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Alcohol And Drug Rehabs That Accept Anthem Health Insurance

Dr. Gerardo Sison

Medically reviewed by

Dr. Gerardo Sison

April 11, 2019

Anthem Blue Cross Blue Shield health insurance provides varying levels of substance abuse coverage in their health plans. Determining how to pay for rehab can be stressful. Having health insurance through Anthem can help.

Treatment for substance abuse and addiction can be costly without financial assistance. Under federal law, most health insurance companies in the United States are required to offer some type of coverage for substance abuse treatment.

Using your health insurance to help cover costs can reduce your financial burden and allow you or your loved one to focus on their addiction recovery.

Through Blue Cross Blue Shield, Anthem health insurance offers substance abuse benefits as part of their health plans. Anthem’s behavioral health division provides access to care managers that can coordinate with doctors to find treatment services that can meet your needs.

Does Anthem Cover Alcohol And Drug Rehab Costs?

Anthem health plans that include substance abuse benefits may be able to reduce or cover rehab costs. The amount of coverage can vary depending on your plan and location.

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Anthem health insurance is not available in every state. Anthem currently offers behavioral health insurance in 14 states nationwide, with some specialty plans available for members in other states.

Anthem’s behavioral health division serves 13.8 million members, aiming to provide more accessible and affordable options for mental health and substance abuse treatment.

Substance Abuse Treatment Services Covered By Anthem

For many people, seeking treatment for alcohol and drug addiction can be life-saving. With Anthem behavioral health benefits, you may be able to reduce or cover costs of you or your loved one’s treatment. This can include a variety of commonly-recommended addiction treatment services that may be needed throughout the recovery process.

Drug and alcohol treatment services that may be covered by Anthem include:

  • medically assisted detox
  • inpatient rehab programs
  • dual-diagnosis
  • partial hospitalization programs (PHP)
  • intensive outpatient programs (PHP)
  • family counseling
  • medication-assisted treatment (MAT)
  • other outpatient treatment services

Inpatient Treatment

Addiction is a serious and complex disease that often requires treatment within an inpatient facility. Rehab centers for drug and alcohol abuse offer supervised and structured programs to help people overcome addiction. This involves living onsite for 24-hour specialized care.

Inpatient programs may often include a variety of treatments that can be effective in treating substance abuse. Patients may attend individual counseling, group therapy, and receive medications to ease cravings and withdrawal symptoms. Additional activities may also be offered, as well as dual-diagnosis treatment and family therapy.

Anthem’s behavioral health division recognizes the benefits of these services. Certain factors such as the type of plan and your location may affect your inpatient treatment coverage. You may be required to cover an admission fee or travel out-of-state for a rehab center that accepts your insurance. Talking to an Anthem representative can help you understand your options.

Outpatient Treatment

Recovery from substance abuse is a lifelong process. Outpatient treatment may be necessary to help you or your loved one along in their sobriety. Attending counseling, support groups, and taking prescribed medications can help keep a person on track and reduce their risk for relapse.

Some outpatient services, such as counseling, may be accessed through an individual provider. Outpatient treatment is also offered within some rehab facilities. This includes day treatment programs like partial-hospitalization and intensive outpatient, which may be recommended for patients based on their needs.

Anthem’s Behavioral Health programs offer care coordination services to help members find outpatient treatment that can be covered by their insurance. Out-of-pocket costs for services may vary depending on the type of treatment, the provider, and guidelines specified in your plan.

Medication-Assisted Treatment (MAT)

Both inpatient and outpatient doctors may prescribe certain medications to help ease symptoms during withdrawal and to relieve cravings. People with co-occurring mental health problems may also benefit from prescribed medications.

Medication-assisted treatment, or MAT, is commonly used to treat alcohol and drug abuse. Combining the use of medication and behavioral therapy, MAT is referred to as a “whole-person” approach.

Medications that are provided during detox and throughout the course of treatment may be covered under your Anthem plan. Prescription drug coverage may vary depending on the drug and the policies within your plan. While reduced costs are available for many drugs with insurance, a copayment may be required.

Information about covering prescription drug costs with Anthem insurance may be found in your plan’s description of pharmacy and prescription drug benefits.

Things To Consider Before Using Anthem Insurance For Addiction Treatment

Paying for inpatient rehab out-of-pocket can cost up to tens of thousands of dollars a month, depending on the facility. Using your Anthem health insurance to cover treatment costs can be a more affordable alternative.

Talking to a treatment specialist and Anthem representative can give you a better understanding of how much your health plan will cover. While some treatment services may be fully covered by your insurance, this may not apply for all treatment services or Anthem plans.

You may, for instance, be responsible for paying certain premiums, meeting a deductible, or providing copays. These requirements vary from plan to plan. In most cases, these costs are just a small fraction of typical out-of-pocket costs.

A treatment specialist can help you find treatment options covered by your insurance.

Common Questions About Using Anthem To Pay For Rehab

The process for receiving coverage through health insurance can be confusing. By talking to a treatment specialist and an Anthem representative, you can get a clearer picture of what your health plan can cover.

To avoid unexpected costs and fees during the treatment process, it may be best to reach out to a specialist before entering a treatment program. This can provide you with an understanding of your financial responsibilities upfront, and help you prepare for treatment.

Common questions about using Anthem for treatment costs include:

  • Does my Anthem plan cover medically assisted detox?
  • Does Anthem cover inpatient treatment? If so, what lengths of stay will my plan cover?
  • Would I be responsible for paying an admission fee for an inpatient program?
  • Does my Anthem plan cover medication-assisted treatment?
  • What are my responsibilities if any for premiums, deductibles, and copayments?
  • Do I need to submit any paperwork from my doctor before entering treatment?
  • Will Anthem cover my prescription drug costs?
  • Does Anthem cover outpatient services such as counseling, support groups, and day programs?

How To Find Rehab Centers That Accept Anthem Health Insurance

Our treatment specialists can ease the process of finding a rehab center that accepts your insurance. Finding treatment for yourself or a loved one can be stressful. Having professionals on your side who can help you understand your options can relieve some of your stress.

Contact us today to find rehab centers that accept your Anthem health insurance.

* Disclaimer: is not affiliated with or endorsed by Anthem Health Insurance. Details about Anthem’s coverage are intended for informational purposes only. The specific details of your plan may vary and the specific treatment services you require may or may not be covered.

Anthem - Behavioral Health and Substance Abuse Services, Behavioral Health Medical Necessity Criteria

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