Exceptional care tailored to you
Ambetter Outpatient Rehab
Finding the right mental health and addiction treatment can be a pivotal step toward a healthier life. At Enhance Health Group, we understand that navigating insurance coverage is a significant part of this journey. We are proud to be an in-network provider with Ambetter from Health Net in California, making it easier for you to access the high-quality care you deserve.
Our clinical team is passionate about helping you live an enhanced, balanced, healthy life —where mental health doesn’t stand in your way. We offer comprehensive services for mental health and substance use disorders, all designed to support your path to lasting well-being.
Verify Your Ambetter Benefits Today
Call our team or fill out the form to verify your Ambetter insurance policy benefits. We’ll review your insurance verification and get back to you as soon as possible. In some cases, your Ambetter insurance will cover 100% of treatment costs. Don’t wait to get help, our team is here to guide you on your healing journey.
Our Approach to Care
At Enhance Health Group, we recognize that struggling with a substance abuse disorder or mental health condition can feel overwhelming, but you don’t have to face it alone. Our mission is to create a safe, supportive environment where every patient can find the right level of care to meet their unique needs. Whether you are dealing with anxiety, depression, a co-occurring disorder, or another type of addiction, our treatment centers offer a comprehensive range of options—including inpatient treatment, various therapy modalities, and evidence-based medications—to help you take the next step toward recovery.
We believe that exceptional care starts with understanding. Our experienced team works closely with each patient to develop a structured, personalized treatment plan that addresses their specific condition and goals. From the moment you contact us, we provide clear information and guidance, helping you navigate important decisions about your healthcare. We know that verifying insurance coverage and understanding out-of-pocket costs, deductibles, and plan details can be confusing, so our dedicated representatives are here to answer your questions and help you confirm your Ambetter insurance benefits. We accept Ambetter insurance, including bronze, silver, and gold plans, as well as other types of insurance, to make our services as accessible and affordable as possible.
Our approach to addiction treatment is considered medically necessary and is designed to help you achieve lasting change and a higher level of well-being. We offer a variety of therapy options and support for all types of substance abuse and co-occurring disorders, ensuring that each patient receives the care that’s right for them. Our rehab center is committed to providing a secure, welcoming space where you can focus on your recovery with confidence.
As part of the Ambetter network, we collaborate with other healthcare providers to ensure you receive the highest level of care throughout your journey. Our goal is to help you navigate life free from the burdens of addiction and mental health challenges, empowering you to live the life you deserve. If you or a loved one is struggling, don’t wait—contact us today to learn more about our treatment options, get answers to your insurance questions, and take the first step toward a healthier future.
Your Questions About Ambetter Rehab Coverage Answered
It’s common to have questions about how your insurance works when seeking treatment. Here are some frequently asked questions about Ambetter coverage for mental health and addiction rehab in California:
What rehab does Ambetter cover?
Ambetter plans, including those offered by Health Net in California, typically cover a broad range of mental health and substance use disorder treatments. As part of the Affordable Care Act (ACA) essential health benefits, Ambetter is mandated to provide coverage for:
- Inpatient Rehab: For intensive, residential treatment where you live at the facility.
- Outpatient Rehab: Including Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs), which provide structured therapy while allowing you to live at home or at one of our structured living environments.
- Detoxification (Detox): Medically supervised detox services to safely manage withdrawal symptoms.
- Therapy and Counseling: Individual, group, and family therapy sessions (e.g., Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), trauma-informed therapy).
- Medication Management: Including psychiatric medications and Medication-Assisted Treatment (MAT) for addiction.
- Co-occurring Disorders: Treatment for individuals experiencing both mental health conditions and substance use disorders simultaneously.
The specific level of coverage will depend on your individual Ambetter plan (e.g., Bronze, Silver, Gold tiers) and whether the treatment is deemed “medically necessary” by Ambetter. It’s always best to verify your specific benefits.
Why would insurance deny rehab?
While Ambetter generally covers mental health and substance use treatment, denials can occur for several reasons. Understanding these can help you avoid potential issues:
- Lack of Medical Necessity: The most common reason. Insurance companies require clear documentation from healthcare providers demonstrating that the requested level of care (e.g., inpatient vs. outpatient) is essential for your health.
