Ambetter Nevada: SilverSummit Healthplan of Nevada

Does SilverSummit Healthplan Cover Rehab Treatment?

Yes, Ambetter’s SilverSummit Healthplan in Nevada covers essential medical care and wellness services, which include everything from emergency care and prescriptions to mental health and substance misuse treatment.⁵

The Affordable Care Act (ACA) mandates that all Healthcare Marketplace plans provide their members with access to mental health services and substance misuse treatment.  You may have to pay for some of the treatment via copays, deductibles, etc. due to the limitations of your plan. And plans may not cover all types and durations of treatment.⁶ However, you can’t be denied all treatment services. Additionally, the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires insurance carriers to provide the same benefits for both healthcare and substance use treatment.⁷

SilverSummit Healthplan provides the following 10 essential health benefits:⁸

• Mental health and substance use disorder services.
• Preventative and wellness care.
• Ambulatory or outpatient services.
• Emergency services.
• Hospitalization.
• Laboratory services.
• Maternity care.
• Pediatric services.
• Therapy services (e.g., physical therapy).
• Prescription drugs.

To verify your benefits, contact a SilverSummit Healthplan representative to discuss your plan and determine your deductible, copays, etc. Or simply reach out to American Addiction Centers (AAC) at , and an admissions navigator will verify your insurance benefits for you. If you don’t have time to chat now, simply fill out an online insurance verification form, and an admissions navigator will complete the verification and get in touch with you later.

Types of Rehab Covered by Ambetter SilverSummit Healthplan

Treatment isn’t a one-size-fits-all solution, as treatment plans are customized to the unique needs of each individual. To develop a plan, professionals consider factors such as:⁹

• Type of substance(s) used.
• Duration of use.
• Potential for and degree of withdrawal, and detox.
• Personal characteristics.
• Presence of a co-occurring disorder.

Treatment professionals will assist you in determining which forms of treatment best suit your needs. SilverSummit Healthplan may cover the following types of addiction treatment:^10,11

• Detox. A form of supervised withdrawal from substance use, detox helps the body eliminate the substance while also treating the symptoms of withdrawal. However, detox alone isn’t treatment. Rather, it’s the first step in a treatment program.
• Inpatient treatment. With an inpatient rehab program, patients live in a treatment facility 24/7 where they receive highly structured and supervised care for their substance misuse issues.
• Partial hospitalization program (PHP). Often referred to as the midway point between inpatient and outpatient care, a PHP provides many of the same therapies someone would receive during inpatient care, just at a slightly lower intensity. And instead of staying in the treatment facility, PHP patients return home at night.
• Intensive outpatient program (IOP). An IOP is another type of outpatient program that offers similar therapies to that of inpatient care. However, the intensity and frequency of services are less than those of a PHP.
• Outpatient treatment. A traditional outpatient rehab program offers scheduled individual and group therapy sessions, but participants live in their own homes.
• Aftercare. Often taking the form of 12-step meetings, long-term outpatient care, ongoing counseling, sober-living homes, and more, aftercare aids the long-term recovery process following treatment.

Types of Addiction Covered by SilverSummit Healthplan

Myriad types of substance use disorders are covered fully or partially by insurance. SilverSummit Healthplan may provide coverage for addiction treatment for substances such as:

• Alcohol.
• Benzodiazepines.
• Cocaine.
• Fentanyl.
• Heroin.
• Marijuana.
• Methamphetamine.
• Opioids.
• Prescription drugs.

What Length of Treatment Does SilverSummit Healthplan Cover?

The length and type of treatment you need depends on a range of factors. A professional can assist you in identifying the best course of action and duration of treatment.

However, like many other types of coverage, SilverSummit Healthplan may cap the duration of treatment coverage according to plan variables. To learn more about coverage duration, contact a SilverSummit Healthplan representative. Or reach out to American Addiction Centers (AAC) at , and an admissions navigator will provide additional infor on coverage duration.

How to Verify Your SilverSummit Healthplan Coverage

You can contact SilverSummit Healthplan insurance by calling the number on the back of your card or looking up your benefit information online.

However, another way to verify insurance—which also allows you to discuss treatment options, ask questions, and discuss your personal story—is to contact American Addiction Centers at . AAC is a widely respected substance misuse treatment provider with facilities scattered across the United States, including one—Desert Hope—conveniently located in Las Vegas.

Does SilverSummit Healthplan Cover Mental Health?

Yes, SilverSummit Healthplan covers mental health services as part of its essential health benefits.⁸ Also, as mentioned earlier, the Affordable Care Act mandates that insurance providers offer coverage for mental health services.

Many rehabs also treat for co-occurring disorders, which is when someone with a substance use disorder also has one or more mental health disorders, such as depression, anxiety, bipolar disorder, personality disorders, attention deficit hyperactivity disorder (ADHD), schizophrenia, and more.¹²

Many people with a substance use disorder have a mental disorder as well. According to the National Institute on Drug Abuse, when these conditions co-occur, it’s usually best to treat both at the same time.^12,13

SilverSummit Healthplan Coverage Levels and Plans

SilverSummit Healthplan offers the following plans for individuals and families:⁵

• Ambetter Bronze Care. This coverage option takes care of your essential needs. Of the three plans, its monthly premiums are typically lower, but if you need a considerable amount of care, you could experience higher out-of-pocket costs.
• Ambetter Silver Care. This middle-of-the-road plan offers moderate premium costs and out-of-pocket expenses.
• Ambetter Gold Care. The top-level tier has more expensive premium costs but lower out-of-pocket expenses.

How to Pay What SilverSummit Healthplan Doesn’t

If you don’t have insurance coverage for treatment or SilverSummit Healthplan doesn’t fully cover your treatment, there are other ways to pay for rehab.

Some facilities offer financing options and sliding fee scales based on your income. However, there may also be grants and funding options available to you. Finally, free and state-funded programs may also be an option.

Bottom line: A lack of funding shouldn’t be a barrier to treatment. Contact AAC to discuss your options today at .

1. SilverSummit Healthplan. (n.d.). About us.
2. Healthinsurance.org. (n.d.). Nevada Health Insurance Marketplace Guide 2023.
3. Ambetter from SilverSummit Healthplan. (n.d.). About us.
4. Ambetter from SilverSummit Healthplan. (n.d.). Coverage area map.
5. Ambetter from SilverSummit Healthplan. (2023). About our plans.
6. Healthcare.gov. (n.d.). Mental health and substance abuse coverage.
7. Centers for Medicare & Medicaid Services. (n.d.). The Mental Health Parity and Addiction Equity Act (MHPAEA).
8. Ambetter from SilverSummit Healthplan. (n.d.). Essential health benefits.
9. National Institute on Drug Abuse (NIDA). (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
10. FindTreatment.gov. (n.d.). What to expect.
11. Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration. (2004). What is substance abuse treatment? A booklet for families. HHS Publication No. (SMA) 14-4126. Rockville, MD
12. National Institute of Mental Health. (n.d.). Substance use and co-occurring mental health disorders.
13. National Institute on Drug Abuse. (2020 April). Common Comorbidities with Substance Use Disorders Research Report Part 1: The connection Between Substance use Disorders and Mental Illness.