/or dental services in the U.S. Puerto Rico or the U.S Virgin Islands, Use these claim forms. For anywhere else or on a cruise ship outside the U.S. use the Blue Cross Blue Shield Global Core international claim forms. For prescriptions inside or outside the U.S. or U.S. territories: Use these claim forms.


If you receive non-emergency services from an out-of-network provider, you may be responsible for the entire cost of the medical bill, unless otherwise required by state or federal regulations. To take full advantage of your Ambetter coverage, it is important to only use in-network providers. To appeal a claim that was denied by Ambetter, the member should contact 1-877-687-1197.

Seeking Addiction Treatment Using Your Ambetter Plan

Your ability to pay should not be a factor in seeking the addiction treatment that will allow you to begin your recovery journey. Ambetter insurance plans offer various levels of coverage for an individual who seeks to end the vicious cycle of alcohol or drug abuse.

Depending upon the type of plan you have, you may end up paying anywhere between 0 and 40 percent in coinsurance with an in-network rehab center once your deductible is met. You may end up paying more if you elect to work with an out-of-network rehab center.

To learn more about rehab centers which accept your Ambetter insurance plan, or to find a rehab center for you or a loved one, contact us today.

Written by the Addiction Resource Editorial Staff

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

  • Ambetter What is Ambetter?

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Blue Cross Blue Shield Vs Ambetter: What You Need To Know

Blue Cross was formed in 1929 as a partnership between Baylor University Hospital and its patients who were struggling financially. The administrators of the hospital wanted to make healthcare more affordable for some patients, many of whom were Dallas public school educators on restricted budgets. The initial payment plan set up by Baylor University Hospital consisted of a 50-cent prepay each month for up to 21 days of hospitalization per year. The success of the program lead to enrollment by employees in other professions across Dallas.

Ambetter is a health insurance company owned by Centene Corporation, a multi-national company that provides programs and services to under-insured and uninsured individuals. Centene is the largest Medicaid managed care organization in the country and the number one insurer on the Health Insurance Marketplace. Each state works differently through Ambetter to provide health insurance marketplace plans, including Medicaid and Childrens Health Insurance Programs . Both Centene and its new acquisition, Wellcare Health Plans, serve Medicaid and Medicare members.

To learn more about each company, you can check out the Blue Cross Blue Shield Overview and Ambetter Overview.

Verify Your Insurance Coverage

Rates &  Insurances

While health insurance can help with the cost of a drug rehab program, its important to understand what shapes insurance costs. There are different health insurance costs like deductibles, premiums, and copays that can all change your out-of-pocket costs.

If you or a loved one lives with addiction, learn more about your addiction treatment coverage by contacting us today.

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Which Pharmacies Accept Ambetter Insurance

Looking for which pharmacies accept ambetter insurance? Get direct access to which pharmacies accept ambetter insurance through official links provided below.

Follow these easy steps:

  • Step 1. Go to which pharmacies accept ambetter insurance page via official link below.
  • Step 2. Find the official insurance at the bottom of the website.
  • Step 3. If you still cant access which pharmacies accept ambetter insurance please leave a message below .

Ambetter members can use the list below to find pharmacies that participate in the Ambetter 90-Day Extended Network. What is the Ambetter 90 mind that just because a drug is included on the list does not mean that it is covered through your specific insurance plan. Please refer to your benefit materials to ensure your prescription

Ambetter has a variety of convenient in-network pharmacies. These include: HEB, CVS and Walmart, as well as many independent pharmacies in your area. To find a network pharmacy near you, use our Find a Provider Tool and follow these steps: Enter your zip code or address, or click Use my Current location.

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