Anthem is a health insurance provider that is part of the Blue Cross Blue Shield network and provides an integrated approach to help improve health while lowering costs and providing peace of mind to its members. Anthem insurance is accepted nationally by a large number of providers and there are more than 30 million people covered. In addition to a wide provider network, Anthem offers insurance coverage for alcohol rehab and mental health disorders.
In this guide, you’ll learn which types of addiction treatment and substance use disorder treatment they provide and any potential benefits and costs.
Does Anthem Cover Alcohol Rehab?
Yes, Anthem has many insurance plans that cover the costs (either partially or fully) for addiction treatment. There are 14 states where Anthem insurance coverage is available, including California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.
Many Anthem plans cover some or all of the below addiction treatment services:
- Assessments and Screenings
- Psychiatric Evaluation and Management
- Detoxification (Detox)
- Inpatient/Residential Treatment
- Intensive Outpatient Program (IOP)
- Outpatient Treatment (OT)
- Group Therapy
- Individual Therapy
- Medical Evaluation and Management
- Wellness and Prevention Services
Any medication costs during substance abuse treatment programs require a separate deductible amount to be met, depending on your specific health insurance coverage.
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Does Anthem Cover Out-Of-Network Addiction Treatment?
Yes. Unlike many other health insurance companies, some of Anthem’s tiered insurance plans might cover addiction treatment and alcohol rehab that is out-of-network. Coverage could be up to 50% after the deductible is met. The exact amount of the deductible will depend on the insurance plan.
For questions related to your alcohol rehab coverage and mental health services under your Anthem health insurance plan, contact our rehab advisors. We are here to help you navigate your policy while maximizing your plan’s benefits and minimizing your out-of-cost expenses.
Does the Anthem Insurance Provider Cover the Cost Of Suboxone?
Suboxone, an opioid medication that reduces the effects of withdrawals and blocks cravings, might be included in your Anthem medication-assisted insurance plan benefits. The exact amount of your copay will depend on your plan.
How Many Rehab Stays Will Anthem Insurance Coverage Provide?
Under many Anthem plans, there are specific criteria related to the severity of illness and intensity of the rehab service that must be met and which will determine how many inpatient rehab stays Anthem might cover. For specific questions related to your plan benefits and residential treatment coverage, contact Anthem’s member services.
Inpatient Treatment with Anthem BCBS
The following inpatient rehab services might be covered, depending on your Anthem insurance plan:
- Screenings and Assessments
- Psychiatric Evaluations
- Medical Examination and Treatment
- Detoxification (Detox)
- Inpatient Rehab Stay
- Aftercare Services
- Individual Therapies
Outpatient Treatment with Anthem BCBS
The following outpatient rehab services might be included with your Anthem insurance company plan:
- Partial Hospitalization (PHP)
- Intensive Outpatient (IOP)
- Group Therapy
- Individual Therapy
- Psychiatric Evaluation and Management
- Assessments and Screenings
Insurance Plans Available Through Anthem Blue Cross Blue Shield
Anthem offers the following insurance plans for addiction treatment and mental health services: Bronze, Silver, Gold, and Platinum. Coverage varies depending on which plan members select.
Bronze plans typically cover up to 60% of costs with lower monthly payments. However, deductibles are often high.
Silver plans typically cover up to 70% of costs with lower monthly payments. While deductibles are lower than Bronze plans, they are still considered to be high.
Gold plans often cover 80% of costs and have higher monthly payments. Deductibles are lower than Silver and Bronze plans.
Platinum plans are the highest tier available, with 90% of costs covered and low deductibles. Monthly payments will be the highest in this tier.
Plan details might vary depending on state.
Will Receiving Treatment at an Alcohol Rehab Facility Cause My Insurance Premium to Increase?
No. It is illegal for any insurance provider within the U.S. to increase insurance premium rates as a result of receiving treatment at an alcohol rehab facility.
Do I Need a Referral From My Primary Care Physician To Receive Substance Abuse Treatment?
You might need a referral from your primary care doctor to receive inpatient treatment and some outpatient treatment services. If your inpatient treatment needs to be lengthened, you might need to be re-evaluated for Anthem to determine if your additional inpatient stay is needed.
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Affordable Care Act and Behavioral Health Treatment
If you’re worried about how you will pay for addiction treatment coverage, know that the Affordable Care Act made it mandatory for insurance companies to provide coverage for alcohol addiction treatment and other mental health conditions. As a result, you might have improved access to behavioral health treatment. This includes Medicaid, Medicare, private coverage, military insurance, and state health insurance.
For assistance selecting an alcohol rehab facility that meets your needs, contact us.
