Anthem Health Insurance Coverage for Addiction Treatment

Using Anthem Health Insurance Coverage to pay for addiction treatment: Many drug and alcohol treatment centers accept Anthem insurance. Depending on your plan and the treatment provider that you choose will determine what Anthem will cover. With so many addiction rehab centers that accept Anthem insurance, it is best to know exactly what your coverage will pay before deciding which program to choose for your recovery. Some rehabs we work with are in-network with many providers including Anthem, which means that your treatment may be fully covered or partially covered depending on your insurance plan. You can also call us to find out if there are any drug rehab centers nearby that take Anthem Insurance. Most insurance plans will cover drug and alcohol rehab treatment programs. When the Affordable Care Act was passed, it helped more Americans have access to most forms of addiction treatment. If you would like to find out more about drug rehab programs near you, give us a call and we can get your insurance verified today. 

1-800-513-5423

What you will learn:

• Does Anthem insurance cover alcohol and drug addiction rehab?
• What Types of Rehabs Does Anthem Insurance Cover?
• Does Anthem cover medication-assisted treatment programs (MAT)?
• Sober Living Covered by Insurance
• How to verify my insurance
• How you can check your Anthem insurance benefits

Does Anthem insurance cover alcohol and drug addiction rehab?

Anthem does cover drug and alcohol treatment programs. Depending on your plan and list of providers, you may be out little to no out-of-pocket expense for your rehab stay. Every Anthem insurance plan is comprehensive and will include the following essential services:

• Pediatric services
• Emergency services
• Therapeutic services including physical therapy
• Prescription drugs
• Wellness preventative services
• Laboratory services
• Mental health and substance abuse services
• Detox
• Hospitalization

Depending on your plan you may have higher out-of-pocket expenses including co-payments. Coverage plans are broken into three categories and two different types of plans.

The 3 different insurance plans available

Bronze Plan is the Anthem basic plan which will cover essential services with a high deductible. This plan has the lowest monthly premiums but has the highest deductible.
Bronze plans cover about 60 percent.

Silver Plan is the balanced care plan. Arguably the best value for the everyday person. The Silver Anthem plan offers a balance between deductible and the premium you would pay.
Silver plans cover about 70 percent unless you're eligible for the cost-sharing reduction.

Gold Plan by Anthem also known as the Anthem secure care plan, offers a low deductible with a high premium. This plan will lower the out-of-pocket expense for those needing extensive care. 
Gold plans cover about 80 percent.

With the three plans available there are 2 different types of insurance coverage HMO and PPO. HMO plans use a primary doctor who recommends further treatment at one of the contracted providers from the list they have been given by the insurance company. With PPO plans, you can go out of network to find a program for your recovery. With that being said it is less expensive usually to stay in-network as your insurance provider has negotiated the price they are willing to pay for treatment and you will never see a bill outside of your initial co-payment.

What Types of Rehabs Does Anthem Insurance Cover?

Anthem will pay for inpatient substance abuse treatment for drug and alcohol dependency. The amount of coverage depends on a variety of factors, including the location of treatment, and the type of insurance plan you have chosen.

Anthem will cover part, or all your detoxification needs as long as it is medically needed. You may need to get a doctor’s approval before being covered just to make sure that it is necessary and medically needed to ensure your safety. Depending on the level of addiction and physical dependency will determine if they cover the costs of detox.

Anthem insurance plans generally cover outpatient treatment programs, levels of coverage depend on the plan you have chosen. Outpatient treatment programs offer substance abuse counseling, and alcohol dependency programs on specific days at specific time, for group therapy, individual counseling sessions, and other treatment sessions. Outpatient rehabs do not have housing normally, so you stay at home or in a sober living environment while enrolled on their program.

Does Anthem cover medication-assisted treatment programs (MAT)?

Anthem uses ASAM criteria to determine which services are medically necessary including MAT services. Mat is approved by the (FDA) food and drug administration and is used in conjunction with counseling and therapy to help address the underlying issues that have led to the addiction in the first place. The FDA has approved specific medications for different drugs including alcohol, opioids, and benzodiazepines. MAT may be covered by your insurance plan, but it will depend on your coverage and what the treatment program you have chosen recommends and deems medically necessary.

Sober Living Covered by Insurance

Sober living can be used in conjunction with outpatient treatment, and for aftercare programs to give a safe place to transition from inpatient rehab to life back in the real world. This important step in the recovery process may be covered by Anthem insurance plans. Sober living can be thought of as a less restrictive program than an inpatient treatment program. Your Anthem insurance may cover this form of treatment depending on your policy and the plan you have chosen.

Sober living environments have their own set of rules, curfews, and schedules, and administer drug and alcohol tests to ensure the safety of the group. These sober living homes provide a safe space while providing an opportunity to recover while living a life free of substance addiction. Learning to navigate life and relearn to have fun without the need to self-medicate is an important part of everyone’s recovery. Sober living gives the person a good start on living a life and enjoying activities without drugs or alcohol.

How to verify my insurance

When you have decided to get help for substance abuse or alcohol dependency, the last thing you need is to try and navigate the world of insurance. This can be overwhelming and lead to frustration. Fortunately, there are admissions specialists at drug rehab centers who are here to help you navigate such problems. If you have Anthem insurance, you may be covered for part or all of your treatment for alcohol or substance abuse. It does not matter if you are struggling with alcohol dependency or drug addiction, Anthem insurance can help cover expenses related to the treatment for addiction.

How you can check your Anthem insurance benefits

If you would like to speak to an Anthem representative and find out which providers are in-network with your current plan, call the number on the back of your insurance card. Your health insurance representative will be able to discuss the entirety of your behavioral health benefits. Anthem representatives are available most business days. Anthem also has its own online insurance portal where you can confirm your insurance coverage benefits.

If you have found a treatment center that you would like to go to, you can also have the center contact your insurance company and inquire about having your insurance cover your addiction treatment services at the center of your choice. Our addiction specialists can help you verify your insurance coverage today. Our admissions specialists are available to help you 24 hours a day 7 days a week. 

1-800-513-5423

Sources

Elevance Health

FEPBlue.org

BCBS Insurance Tiers

Medications, Counseling, and Related Conditions

Erik Epp – Content Author