Does AmeriHealth Insurance Cover Rehab Costs?
AmeriHealth covers drug and alcohol rehab costs under its Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) plans. Rehab services must be deemed medically necessary, however, and the policyholder’s Primary Care Physician (PCP) is required to make a referral for such services. AmeriHealth’s provider network of substance abuse/rehab services is managed and delivered by Magellan Behavioral Health, Incorporated.
Depending upon the type of plan, rehab coverage may be limited by a benefit maximum (i.e., number of allowed visits or duration of treatment). Members can consult their contract or member handbook for details about specific coverage. If they prefer, they can call a representative at the Member Service Department. The phone number is listed on the back of their Member ID Card. A third option is to send an e-mail, available here.
AmeriHealth PPOs are available to individuals living in New Jersey and Pennsylvania. The company offers two types of PPOs to individuals. Each of these PPOs covers inpatient and outpatient treatment of drug and alcohol abuse to varying degrees.
Six different AmeriHealth HMOs are available to individuals living in Delaware, New Jersey, and Pennsylvania. At least two of these plans, the IHC Preferred and the IHC Basic, cover substance abuse rehab as a separate entity. The remaining HMO plans combine drug and alcohol rehab coverage with non-biologically based mental illness. AmeriHealth has a third option, called “AmeriHealth New Jersey Protect.” This plan, which represents a joint effort with The New Jersey Individual Health Coverage Program, was designed in an effort to meet the needs New Jersey residents who are both uninsured and who have pre-existing conditions. AmeriHealth New Jersey Protect offers rehab coverage in combination with non-biologically based mental illness.
In addition to individual plans, AmeriHealth offers group insurance. Group coverage is available to employers of 50 or more employees as well as to smaller companies. Group plans are available in Delaware, New Jersey, and Pennsylvania and, depending upon the type of plan chosen, may offer rehab coverage. In addition to geographically limited plans, AmeriHealth offers a special group plan, the Personal Choice PPO, to businesses located throughout the United States. The Personal Choice PPO requires, however, that providers be part of their local Blue Cross/Blue Shield network.