Ambetter from NH Healthy Families Coverage for Addiction Treatment in New Hampshire

Ambetter is the marketplace brand of NH Healthy Families, part of Centene. If you bought your own coverage on HealthCare.gov rather than through an employer, there is a good chance it is an Ambetter bronze, silver or gold plan. Every marketplace plan must cover substance use treatment as an essential health benefit, and federal parity law requires it to be covered on the same terms as medical care. The differences between plans are in the deductible, the copays and the authorization rules, not in whether treatment is covered.

At our Londonderry center, Ambetter members typically use these levels of care:

• Partial Hospitalization (PHP). Many Ambetter plans cover PHP when a clinical assessment supports it, with authorization approved before the first day.
• Intensive Outpatient (IOP), day or evening. Many plans cover IOP, usually with an authorization step up front.
• Outpatient (OP). Weekly therapy is billed like other specialist visits, with a copay or coinsurance.
• Medication-Assisted Treatment (MAT). The visits are covered like other outpatient care. The medication runs through the pharmacy benefit and Ambetter's formulary.

Coverage depends on your plan. A bronze plan with a high deductible can mean paying the full contracted rate until the deductible is met, while a silver plan with cost-sharing reductions can mean a small copay from the first visit. We verify your benefits in one call and tell you where your plan stands before anything is scheduled.