AMBETTER

Ambetter Coverage for Addiction Treatment in Albany, NY

Recovery shouldn’t be put on hold while you sort out insurance. At Fusion Recovery in Albany, NY, our admissions team will verify your Ambetter from Fidelis Care benefits, explain what’s covered in plain language, and help you start treatment, often the same day.
fentanyl

Personalized Outpatient Treatment for Albany Residents

At Fusion Recovery, we understand the weight that addiction places on your life and the lives of those you love. That’s why we offer personalized outpatient addiction treatment built around your specific situation, your goals, your schedule, and your recovery needs. As an outpatient rehab serving the Albany, NY region, we provide flexible scheduling so you can stay engaged with work, family, and other commitments while getting the help you deserve. Our team blends evidence-based therapies with medication-assisted treatment, clinical counseling, and holistic support to help you build a recovery that lasts.
As an outpatient rehab serving the Albany, NY region, we provide flexible scheduling so you can stay engaged with work, family, and other commitments while getting the help you deserve. Our team blends evidence-based therapies with medication-assisted treatment, clinical counseling, and holistic support to help you build a recovery that lasts.
If you or someone you love is struggling, contact us today. Our admissions team will verify your Ambetter from Fidelis Care benefits, walk you through your treatment options, and help you take the next step at no cost and with no pressure.

ABOUT AMBETTER IN NEW YORK

Understanding Ambetter from Fidelis Care

In New York, Ambetter is offered as Ambetter from Fidelis Care, a product of Fidelis Care, a Centene Corporation company that serves more than 2.4 million New Yorkers statewide. Ambetter from Fidelis Care plans are Qualified Health Plans (QHPs) sold through the NY State of Health marketplace and are available across 56 New York counties, including Albany County and the surrounding Capital Region.

Ambetter from Fidelis Care offers plans across five metal tiers, Platinum, Gold, Silver, Bronze, and Catastrophic, each with different premiums, deductibles, and out-of-pocket costs. While the structure of each tier varies, all Ambetter plans are required by the Affordable Care Act to cover essential health benefits, which include mental health and substance use disorder treatment.

Under the Mental Health Parity and Addiction Equity Act, Ambetter must cover behavioral health and substance use treatment at the same level as physical health services. That means the same access, the same standards, and the same protections you’d expect for any other medical condition.

OVERVIEW OF AMBETTER BENEFITS

What Ambetter Covers at Fusion Recovery

Coverage details vary by plan tier and your specific Ambetter from Fidelis Care policy, but most plans cover a comprehensive range of addiction treatment services at Fusion Recovery.

Treatment services typically covered

Coverage Details

Out-of-pocket costs, including copays, coinsurance, and your deductible, depend on your specific Ambetter plan and metal tier. Lower-tier plans (Bronze, Catastrophic) typically have lower premiums but higher out-of-pocket costs, while higher-tier plans (Gold, Platinum) have higher premiums but lower costs at the point of care. Our admissions team will verify your benefits and explain exactly what to expect before you start treatment.

Preauthorization Requirements

Some Ambetter plans require prior authorization for medication-assisted treatment, intensive outpatient programs, or partial hospitalization. Fusion Recovery’s admissions team handles the authorization process for you, including any continued-stay reviews if your treatment needs extend beyond the initial approval.

Call Now to Verify Your Coverage

HOW IT WORKS

How to Verify Your Ambetter Benefits

Verification is fast, free, and fully confidential. Here’s how it works:

01.

Share your details

Call us at 1.866.936.2290 or fill out our contact form with your Ambetter from Fidelis Care member ID and group number.

02.

We verify your benefits

Our team contacts Ambetter directly to confirm in-network status, deductibles, copays, prior authorization requirements, and what level of care is covered under your plan.

03.

We explain your options.

The DEA has determined that 2 mg of fentanyl is a fatal amount. However, any amount can lead to overdose or death. The smallest trace can be deadly.

04.

You take the next step.

When you’re ready, we schedule your clinical assessment and help you begin treatment, often the same day.

WHAT WE TREAT

Conditions We Treat at Fusion Recovery

Our Albany, NY treatment programs serve adults struggling with a wide range of substance use and co-occurring mental health conditions, including:

Ready to Take the First Step?

