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Anthem Insurance Coverage for Drug and Alcohol Rehab

One of the largest health benefits companies in the country, Anthem, Inc. companies provide a variety of health services through a broad portfolio of integrated health care plans and related services.1 Those with Anthem insurance may have confusion about what exactly their insurance plan covers when it comes to substance abuse and mental health services. Does Anthem cover the cost of drug and alcohol addiction treatment? Yes, Anthem Health Insurance provides at least some coverage for drug and alcohol detox and rehabilitation, but this page is intended to help you figure out what your Anthem healthcare does and does not cover.
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Yes. Anthem covers drug and alcohol rehab.
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Does Anthem Cover Drug and Alcohol Addiction Treatment?

Yes, Anthem does provide at least some coverage for inpatient and outpatient alcohol and substance abuse treatment services, although the amount of coverage can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your insurance plan level. The Affordable Care Act (ACA) requires that insurance companies provide some degree of coverage for mental health treatment, which includes substance use disorder (SUD) treatment, including coverage for drug and alcohol addiction, so Anthem does cover drug and alcohol addiction treatment.2

Anthem, Inc. is an independent licensee of the Blue Cross and Blue Shield Association and provides insurance to people in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin; and specialty plan members in other states.Anthem Blue Cross and Blue Shield’s Behavioral Health programs include mental health and substance abuse benefits as part of its insurance plans.3

With an Anthem plan, key features of your care include:3

  • Access to behavioral health providers, including physicians and therapists.
  • Access to contracted facilities.
  • Management of your treatment by licensed care managers.
  • Evaluation for facility-based mental health and substance abuse treatment.
  • A credentialed network that includes programs for intensive outpatient and residential treatment.

The amount of coverage you have can vary widely based on your state of residence, whether the rehab facility is in- or out-of-network, the length of your stay, and your insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.

What Are the Coverage Levels and Plans for Anthem?

It’s always best to be sure about what your healthcare benefits entail. You don’t want to be caught by surprise with unexpected financial costs. You may wonder if Anthem covers drug and alcohol rehab treatment, and the only way to really have the answer is to check your Anthem health plan coverage. Knowing exactly what Anthem plans cover can give you peace of mind while you or your loved one is in a rehabilitation facility. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. Call one of our admissions navigators at , click here, or fill out the form below.

What Rehab Centers Take Anthem Insurance?

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have an Anthem insurance plan, the following AAC facilities accept Anthem for drug and alcohol addiction rehab.

  • AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and telehealth.
  • Desert Hope Treatment Center: Located in Las Vegas, Nevada, Desert Hope provides bespoke care programs as well as offering a full continuum of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, and telehealth.
  • Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers customized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth, all in a luxurious setting with high-end amenities.
  • Laguna Treatment Hospital: Located in Orange County, California, Laguna is a chemical dependency recovery hospital that focuses on treating people who are medically compromised and need 24/7 oversight. Provided care includes detox services, residential treatment, dual-diagnosis treatment inpatient treatment, and intensive outpatient services.
  • Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and telehealth, all with tailored treatment programs.
  • Sunrise House Treatment Center: Located in Lafayette Township, New Jersey, Sunrise House provides treatment for people suffering from substance abuse from a medical and holistic standpoint. With various evidence-based therapeutic interventions, personalized care is provided through detox, residential treatment, dual-diagnosis treatment, and outpatient services.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Anthem insurance.

Do Treatment Centers Need to Be In-Network?

In-network providers have a contract with the insurance carrier to offer services at a set price. This means that your out-of-pocket expenses will typically be lower than if you choose an out-of-network facility. In some cases, you may even be responsible for the full cost of drug and alcohol rehab if you choose an out-of-network facility.

Whenever possible, try to choose a substance abuse facility that is in-network with Anthem. If you are unable to find an in-network provider or prefer a rehab facility that is out-of-network, you may be able to work out a payment plan with the facility so you can pay back the cost of treatment over time.

