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Amerigroup Insurance: Substance Abuse Coverage

Last Updated: February 16, 2022

Authored by Isaak Stotts, LP

Reviewed by Michael Espelin APRN

Amerigroup insurance is a company that helps low-income and other in-need individuals access government healthcare plans and supplement them with additional coverage when needed. Many individuals rely on Amerigroup health insurance to access drug rehab and therapies for substance abuse. Its health plans cover many addiction services, and there is also supplemental insurance, like Amerigroup Medicaid or Medicare.

Learn about the specifics of healthcare plans and how to access the benefits offered by the company.

What Is Amerigroup Insurance?

Amerigroup Insurance is American-based health insurance and managed care provider. It was founded in 1994 and is currently based in Virginia Beach, Virginia. With over 10,000 employees and providing coverage to over 7.7 million individuals, it is the largest healthcare provider for public programs in the United States.

It benefits many low-income families, individuals with disabilities, federal employees, and other federally sponsored beneficiaries.

They Operate Within the Following States:

  • Georgia
  • Iowa
  • Maryland
  • New Jersey
  • Tennessee
  • Texas
  • Washington
  • Arizona
  • New Mexico

Amerigroup health insurance offers a range of well-suited policies for different clients. Some well-known plans include the Medicare Advantage plan, the Children’s Health Insurance Program, the Seniors and People with Disabilities plan, the Temporary Assistance for Needy Families, and the Family care plan. They also offer supplemental Amerigroup Medicare Advantage coverage for individuals who do not want comprehensive managed care coverage.

Amerigroup Medicaid and Medicare

The company offers several Medicaid and Medicare policies as well. Amerigroup Medicaid refers to federal and state-backed programs which provide medical insurance to low-income families and individuals. Medicare is a federal program that covers healthcare expenses for citizens over 65 or if you’re under 65 but has a disability, irrespective of your income level.

Some Popular Medicare Plans Include:

  • Amerigroup Medicare Advantage Plan: This offers covers everything of the original Medicare plan in addition to services that were excluded from the original plan.
  • Medicare Supplement (Medigap) Plans: This plan is exclusive to Arizona and Texas. It provides some degree of coverage for medical services not adequately covered by the original Medicare plan.
  • Stand-alone Prescription Drug Plans: This plan covers prescription drug costs which the original Medicare plan may not have. One can combine it with the original Medicare plan or the supplement plan. However, it is not compatible with the Amerigroup Medicare Advantage Plan as the Advantage Plan usually covers prescription drugs.

For low-income clients, the group also offers special discounts. It may include benefits such as copayments as low as $0, low or zero-dollar premiums, telehealth visits, personal care helpers, allowances for transportation, and healthy food deliveries.

Amerigroup Mental Health Coverage

Mental health treatment is covered by most health plans, including those for alcohol and drug addiction. Amerigroup health insurance is unusual in that it actually offers plans strictly for mental health coverage.

Amerigroup Rehab Centers Coverage

Treatment in a rehab center often includes the use of therapies for addiction. In addition to that, many addicts suffer from co-occurring mental health disorders, which also require treatment.

Psychotherapy session.

Amerigroup mental health can help cover the expenses associated with therapy. The Behavioral Health Services Only (BHSO) plan allows users to take out a policy covering behavioral health and substance abuse disorder treatment. It also gives the insured access to their behavioral health crisis line. There are no copays or coinsurance, and people with the plan do not need to see a primary care provider to get a referral. Substance abuse coverage is valid with any provider in their network, and patients only need to show their Amerigroup insurance card before treatment.

How Can One Enroll In a Drug Rehab Plan?

Anyone interested can enroll in an Amerivantage plan, which covers behavioral health, including treatment in a drug rehabilitation facility, as well as other aspects of health insurance. Applications can be completed over the phone, online, or by mail.

The important information is that substance abuse insurance only extends to providers within their network. Since Amerigroup rehab centers coverage is only available in some states (Arizona, New Jersey, New Mexico, Tennessee, Texas, and Washington), users need to consider this when pursuing treatment. Additionally, the policies are only applicable if the user’s treatments are not covered under a Medicare or Medicaid policy. If they are, the insured is expected to use those benefits first.

Covered Services

Amerigroup rehab centers’ policies across their plans extend to cover substance abuse treatment. Anyone with a policy through the company will have access to detoxification, inpatient rehab, and outpatient rehab as long as they meet the criteria for treatment at a given drug facility.

Within the Umbrellas of Detoxification and Rehab, Many Substance Abuse Services Are Covered, Including:

Because of the nature of Amerigroup insurance for drug rehab and its partnership with government healthcare providers, its policies can only be used at locations certified by the Department of Social and Health Services (DSHS). While this does restrict coverage, any state served by the company will have providers available.

How To Get Coverage For Drug Rehab

The process of getting the coverage varies based on state, what public insurance a person has, and what policies they want to take out.

For example, the company offers the state of Tennessee coverage through TennCare. It is a public healthcare option that people can take out through Amerigroup health insurance. The first step in accessing this coverage is for the interested party to check whether they qualify for a policy. It is done at the government TennCare website.

Young man receiving treatment at a psychologist's.

If one is qualified, they can then apply for drug rehab coverage. It is done online, over the phone, or at a kiosk at any DHS office in the state of Tennessee. If approved, the insured individual will receive a letter in the mail.

People who do not have TennCare can still take out an Amerigroup policy. However, they will need to speak directly with a representative to determine how.

How To Use Coverage For Drug Rehab

Once someone has their Amerigroup insurance verification, they are ready to use their policy. However, how to use the policy will often depend on the rules and regulations of the state coverage being backed by the provider.

What Documents Should Be Given To A PCP?

In most cases, an insured must have a primary care provider (PCP) who will be responsible for giving referrals for other services, including drug rehabilitation. Anytime the insured sees a doctor, they need to bring their Services Card and health plan ID card. Additional documents may be requested as well.

Are Prescription Drugs & Medical Equipment Covered?

Prescription medication coverage is restricted to drugs that are on the approved list. In addition, the patient must have a documented medical need for the medication. Medical equipment is also covered, but again, the patient must have a documented medical need for coverage to kick in.

Insured individuals should keep in mind that these policies are not set in stone and change from state to state. Therefore, anyone looking to utilize Amerigroup insurance for rehab or other treatment should verify coverage in advance.

Verify Insurance And Start Treatment

If someone has Amerigroup health insurance and is battling a substance use disorder, treatment is within reach. Drug rehab coverage ensures that users can get clean and live a better life. Contact the company to verify coverage and begin treatment.

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Page Sources

  1. Amerigroup, The States We Serve. https://www.amerigroup.com/for-our-state-partners/states-we-serve
  2. Division of TennCare https://www.tn.gov/tenncare/

Published on: October 2nd, 2019

Updated on: February 16th, 2022

About Author

Isaak Stotts, LP

Isaak Stotts is an in-house medical writer in AddictionResource. Isaak learned addiction psychology at Aspen University and got a Master's Degree in Arts in Psychology and Addiction Counseling. After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.