Recovery begins when you reach out. Our admissions team is available to verify your Ambetter coverage, answer your questions, and help you start treatment in Albany, NY. Call anytime, we’re here when you’re ready.

Frequently Asked Questions

01. Is Fusion Recovery in-network with Ambetter?

Fusion Recovery may be in-network with Ambetter from Fidelis Care plans serving Albany, NY and the surrounding Capital Region. Network status can vary by your specific plan and tier, so we recommend calling our admissions team at 1.866.936.2290 to verify your in-network benefits before starting treatment.

Yes. Ambetter from Fidelis Care plans typically cover FDA-approved medication-assisted treatment medications, including Sublocade and Suboxone for opioid use disorder, as well as naltrexone and Vivitrol for opioid and alcohol use disorders. Some medications may require prior authorization, which our admissions team handles for you.

Most Ambetter from Fidelis Care plans don’t require a referral for substance use or mental health treatment, but some specific plan types may. Our admissions team will check the requirements for your specific policy during the verification process.

Federal law (HIPAA and 42 CFR Part 2) provides strong confidentiality protections for substance use treatment records. Your employer is not notified, and Ambetter cannot share your treatment details with anyone without your authorization. Our admissions team is happy to walk you through how your privacy is protected at every step.
Yes. Once your Ambetter from Fidelis Care plan is active (coverage typically starts January 1 for plans enrolled during open enrollment), you can begin treatment as soon as your benefits are verified. Open enrollment for the NY State of Health marketplace runs from November 1 through January 31 each year.

Ambetter from Fidelis Care plans cover a range of substance use treatment services as part of the essential health benefits required by the Affordable Care Act. This typically includes medical detox, outpatient rehab, intensive outpatient programs (IOP), individual and group therapy, medication-assisted treatment, dual diagnosis care, and aftercare. Specific coverage depends on your plan tier.

Out-of-pocket costs depend on your Ambetter plan tier (Platinum, Gold, Silver, Bronze, or Catastrophic), your deductible, and any copays or coinsurance under your specific policy. Our admissions team will verify your benefits and give you a clear picture of any expected costs before you begin treatment.
Most Ambetter benefit verifications are completed within one business day, often within a few hours. In urgent situations, we can frequently verify benefits the same day you call so treatment isn’t delayed.
If your plan limits the duration or level of care, our team works directly with Ambetter on prior authorizations and continued-stay reviews to extend coverage when clinically appropriate. We’ll also discuss options like step-down to a less intensive level of care or other resources if needed.

Call Fusion Recovery at 1.866.936.2290 or fill out our contact form. Our admissions team will verify your Ambetter from Fidelis Care benefits, schedule your clinical assessment, and help you begin treatment as soon as you’re ready.

Disclaimer: The information provided on this website regarding insurance coverage is only a summary. It does not include all limitations, exclusions, or qualifiers that may apply to your actual coverage. Please refer to your health plan's Evidence of Coverage or Summary Plan Description for full details. Treatment services must be medically necessary to be covered. Any treatment decisions must be discussed with your health provider. We cannot guarantee any coverage or reimbursement. Please contact your health plan directly for the most accurate information regarding your benefits.

Take the first step

Providing hope to all. Compassionate outpatient care for our community.
Ready to talk?

Recovery begins when you reach out. Questions?
Call anytime to speak with an Admissions
Specialist, or request a consultation and we’ll follow up.

David Sietz, M.D.

Chief Medical Officer, Fusion Recovery

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HOW WE CAN HELP

Find Treatment for Fentanyl Addiction

After an overdose, it is important to seek medical care immediately. If you or a loved one are struggling with drug addiction, Fusion Recovery is here to help. We have fentanyl addiction treatment options available, including medication-assisted treatment to help alleviate withdrawal symptoms and programs to get you on the road to recovery.

01.

Assessment

A comprehensive clinical evaluation including a physical exam, opioid use history, overdose history, and current symptoms to create a personalized detox and treatment plan.

02.

Treatment

Our program combines medically supervised detox with MAT options including methadone, buprenorphine, and Suboxone, alongside behavioral therapies to address the root causes of addiction.

03.

Recovery

Ongoing therapy, IOP and outpatient options, and structured aftercare help you maintain sobriety long-term. We ensure your treatment plan evolves with your progress toward a fentanyl-free life.
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