Does Ambetter Cover Mental Health Services in Tennessee?

Yes, all of your Essential Health Benefits¹ are covered by every Ambetter insurance plan, including mental health and behavioral health services.

How to Verify Ambetter of Tennessee Mental Health Benefits

Athena Care is in-network with most major insurance plans. Find out more about your insurance coverage by calling your insurance company or contacting Athena Care at 877-641-1155.

Jump to Section

• How to Verify Ambetter of Tennessee Mental Health Benefits
• Which Mental Health Services Are Covered by Ambetter Insurance?
• Which Mental Health Conditions Are Covered by Ambetter Insurance?
• How To Find Mental Health Services & Providers Near Me in Tennessee?
• About Ambetter Insurance
• Does Ambetter Insurance Cover Online Therapy?
• Does Ambetter Cover Medications?
• What Services & Treatments Are Not Covered by Ambetter of Tennessee?
• How Much Do Mental Health Services & Testing Cost?

Which Mental Health Services Are Covered by Ambetter Insurance?

Ambetter has many programs and tools to help you improve your overall health and well-being. Your Ambetter mental health benefits may include coverage for the following mental and behavioral health services in Tennessee:²

• Telehealth
• Depression Management
• Developmental Monitoring and Screening³
• 24/7 Nurse Advice Line⁴
• Access to a Care Manager⁵
• Stress Management⁶
• Electroconvulsive Therapy⁷
• Mental Health Therapy
• Substance Abuse Treatment⁸

Which Mental Health Conditions Are Covered by Ambetter Insurance?

Ambetter insurance of Tennessee may cover the following mental health conditions:

• ADHD
• Anxiety
• Depression
• Stress

How To Find Mental Health Services & Providers Near Me in Tennessee?

With Athena Care, gaining access to mental and behavioral health tests and treatments has never been easier. A care coordinator can assist you in finding treatment at one of our three mental health clinics in Tennessee. These include locations in Nashville, Murfreesboro, and Hendersonville.

When searching for Ambetter mental health providers, keep the following in mind:

• Education, training, license, and years of experience
• Specialties and services offered
• Treatment methods and philosophies
• Insurance companies they work with
• Office hours
• Pricing
• Session length

Also, don’t hesitate to ask questions.

Athena Care mental health clinics are open Monday through Friday, 7:00 a.m. to 6:00 p.m.

Here you’ll find a list of practitioners organized by city, along with information about their backgrounds and specialties.

About Ambetter Insurance

Ambetter of Tennessee is Centene Corporation’s health insurance marketplace offering. Centene Corporation is a Fortune 500 company with a diverse portfolio of specialty health solutions and over 30 years of experience in the Managed Care sector.⁹

Ambetter now has over 2 million members nationwide and offers a wide range of plans and healthcare services to fulfill health needs.¹⁰

Ambetter plans are available in Bronze, Silver, and Gold levels:¹¹

• Bronze – Ambetter Essential Care: These plans cover your essential healthcare needs. Generally, you’ll see lower monthly premiums but higher out-of-pocket costs. This could be an excellent plan if you don’t go to the doctor often or don’t have many medications.
• Silver – Ambetter Balanced Care: Of all the plans offered, this has the best value and balance between monthly premium payments and out-of-pocket expenses, particularly if you qualify for financial help.
• Gold – Ambetter Secure Care: With this plan, you’ll enjoy peace of mind for all of your healthcare needs. Expect higher monthly payments that help keep your out-of-pocket expenses to a minimum.

Does Ambetter Insurance Cover Online Therapy?

Yes, Ambetter insurance covers online therapy. All members also have access to 24/7 Telehealth. Ambetter behavioral health and mental health services are part of Ambetter’s Essential Health Benefits.

Does Ambetter Cover Medications?

Ambetter collaborates with doctors and pharmacists to guarantee that medications used to treat many mental health problems are covered.

When prescribed by Ambetter mental health providers, Ambetter may cover some brand-name, generic, and mail-order prescriptions.¹² Not all drugs are covered by the Ambetter pharmacy program. Some require Prior Authorization or have age, dosage, and quantity restrictions.

What Services & Treatments Are Not Covered by Ambetter of Tennessee?

Investigational, experimental, untested, or non-medically necessary healthcare services are not covered by Ambetter.¹³

Exams, screenings, testing, or immunizations are not covered if they are:

• Required solely for a career, education, sports or camp, travel (including travel immunizations), employment, insurance, marriage, or adoption
• Related to judicial or administrative proceedings or orders
• Conducted for medical research
• Required to obtain or maintain any type of license.

How Much Do Mental Health Services & Testing Cost?

Costs can vary depending on your specific Cigna mental health coverage and personalized treatment needs. The following are average costs for therapy, though they may vary by location and other variables and may not reflect the actual cost of treatment or what you may actually pay. 

For example, In the United States, the typical cost of psychotherapy ranges from $100 to $200¹⁴ a session, dependent upon the state and the length of the session. With health insurance, you’ll most likely have a co-pay that can range from a few dollars to $50 or more a session.  

Cognitive Behavioral Therapy (CBT) sessions are typically 45+ minutes long and cost between $100 and $200 per session, while Dialectical Behavioral Therapy (DBT) usually consists of a weekly individual therapy session, a weekly group therapy session, and weekly phone conversations. DBT costs vary depending on the type of services rendered. 

Such factors, like whether the therapist is in-network or out of network, can influence this out-of-pocket cost. 

Even with insurance, you will normally have to pay some or all of your medical expenditures until your total medical expenses for the year reach the deductible. Depending on your plan, you may be required to pay a co-pay or coinsurance for each treatment. 

Some therapists will work with patients on a sliding scale for those who do not present insurance. If you find a therapist who offers a sliding scale payment plan, they will most likely base the cost of your sessions on your income. This sliding scale can also vary from therapist to therapist.  

Other In-Network Insurance Providers

Aetna
Blue Cross Blue Shield
Cigna
Evernorth
Medicare
Multiplan
Optum
PHCS
TRICARE
United Healthcare
Vanderbilt