AmeriHealth Caritas Pennsylvania is a national leader in health care solutions and one of the country's largest Medicaid management care organizations. Established in Philadelphia in 1983, the organization now helps individuals who are chronically ill and/or living at a low income level. Currently, AmeriHealth Caritas PA serves approximately five million members.
In the face of the opioid epidemic, the organization has been ramping up its opioid addiction resources. In addition to education tools, tangible help is being made available in the form of medications for addiction treatment (MAT) for those living with opioid use disorder (OUD). Learn more below.
OUD treatment benefits for AmeriHealth Caritas members
Addiction AmeriHealth Caritas PA takes a holistic approach to OUD, addressing both the physical and mental components of addiction.
Behavioral health
Behavioral health resources, including drug and alcohol services, are available on a county-by-county basis. As an AmeriHealth Caritas PA member, you can self-refer yourself for help. Depending on the circumstances, you may need a physical healthcare provider to refer you. Healthcare providers can also call provider services for help with referrals.
OUD medications
The organization can connect individuals with physical health treatment, including prescription medications. Although Medicaid does cover MAT, different states have different eligibility criteria and levels of coverage. The good news: In Pennsylvania, Medicaid covers Suboxone® (important safety information), a popular medication used in MAT programs. Suboxone is considered the gold standard of OUD treatment and has been approved by the U.S. Food and Drug Administration (FDA) for OUD treatment since 2002.
Telehealth support
AmeriHealth Caritas PA also provides other services to help address the opioid epidemic, such as coordinating access to naloxone. Sometimes referred to by its brand name, Narcan®, this medicine can reverse an overdose. It can be lifesaving for people living with OUD and valuable for friends and family members to have in their possession.
While it's positive that eligible AmeriHealth Caritas PA members can access Naloxone and Suboxone through Medicaid, many other added costs can make traditional rehab prohibitively expensive. For instance, Medicaid might cover the cost of an inpatient treatment program and medication, but not room and board, education, and vocational services. And if a patient needs help covering caregiver duties during treatment, they can expect to incur even more expenses for services insurance doesn’t cover.
Ophelia’s telehealth services offer a more cost-effective solution, allowing patients to get the help they need from the comfort of their own homes—without disrupting their day-to-day lives. When patients need additional behavioral and peer support, we can connect you with resources your AmeriHealth Caritas PA benefits include.
Ophelia + AmeriHealth Caritas PA partner to provide telehealth OUD treatment
Telemedicine services have transformed OUD treatment in several ways. In addition to providing patients in more rural areas with easier access to care, telemedicine offers increased privacy while reducing daily disruptions. Individuals don't have to worry about missing time off work or organizing child or elder care.
A telehealth appointment for OUD is similar to an in-office visit, except that you meet your provider virtually. With Ophelia, you are connected to your clinical care team via video appointment. If eligible, you will get a Suboxone prescription called into your local pharmacy. You then receive ongoing medical support and maintenance seven days a week.
Ophelia's clinical care teams will even organize at-home drug testing with a discreet kit sent through the mail. Just save the kit until your appointment, log on for your video call, and we’ll walk you through the process of opening the sealed package and providing a urine sample. When you return to your video call, show the clinician all four sides of the cup. The results take about five minutes to show up. Our remote drug testing guide has more details.
Ophelia accepts insurance for a growing number of insurance plans, including Medicaid and ACA-compliant plans for low-income families and individuals. To see if you're covered, find your state using our online coverage tool. The Ophelia team will then confirm your eligibility.
Ophelia's complete treatment guide provides additional details on eligibility criteria and how the process works. You can see if you're a candidate for Ophelia's services by starting with a free 15-minute welcome call.
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