Anthem Insurance Coverage for Rehab Centers

Does Anthem Cover Rehab for Drugs and Alcohol?

Anthem insurance offers comprehensive alcohol and drug addiction treatment coverage, which includes detox and rehab. Review options you have available within your state and for your specific situation, as Anthem addiction coverage varies by each plan. This gives you options so that financial concerns are not a roadblock to receiving the treatment that you need.

Types of Treatment Covered by Anthem Insurance

Anthem substance abuse coverage offers benefits to various types of addiction treatment programs, such as:

• Detox Treatment
• Inpatient Rehab
• Outpatient Rehab
• Medication-Assisted Treatment

How to Check Your Anthem Benefits

To verify your Anthem coverage for alcohol or substance use treatment, you can:

• Go to the login page.
• Register or login.
• Once you log on, you can check claims, review your benefits, find care, or start a live chat.

You may also speak with an Anthem representative to give you the direction you need based on your unique circumstances. American Addiction Centers is in-network with Anthem, which we can help you verify your exact Anthem coverage details.

How to Use Your Anthem Insurance for Rehab

Once you’ve decided to receive addiction treatment, you’ll need to use your Anthem insurance benefits to cover some or all of the cost. An important first step is to determine what the extent of your Anthem coverage is and if you require preauthorization before beginning treatment. You can determine this by contacting an Anthem representative. You can find their contact information on the Anthem website or by checking the back of your Anthem member insurance card. Additionally, you’ll also need to check if the rehab you’re going to is in-network. This can be done by contacting the rehab directly and asking if they are in-network with Anthem. While you can still attend treatment at an out-of-network facility, your Anthem coverage and benefits may be greatly reduced.

How Much Can Anthem Insurance Cover?

The exact amount that Anthem insurance will cover can vary greatly depending on a number of factors. While the Affordable Care Act requires all insurance plans to provide some degree of coverage for medically necessary substance use disorder treatment,  Some of these factors may include:

• The type of Anthem insurance plan.
• Where you receive treatment.
• If a rehab is in-network with Anthem.
• Intensity of treatment.
• Length of treatment.
• Accommodations and amenities offered by a rehab.

It’s important to reach out to any prospective rehab centers before committing to treatment to determine if they are in-network with Anthem.

Do Treatment Centers Need to Be In-Network with Anthem?

In most cases, to receive the maximum coverage from your Anthem insurance plan, you’ll need to attend an in-network facility. In-network facilities will partner with Anthem to provide their members with quality care. While you can still receive treatment at an out-of-network facility, you may see your Anthem benefits severely reduced. It’s important to determine if a rehab is in-network with Anthem before committing to treatment.

Types of Anthem Insurance Plans

Anthem insurance covers 42.45 million medical members in its affiliated health plans, which totals 106 million lives served. One out of eight Americans has medical coverage through Anthem’s affiliated plans. Those working with Anthem companies serve as members as the Blue Cross licensee for California and as the Blue Cross and Blue Shield licensees for several states, including Connecticut, Nevada, and New York.*

From employer group plans, to Medicare and Medicaid, to individual and family plans, Anthem provides coverage for different circumstances and plans to fit individuals.

Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), and assorted hybrid specialty products have been created by Anthem, Inc. affiliated health plans that provide cost-effective services.

• With Anthem Blue Cross HMO Plans, more of the cost of your healthcare is covered more than other plans. You choose either an Independent Practice Association or a Participating Medical Group. You also choose a physician within the group to be your primary care physician.
• With Anthem Blue PPO Plans, medical providers are contracted with the PPO, which includes physicians and hospitals that are within the same network. Members can reduce the cost of their addiction treatment by using those providers within network.

Individual members can select from comprehensive plans down to basic ones. Employer groups have the same option. Additionally, there is a variety of specialty products/services including flexible spending accounts and COBRA (Consolidated Omnibus Budget Reconciliation Act). COBRA gives former employees and their families who lose health insurance the right to continue with group health benefits provided by their group health plan for a certain timeframe and under specific circumstances. For example, situations like the loss of a job or transition between one, death in the family, or even divorce.

Anthem, Medicare, & Medicaid

Each health plan offers different options depending on your age, individual or family situation, financial circumstances, employment status, and the state that you live in. View your options to see what would work for you, while taking the following variables into consideration:

• Individual and family plans cover an individual and/or eligible household/family members.
• This is the federal health insurance program for those under 65 with certain disabilities, over 65, and those with end-stage renal disease.
• This is a health coverage option that is administered by each state but must adhere to the federal requirements. It covers eligible pregnant women, people with disabilities, low-income children and adults, and elderly adults.

How to Find Drug Rehabs that take Anthem Insurance

When an individual is dependent on drugs or alcohol, they will more than likely need to detox in order to safely rid their body of the substances. They do this by discontinuing the use of the substance and by working with medical support staff. Detox may take anywhere from a few days to a few weeks, contingent on what substances the user has in their body, the level of substance dependency, and the support available to the user.¹

American Addiction Centers provide detox in a safe environment with licensed physicians and support staff. We are in-network with many health insurance companies, including Anthem Insurance. For information about how American Addiction Centers can help you or your loved ones find a local treatment facility and recover from substance use, please call our rehab hotline.

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