Does Anthem Insurance Cover Drug Treatment?

  If you have a drug addiction problem, it’s vital to seek rehab treatment as soon as possible. For many people, their first concern when it comes to moving forward with addiction treatment is the thought of insurance coverage. You might be wondering about your Anthem rehab coverage and whether it will provide benefits for […]

 

If you have a drug addiction problem, it’s vital to seek rehab treatment as soon as possible. For many people, their first concern when it comes to moving forward with addiction treatment is the thought of insurance coverage. You might be wondering about your Anthem rehab coverage and whether it will provide benefits for treatment.

Anthem is an independent licensee of the Blue Cross and Blue Shield Association and offers a wide range of plans for its members.1 It serves members in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.1 Members with a specialty plan have access in other states as well.1

You can take the first step in seeking addiction treatment by checking your Anthem insurance coverage. Simply call the number on the back of your insurance card and speak to a representative about what your plan will cover. You can also contact a rehab center in your area and ask if they are an Anthem behavioral health provider. Moving forward to find out more about your Anthem health insurance is taking the first step on the journey to sobriety.

Anthem Insurance Coverage

The Anthem healthcare plans will provide various types of treatment programs for addiction. You can speak with a rehab therapist about which type of treatment program is best for you. Some of the determining factors include what type of substance you are using, how long you have been using it, and how much you were taking. A rehab coordinator can help you plan a course of treatment that will work with your Anthem Insurance drug treatment plan. Here are some of the programs you might encounter: 2

  • Inpatient/residential rehab: This type of program consists of around-the-clock therapy and rehab.
  • Outpatient rehab/therapy: During outpatient therapy, you’ll attend treatment as much as needed based on your need.
  • Intensive outpatient programs (IOP): IOPs are ideal for people who have more extensive outpatient needs. You’ll attend rehab several hours a week.
  • Partial hospitalization programs (PHP): This program is similar to a residential program, except you go home at night.

Mental Health Coverage by Anthem

Struggling with a mental health condition while also having a substance use disorder is overwhelming and requires specialized help. When you have these two conditions occurring together, it’s referred to as a co-occurring disorder.3 Co-occurring disorders are common among people who have substance use disorder, according to the National Institute of Mental Health.3 It’s critical to use your Anthem mental health coverage to treat both conditions so that you minimize the risk of a relapse. It is also helpful to work with an addiction center that specializes in co-occurring disorders.

You don’t need to worry about Anthem coverage for a co-occurring disorder, because under the Affordable Care Act, insurance providers must cover mental health care and substance abuse treatment.4 This allows you to seek treatment for a co-occurring disorder or a stand-alone drug addiction issue.

Anthem Insurance Rehab Coverage Duration

Getting the right addiction treatment is critical to your success and healing. You may wonder how long you will be in a rehab program and if your Anthem insurance will cover the duration. These are valid questions, and the answers will vary depending on the specifics of your case.

However, research shows that a longer time in treatment produces better results.5 The NIH recommends at least 3 months in rehab for a better chance at minimizing a relapse.5 You can continue to attend outpatient therapy after the initial stage of treatment. This can strengthen what you’ve learned in rehab and assist you if you run into temptations or problems.

To check the specific coverage for Anthem Insurance drug treatment programs, call the phone number listed on the back of your insurance card. The administrator can look up your policy and give your plan’s information.

Rehabs Not Covered by Anthem Insurance Policy

What can you do if you opt to go to a rehab that doesn’t accept Anthem insurance, or if your Anthem Insurance rehab covers only part of the detox and therapy services you need? Many drug addiction rehab facilities will help with the costs by offering financing or scholarship awards. Some have sliding-scale fee adjustments that are based on your income, while others can provide a discount for any costs that your insurance does not cover.

It never hurts to ask what type of financial assistance is available. The main goal is getting addiction treatment right away. Don’t delay your well-being and happiness.

Anthem In-Network vs. Out-of-Network Rehab Centers

You will have to select from one of the in-network Anthem Insurance drug treatment providers if you have an Anthem HMO. This means the providers work with your insurance company on a contract basis to keep the costs down. 6

Visiting an out-of-network facility will cost you more out-of-pocket.6 You can find out whether a facility or doctor is in-network by following these steps:

  • Go to the main portal for Anthem here.
  • If you are already a member, log in and begin your search.
  • If you’re not a member, you can search by selecting the guest option.
  • You will select the type of care you want. For substance abuse care, you should select “Medical.”
  • Next, enter the state where you are seeking treatment, the type of plan you have, and the type of network. Drop-down menus offer options for each question.
  • On the next page, enter your zip code. You can search for a specific facility or look at the list of “Common Searches.”

Remember, you can also check directly with the rehab facility to see if they are in-network.

Check Anthem Coverage for Addiction Treatment

Anthem offers a range of plans for addiction. With Anthem Insurance detox treatment available nationwide, you are sure to find a provider near you to help with your substance use disorder. Whether you have an employer-sponsored plan, Medicare, or a federal employee plan, there are several options for addiction treatment. The state you live in largely determines the type of plan you likely have. Be assured that coverage for behavioral health and substance abuse is mandated through the Affordable Care Act. 4

Don’t delay reaching out for help for an addiction problem. At American Addiction Centers (AAC), we can verify your insurance coverage right now. Just complete the form below and receive an answer right away. If you would rather talk to someone on the phone, call the AAC helpline. Take the first step today to seek addiction treatment.

Let’s verify your coverage for addiction treatment at an American Addiction Centers location. Your information is always confidential.

Sources:

 

  1. (2020). Company History.
  2. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide: Types of Treatment.
  3. National Institute of Mental Health. (n.d.). Substance Use and Co-Occurring Mental Disorders.
  4. gov. (n.d.). Mental health & substance abuse coverage.
  5. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide: Principles of effective treatment.
  6. (2021). Understanding Your Health Plan’s Network.
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