- Out-of-Network Providers: If you choose a facility or provider that is not in Ambetter’s network, your coverage may be significantly limited or denied, resulting in higher out-of-pocket costs.
- Lack of Prior Authorization: Many Ambetter plans require pre-approval (prior authorization) before you begin certain treatments, especially for inpatient or intensive programs. Starting treatment without this approval can lead to denial.
- Incomplete or Inaccurate Documentation: Missing information, errors in coding, or insufficient progress reports from the treatment facility can lead to claim denials.
- Policy Limitations: Your specific plan may have limits on the number of days or visits covered per year for certain services.
- Perceived Lack of Progress: Although relapse is often part of recovery, some insurers might deny continued funding if they perceive a lack of progress, emphasizing the importance of clear clinical documentation.
If your claim is denied, you have the right to appeal the decision. Our team at Enhance Health Group can assist with insurance verification and work with you to navigate the authorization process.
What services are covered by Ambetter?
Beyond the specific rehab services mentioned above, Ambetter plans in California generally cover a wide array of essential health benefits, including:
- Emergency Services
- Hospitalization
- Prescription Drugs
- Maternity and Newborn Care
- Pediatric Services
- Preventive and Wellness Services
- Laboratory Services
- And, as detailed, Mental Health and Substance Use Disorder Services
For behavioral health specifically, Ambetter typically covers:
- Individual, Group, and Family Therapy
- Medication Management with Psychiatrists or Psychiatric Nurse Practitioners
- Outpatient and Intensive Outpatient Programs (IOP)
- Partial Hospitalization Programs (PHP)
- Inpatient/Residential Treatment (when medically necessary)
- Telehealth services for mental health
How many times does insurance pay for rehab?
Under the Affordable Care Act, Ambetter, like other insurance companies, must cover mental health and substance use disorder treatment to the same extent as other medical conditions. This means there are generally no lifetime limits on the number of times Ambetter will cover addiction or mental health treatment, provided the treatment is medically necessary.
While there isn’t a fixed “number of times,” coverage for subsequent treatment episodes will still be subject to medical necessity reviews, prior authorization requirements, and your plan’s specific deductibles, copayments, and coinsurance. The goal of parity laws is to ensure that individuals can access the care they need for chronic conditions like addiction and mental illness, similar to how one might receive ongoing care for a chronic physical illness.
In-Network Insurance Providers
Enhance Health Group is proud to be in-network with Anthem Blue Cross Blue Shield, along with the following insurance providers:
Enhance Health Group is the Best Mental Health Treatment In Orange County. Our clinical team is passionate about helping you live an enhanced, balanced, healthy life —where mental health doesn’t stand in your way. We are dedicated to providing compassionate, evidence-based mental health care that empowers individuals to achieve lasting well-being.
Contact Enhance Health Group Today
If you’re seeking mental health or addiction treatment in California and have Ambetter insurance, we’re here to help. Contact us to verify your benefits and learn more about how our services can support your recovery journey.
Phone: (714) 862-1907
Website: enhancehealthgroup.com
Things You Need To Know
Frequently Asked Questions
Do I need a referral to see a therapist or begin treatment at Enhance Health Group with Ambetter?
While some Ambetter plans may require a referral for specialists, many mental health services do not. It’s always best to verify with your specific Ambetter plan or let us assist you in checking
Does Ambetter cover telehealth for mental health?
Yes, Ambetter generally covers telehealth (online therapy) services for mental health, often on the same basis as in-person care.12 This offers a flexible option for receiving support.
What is the first step to using my Ambetter insurance at Enhance Health Group?
The best first step is to contact us! Our admissions team can quickly verify your Ambetter benefits and explain your coverage for our services. This helps ensure a smooth process.
What if my Ambetter plan is through Covered California?
Ambetter from Health Net is a prominent plan offered through Covered California. Enhance Health Group is in-network with Ambetter plans, meaning we can accept your coverage if your plan is through Covered California.
Will I have any out-of-pocket costs with Ambetter insurance?
Depending on your specific Ambetter plan, you may have deductibles, copayments, or coinsurance that contribute to your out-of-pocket costs. We will help you understand these details during the insurance verification process.