AmeriHealth is a provider of health insurance for employers and individuals throughout the state of New Jersey. They cover drug treatment that is medically necessary with both their HMO and PPO plans. With AmeriHealth, the user’s primary care physician must make the referral. AmeriHealth’s health insurance will cover various forms of treatment depending on what policy a client has. Recovery Unplugged will walk every potential client with AmeriHealth through this process.
Your AmeriHealth ID card will have a phone number to call where a representative will tell the user specific details about your plan. AmeriHealth’s PPO plans (Preferred Provider Organizers) provide both inpatient and outpatient treatment of drug abuse. Different HMO (Health Maintenance Organization) plans for AmeriHealth are available in Delaware, New Jersey and Pennsylvania. The AmeriHealth drug rehab plans cover substance abuse outside of a mental illness filing, while the other HMO plans cover drug treatment under mental health. There is also a special plan called the “AmeriHealth New Jersey Project.”
Preapproval and continuing authorizations are not required for routine and medication management outpatient mental health services under most AmeriHealth benefits plans. However, Preapproval is required for substance and alcohol abuse services, mental health inpatient services, Partial Hospitalization Programs, and Intensive Outpatient Programs. Members must call Magellan (AmeriHealth’s contracted behavioral health provider) once an appointment has been made to ensure that the Preapproval process is properly initiated. Preapproval for Emergency admissions is not required. When a member is admitted as an inpatient through the emergency room/department, the hospital is required to notify Magellan within 48 hours or on the next business day.