Anthem Insurance Coverage for Addiction Treatment

If you or a loved one is dealing with drug or alcohol addiction, getting appropriate treatment could mean the difference between repeated relapse and sustained recovery. Fortunately, many insurance providers, including Anthem, offer coverage for substance use treatment. The more you know about your benefits, the more readily you can access high-quality care without financial duress.

Anthem, part of BCBS (Blue Cross Blue Shield), is one of the largest health insurance carriers in the United States, covering millions through individual policies, employer-sponsored plans, Medicaid, and Medicare programs. Although the extent of coverage varies based on your specific plan, Anthem typically covers at least part of the cost of detox, outpatient programs, inpatient rehab, and mental health care. Read on to learn more about getting effective and evidence-based addiction treatment with Anthem health insurance.

How Anthem Insurance Supports Addiction Recovery

Substance use disorder—the clinical term for addiction—is a medical condition that requires professional treatment. Since the enactment of the ACA (Affordable Care Act), health insurers must offer coverage for addiction treatment in line with that provided for other chronic conditions.

Anthem offers broad coverage options designed to support recovery, from medical detox to ongoing outpatient care. Whether you need short-term stabilization or long-term treatment, your Anthem plan can help cover essential services. Some addiction treatment options that may be covered include:

Medical detox

Discontinuing the use of drugs or alcohol can trigger withdrawal symptoms ranging from mild to life-threatening. Medical detox provides supervised care to help manage these symptoms and prepare individuals for ongoing treatment. Many Anthem plans cover detox services when deemed medically necessary.

Inpatient rehab

Inpatient or residential rehab delivers continuous care over 30 to 90 days in a structured environment. This level of care is ideal for those who need intensive support, especially those with severe substance use disorders or co-occurring mental health conditions. Anthem insurance often covers at least part of the cost of inpatient rehab for a specified duration based on medical necessity.

PHP (partial hospitalization program)

PHP is a structured treatment setting that bridges the gap between inpatient and outpatient programs. Participants attend therapy sessions and medical appointments during the day or evening, returning home or to a sober living community between sessions. Anthem may cover PHP as a step-down level of care after inpatient rehab. Some people may also initiate treatment in PHP, a core offering at Anchored Recovery Community with Anthem health insurance.

IOP (intensive outpatient program)

IOP enables people to get treatment while maintaining their daily responsibilities at work, home, or school. These programs include group therapy, individual counseling, and educational sessions. Many Anthem health plans cover IOP as part of their behavioral health benefits.

Outpatient therapy and aftercare

Long-term recovery from drug or alcohol addiction demands ongoing support. Outpatient counseling, relapse prevention programs, and aftercare services help individuals stay sober long after leaving rehab. Anthem frequently covers therapy sessions and continued support.

Understanding Anthem Coverage Levels

Anthem offers different health plans, each with varying levels of coverage for addiction treatment. These plans typically fall into one of three categories:

• Bronze: Lower monthly premiums but higher deductibles and out-of-pocket costs. Covers around 60% of medical expenses.
• Silver: Moderate premiums but lower deductibles and co-pays. Covers about 70% of treatment expenses.
  Gold: Higher monthly premiums but lower deductibles and co-pays. Covers roughly 80% of treatment costs.

Some Anthem plans also include Medicaid options, which may cover a greater portion of addiction treatment services. Reviewing your policy details will help establish how much of your rehab costs will be covered.

What Costs Might You Be Responsible For?

While Anthem covers a significant portion of addiction treatment, some costs may still fall on the policyholder. These can include:

• Deductibles: The amount you must pay before insurance begins covering expenses.
• Co-pays: A fixed fee for certain services, such as therapy sessions or doctor visits.
• Co-insurance: A percentage of costs you are responsible for after meeting your deductible.

The exact costs depend on the specifics of your Anthem BCBS plan. Checking your benefits in advance can help you prepare for out-of-pocket expenses and avoid nasty surprises.

How to Verify Your Anthem Insurance Benefits for Rehab

If you’re considering addiction treatment, verifying your insurance coverage is the best first step. Here’s how to do it:

Call the number on your insurance card

Anthem’s customer service representative can help explain your coverage, including what types of treatment are covered and any cost-sharing details.

Use Anthem’s online portal

Logging into your Anthem account allows you to receive benefits, search for in-network treatment providers, and estimate costs.

Contact a treatment center directly

Many rehab facilities have insurance specialists who can verify your benefits and explain what your plan covers. This can simplify the process and provide a clearer picture of your financial responsibility.

Does Anthem Cover Mental Health Treatment?

Since addiction and mental health treatment often go hand-in-hand, Anthem BCBS includes mental health benefits in most of its plans. Coverage may include:

• Dual diagnosis treatment: Programs designed for those battling addictions and mental health conditions at the same time.
• CBT (cognitive behavioral therapy): CBT is proven effective for helping people identify and change negative thought patterns that drive substance use.
• MAT (medication-assisted treatment): Medications like Vivitrol, Suboxone, or methadone may be covered as part of an opioid or alcohol addiction treatment plan.
• Psychiatric care: Access to psychiatrists for medication management and mental health evaluations.

Does Anthem Cover Out-of-State Rehab?

Some people may seek treatment outside of their home state. Anthem offers a nationwide network of providers, and some plans include out-of-state coverage. Anthem’s BlueCard program allows members to engage with treatment at in-network facilities, even when traveling. Confirm coverage in advance to avoid disappointment or unexpected expenses if you’re considering out-of-state rehab.

What if Anthem Doesn’t Cover the Full Cost of Treatment?

If your Anthem plan doesn’t cover all treatment expenses, options remain at your disposal.

• Payment plans: Many rehab centers offer flexible payment options to help spread costs.
• Scholarships or financial aid: Some facilities provide financial assistance for those who qualify.
• HSAs (health savings accounts) or FSAs (flexible spending accounts): These accounts can cover addiction treatment costs.

Get Anthem-Covered Addiction Treatment at Anchored Recovery Community

Making the decision to seek addiction treatment is potentially life-changing. If you have Anthem insurance, you likely have access to a range of covered services that can support your recovery journey and remove financial barriers from your path to sober living.

Whether you need detox, outpatient treatment, or a more intensive outpatient program, understanding your Anthem benefits can help you move forward confidently and make more informed treatment decisions.

Reach out to Anchored Recovery Community today for immediate assistance. We can help you verify your benefits and explain the treatment type most suitable for your needs and recovery goals. Call (844) 429-5554 and kickstart your recovery right away.

FAQs about Anthem Insurance and Addiction Treatment