Different Types of Anthem Substance Abuse Treatment

Getting the proper addiction treatment is essential for your recovery effort. The type of treatment plan you need will depend on the severity of your addiction and where you are in the journey to well-being. You might start out at one level of treatment and work way to another level, then continue until you don’t need treatment for drug and alcohol addiction.

Some of the treatment programs you can expect to be covered through Anthem include:6

Medical Detox Programs or Facilities

During a detox program for drugs and alcohol, clinicians will assist you as you go through the withdrawal stage of recovery. Medically managed detox ensures that you are comfortable and safe as you go through any uncomfortable, painful, or potentially dangerous withdrawal symptoms.

Inpatient or Residential Treatment

This treatment program is also a residential program because patients will stay overnight and be under medical supervision.

Partial Hospitalization Program (PHP)

Partial Hospitalization Program provides therapy and treatment most days of the week for several hours a day.

Outpatient Therapy

Outpatient rehabs or programs may be intensive or just once a week, depending on your situation. They allow you to obtain treatment while living at home.

Addiction Treatment Length Anthem Will Cover

The expected or typical length of stay varies widely among treatment centers. Some common lengths of inpatient rehab treatment can be 30 days, 60 days, 90 days or longer. The length of stay will depend on your circumstances and needs.

When considering the length of stay that is appropriate for each person, the rehabilitation facility and the insurance company will consider the following factors:

  • How long you or your loved one has been using the substance.
  • The type of substance that is being abused.
  • Whether or not there have been any legal repercussions so far for using the substance.
  • Problems at home, work, or school.
  • Any coexisting mental health diagnoses.
  • Family history.
  • Whether there have already been less involved levels of addiction treatment – and what the outcomes were for such prior attempts.

How to Verify the Coverage of Your Anthem Plan?

The cost of drug and alcohol addiction treatment will vary from person to person. It will depend on the treatment center, the type of program attended, and specific services received.

Before deciding on a rehab facility, check your Anthem policy benefits to determine which costs will be covered by your health insurance plan and which will be out-of-pocket for you. Call the number on your insurance card or log in to your account on Anthem’s website to determine how much you may need to cover in terms of copays and any deductible that must be reached before coverage kicks in for the services you need.

American Addiction Centers can also verify your insurance coverage for you. Visit our insurance verification page, enter your information, and you will immediately be able to see if the rehab center you are considering is in-network with Anthem.

What Should I Do if Anthem Won’t Cover the Total Cost of Rehab?

Covering the cost of addiction treatment may feel like one of the biggest challenges for those seeking drug or alcohol treatment. Many rehab facilities will work with you in figuring out how to have access to treatment and make it affordable.

There are other resources to help you cover the cost of substance abuse rehab. You can check with the rehab center for a sliding scale fee or payment arrangement. Additionally, some facilities offer financial aid or scholarships for treatment. If those options aren’t available, you could try to get a loan from family or friends.

Here are some financial resources that can help:

So, can you use your Anthem insurance coverage for drug and alcohol addiction treatment? Yes, you can! The specific details and how much the insurance pays for will depend on your plan and the provider you choose. However, there are options to help you pay if your health insurance doesn’t cover the full cost.

What’s most important is that you can get the help you need to treat substance abuse. There is a lot of information regarding health insurance that can be confusing and perhaps overwhelming. If you would like some help in sorting through this information to the get the addiction treatment you need, make sure to call your insurance company or speak to one of our admissions navigators today. They can outline the details of your plan and help guide your search.

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More Questions About Anthem Insurance Coverage for Drug and Alcohol Rehab?

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Sources

  1. Anthem. (n.d.). Company History.
  2. Healthcare.gov. (2021). Mental Health and Substance Abuse Coverage.
  3. Anthem. (n.d.). Anthem’s Behavioral Health and Substance Abuse Services.
  4. Anthem. (n.d.). How to Choose a Health Insurance Plan.
  5. Anthem. (n.d.). Medicaid and State-Sponsored Programs.
  6. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.
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