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Using Anthem for Drug Rehab: How Will it Work?

Anthem Blue Cross and Blue Shield insurance can cover substance abuse treatment at least partially. The exact amount covered depends on your plan.

This type of insurance is not available everywhere, but it is available in many states.

Anthem Blue Cross Blue Shield is an insurance provider that millions of Americans are covered by in some form or another. According to their website, one in three Americans is covered in some way by a plan under the organization’s parent company, Anthem, Inc. This amounts to around 71 million people.

Overall, Anthem offers coverage in over a dozen states. It also covers those with specialized plans living outside those states.

Anthem insurance plans treat mental health and substance abuse issues similar to other health care needs. Anthem will not cover everything associated with drug rehab, but most plans will offer at least partial coverage.

Coverage

Anthem offers three general levels of plans at different price points. The more expensive plans provide the most comprehensive coverage.

The three main plans are:

  • Bronze. This type of plan covers 60 percent of approved health care costs.
  • Silver. This type of plan covers 70 percent of approved health care costs.
  • Gold. This type of plan covers 80 percent of approved health care costs.

These coverage percentages are averages. Exact coverage will vary, so discuss the specifics of your individual plan with Anthem as well as the treatment provider in question to ensure you are clear on exactly how much you will have to pay out of pocket.

Most insurance plans have a deductible. This is an amount of money you must spend on your health care before the insurance coverage kicks in.

In addition to the above plans, catastrophic coverage is also offered. This is essentially a cheap insurance plan for people who cannot afford a better one. These types of plans are not ideal. If something happens, the coverage can be very low and begin with very high deductibles (over $5,000). These plans are better than nothing, and they conform to the law (meaning some services must be covered), but you should try and get a better plan once you can afford one.

Anthem provides insurance in the following states:

  • California
  • Colorado
  • Connecticut
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Missouri
  • Nevada
  • New Hampshire
  • New York
  • Ohio
  • Virginia
  • Wisconsin

How Will These Plans Affect Rehab?

Anthem’s website touts robust coverage for mental health and substance abuse treatment. Insurance reviewers find that the individual plans provided are reasonable.

Most substance abuse treatment centers have professionals who are knowledgeable about insurance on staff. They can help you navigate any difficulties with coverage. They can help you to maximize your coverage, ensuring you pay the least out-of-pocket costs possible.

coverage plans

Of course, you will need to choose a substance abuse treatment facility that accepts Anthem insurance. Once you have confirmed they take your plan, you will find out what they specifically cover.

Most plans offer a maximum on coverage, and there are specifics on what will be covered when. For example, many plans first require that people attempt outpatient rehab. If outpatient rehab is unsuccessful, someone may then be approved for inpatient treatment.

Many plans set a maximum on the number of days of inpatient care that will be covered in a calendar year. They may also set a limit on the number of outpatient therapy sessions that will be covered in a particular period of time.

Most often, rehab requires approval first. A doctor must deem the treatment medically necessary before insurance covers it.

Certain medications may be covered by insurance. These may include medication-assisted treatments like buprenorphine or methadone, antidepressants, anti-anxiety medications, and other medications that may be used to ease the detox process, such as anti-nausea drugs.

Conclusions

Anthem is a large insurance provider, offering coverage that is in line with industry norms. Their costs are comparable to their competitors.

As with any insurance plan, the exact cost of an Anthem plan will vary depending on things like your age, the plan specifics, and various health risks.

The level of rehab coverage will vary with each plan. Make sure to get the specifics on what you can expect to pay out of pocket before enrolling in a facility. Both an Anthem representative and a representative from the prospective rehab facility can help with this.

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Addiction is a serious chronic disease that has reached epidemic levels in the U.S. Whether you have become dependent on legitimately acquired prescriptions of illicit street drugs, it’s important to seek help immediately. Even though addiction is chronic and difficult to overcome, it is treatable. Through treatment options tailored to your needs and a variety of therapies, you can become addiction-free and start on your road to recovery. Though there are thousands of people struggling with addiction, countless people achieve long-lasting sobriety and go on to live productive lives.

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