Anthem health insurance is a subsidiary insurance provider of Blue Cross Blue Shield (BCBS). Both of these companies offer similar insurance plans in different areas of the United States.
People with substance use disorders can use health insurance for a drug rehab program to cover a substantial portion of the cost.
Treatment programs may include behavioral health services in both inpatient and outpatient settings, such as counseling, detoxification, co-occurring disorder care, and more.
How To Use Anthem Insurance For A Drug Rehab Program
Drug and alcohol rehab programs can be very costly. That’s why health insurance plans through companies such as Anthem are an essential part of making substance use treatment affordable.
Anthem insurance plans come in four tiers, each one with different benefits, deductibles, and copayments.
The Bronze coverage plan will cover approximately 60 percent of a person’s medical expenses, including those accumulated at a drug treatment facility.
The monthly premiums for the Bronze plan will be lower, but deductibles will be higher. Deductibles must be paid out-of-pocket before Anthem will begin to cover the costs.
The Silver plan through Anthem is similar to Bronze, but it covers up to 70 percent of medical procedures and expenses. The deductible for the Silver plan will be slightly lower than that of Bronze.
Gold-tier coverage through Anthem has a substantially lower deductible and pays up to 80 percent of medical bills.
People who opt to buy high-tiered plans such as Gold will pay more for their monthly premium, which is the monthly payment for insurance.
The most comprehensive plan through Anthem is the platinum plan. With this tier of coverage, policyholders can expect rehab coverage that includes up to 90 percent of their medical expenses.
While out-of-pocket costs will be minimal during treatment, the platinum plan through Anthem will have the highest monthly premium.
What Types Of Behavioral Health Services Does Anthem Insurance Cover?
Anthem health insurance will cover a wide range of behavioral health services, including both mental health and substance abuse treatment.
The cost of treatment out-of-pocket will be largely dependent on the level of coverage through your or your loved one’s health plan.
Common addiction treatment options Anthem covers include:
- inpatient rehab programs
- methadone maintenance for opioid addiction
- long-term or short-term residential treatment
- partial hospitalization programs (PHP)
- intensive outpatient programs (IOP)
- medication-assisted treatment (MAT) using Suboxone
- sober living homes
- dual diagnosis treatment
- behavioral therapy
- outpatient rehab programs
- support groups for alcohol addiction
It’s recommended that you contact an Anthem representative to learn more about how much Anthem will pay for the treatment program of your choice.
If the cost is still untenable even with health insurance, many rehab facilities will offer payment plans or feature sliding fee scales based on your income to make treatment more affordable.
There are also a number of free rehab centers available in every state that are funded entirely through donations, federal grants, and state funds.
Factors That Affect Anthem Insurance Coverage For Drug Rehab Programs
Currently, Anthem insurance plans can be acquired in a total of 12 states, including Nevada, Kentucky, California, Colorado, Georgia, and others.
When you seek an out-of-network recovery program, or a treatment center located outside of an Anthem state, you may have issues getting the rehab program covered.
Other factors that may influence coverage for a drug rehab program may include:
- the length of stay needed at a treatment center
- the type of insurance policy
- whether the rehab program offers inpatient or outpatient treatment
- prior authorization or precertification requirements
- the diagnosis you receive from a healthcare provider
- whether your health condition can be treated by the covered health benefits of your plan
Questions To Ask Anthem Before Choosing A Rehab Facility
Whether the rehab facility is in-network or out of state, it’s always best to contact Anthem to discuss your health insurance coverage and the potential costs before attempting to enroll at the treatment center.
You can usually find Anthem contact information listed on your insurance card.
Below are some of the pertinent questions you may want to ask Anthem Blue Cross and Blue Shield about your insurance benefits and coverage.
Questions about your Anthem insurance plan may include:
- What levels of care will be covered by my insurance plan?
- Do I need to seek precertification before I can qualify for payment coverage?
- Are there any referrals I need to seek before starting addiction treatment?
- What is insurance verification, and how does it work?
- Can I receive Medicaid or Medicare benefits through Anthem?
- What is the difference between pre-authorization, pre-certification, and pre-approval?
- What is a patient liability, and will I be reimbursed for any out-of-pocket costs?
Find A Drug And Alcohol Treatment Center Covered By Anthem Insurance Today
Finding a drug abuse treatment provider can be stressful, but help is available.
Call our helpline today, and our team will answer your questions regarding health insurance companies and drug addiction treatment.
Published on October 7, 2022
Free Rehab Centers aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Anthem Blue Cross Blue Shield — How To Choose A Health Insurance Plan
- National Institute of Health (NIH) — Why health insurers should pay for addiction treatment
- U.S. National Institute on Drug Abuse (NIDA) — Types of Treatment Programs
- Substance Abuse and Mental Health Services Administration (SAMHSA) — What Does the Affordable Care Act (ACA) Mean for Behavioral Health?