Does Anthem Pay for Rehab?
Anthem Blue Cross does cover Anthem Blue Cross plans are slightly different, and coverage may vary according to the type of Anthem Insurance plan you have and where you live. However, to be sure about your access to Anthem drug rehab coverage, you will need to check with Anthem Insurance to discuss your plan specifics. In general, however, Anthem Insurance covers many types of substance abuse treatment and rehab, including detox, inpatient, intensive outpatient, and residential treatment.3
Anthem focuses on integrated treatment, addressing mental and physical health simultaneously, with case managers who can help guide your treatment. In addition, Anthem focuses on providing members with evidence-based treatment and access to a carefully reviewed, large network of providers and drug rehab facilities.3 Desert Hope in Las Vegas, Nevada, is a treatment provider that is in-network with Anthem and provides drug rehab programs to help you recover from a substance use disorder.
Using Anthem to Pay for Rehab
It is important to note that, even with insurance, you will have some out-of-pocket costs. Most Anthem plans have some type of deductible, which is the amount of money you have to pay out of pocket before your insurance starts paying for services. In addition, you will also have a co-insurance payment, which is the percentage of charges that your insurance does not cover. Most plans have a yearly out-of-pocket maximum, so after you pay out a certain amount in deductibles and co-insurance, your Anthem insurance will pay 100% of approved services.3
You may also be wondering if family members or your dependents can access Anthem drug rehab insurance coverage. Generally, if a person is listed as a dependent and is on your health insurance plan, then they receive the same coverage and benefits as you do.
How to Check Your Anthem Rehab Benefits
Members of Anthem Blue Cross Blue Shield can call the Anthem Behavioral Health hotline provided on the back of the member card to obtain information on services. Substance abuse services may not require a referral for coverage; however, Anthem may ask for preauthorization in order for services to be covered. Substance abuse and behavioral health services do generally require preauthorization before services are rendered (except in the case of an emergency) in order for the services to be covered by Anthem.
By calling Anthem Behavioral Health, members can talk to a clinical care specialist who can help to determine the appropriate level of care and help to obtain, and offer information on how to obtain any necessary preauthorization for coverage. The clinical care specialist can also connect members with providers within the coverage network or with approved outside providers when coverage allows. Generally, a primary care provider (PCP) can help to provide preauthorization for services as well.
Be sure to check that the required preauthorization is complete before obtaining specialty services, such as addiction treatment services, in order to ensure that these services will be covered. Services may be covered partially or in full, depending on the member’s plan and level of coverage.
Anthem Rehab Coverage
Anthem health insurance plans, like all insurance plans as required by the Affordable Care Act, fall into several categories of coverage. Anthem’s plans are Bronze, Silver, and Gold level plans, with Bronze being the least expensive and Gold being the most expensive. The coverage level of the plans includes:4
- Bronze plans, which cover about 60% of your overall cost of healthcare.
- Silver plans, which cover around 70% of all healthcare costs.
- Gold plans, which cover approximately 80% of healthcare costs.
If you are a Federal employee or retiree, or a family member of a Federal employee or retiree, Anthem offers Blue Cross Blue Shield plans for health insurance coverage, which include:5
- Standard, which provides coverage for in and out-of-network providers.
- Basic, which only covers in-network providers and no deductibles.
- FEP Blue Focus, which only covers in-network providers.
Anthem out-of-state coverage might cover a detox or rehab program, depending on whether the provider is in-network with Anthem. Checking with Anthem to determine your benefits and coverage will help you to determine if you can go out of state for detox or ongoing drug rehab.
Anthem provides Medicare Advantage plans as well.6 Medicare is health insurance coverage for people age 65 and over, as well as people with certain types of medical conditions. All Medicare Advantage coverage plans have to provide the same coverage as traditional Medicare, which means that detox and drug rehab programs are covered services, both on an inpatient and outpatient basis.
American Addiction Centers Accepts Anthem
American Addiction Centers works with many different insurance plans, including Anthem health insurance plans. At American Addiction Centers, you will find evidence-based treatment at numerous locations nationwide, along with caring and compassionate staff who will work with you to develop an individualized treatment plan to help you on your journey to recovery. Call our 24/7 helpline today to speak to a referral specialist. We can be reached at 702-800-2682 or you can use the form below to check your coverage.
- (2020). About Anthem, Inc.
- (2020). Companies.
- Anthem’s behavioral health and substance abuse services.
- Blue Cross Blue Shield. (2021). What’s the difference between bronze, silver and gold plans?
- Blue Cross Blue Shield Federal Employee Program. (2021). Our plans.
- (2021). Medicare coverage with Anthem.
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