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Does Anthem Pay for Rehab?

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Does Anthem Cover Addiction Treatment?

You have made the important decision to seek out assistance for a substance use disorder, and that alone is a brave and difficult decision. As you begin to research treatment facilities, you will start to notice that they may not be as affordable as you would like them to be. The good news is that insurance companies are required by law to provide at least some compensation for rehab as it is considered a mental health service. You can learn more about Anthem and their addiction treatment options below.

About Anthem

Anthem, also referred to as Anthem Blue Cross and Blue Shield (BCBS) and formerly known as WellPoint, is one of the most reputable, long-standing health insurance companies in the US. You will find that Anthem is available in 14 states at this time. However, with the independent licensing of BCBS providers, you should be able to find coverage in most states.

The company is affiliated with a wide array of partners to provide highly comprehensive and seamless health benefits services. In total, they represent roughly 79 million individuals, with 41 million of those clients having some sort of health plans. They also offer affiliated services outside of your state of residence to ensure that you receive the same quality of care while you travel or visit friends and family in other regions. The type of coverage you receive for addiction treatment will vary based on your plan and your state.

Types of Coverage

Anthem and their partners offer several types and levels of health insurance plans. You have a number of options when choosing a plan. Most people choose between four primary plans:

Silver: The silver plan covers roughly 70% of medical expenses. In turn, you will be responsible for slightly more in premiums and slightly less in out-of-pocket fees.

Platinum: This plan is only available in California at this time. You will pay the most for premiums without any deductible. Emergency services, preventative care and regular doctor visits are all covered.

You can choose from the extensive list of providers made available in the BCBS network throughout the US. Individuals do not have to commit to one of the plans listed above if you meet the medical eligibility standards as outlined by their coverage. It is also important to note that Anthem does offer both Medicare and Medicaid insurance options through various affiliate companies in some states. The company also supports state-sponsored health programs in certain cases.

Reviewing Your Specific Benefits

If you are unsure about your exact benefits regarding addiction treatment, you can always call or email customer support at Anthem. Be sure to have your insurance number ready to make the process more efficient for all involved. The Anthem website also provides extensive details regarding various types of benefits within each plan. On the website, Anthem offers a highly useful tool that enables you to estimate the cost of different types of services.

Those who are covered by the Federal Employees Health Benefits Program could have Anthem BCBS insurance. Many federal employees have the opportunity to be covered by Anthem insurance. This includes postal workers, Department of Defense employees, Department of Energy individuals and families, Health and Human Services workers, and more. Retirees and federal employees have access to three different types of plans:

Basic: You will have no deductible with this plan; however, you will be responsible for certain medical coverage. Individuals with this plan can choose from preferred providers.

s coverage will greatly depend on your exact addiction, the length of time you expect to stay, whether or not the treatment is medically necessary, potential legal consequences of your addiction and more.

For your addiction to be considered medically necessary, you must meet several guidelines. It will be required that a physician provides a written statement that treatment is necessary for you to function well. The amount of treatment your insurance company will cover is also dependent on the state in which you reside. You should be able to transition from inpatient coverage to outpatient coverage relatively easily. In some cases, high-end amenities might even be covered, such as private rooms, more frequent visitation privileges, acupuncture, spa services and online access.

Is Addiction Aftercare Included in Anthem Health Plans?

Much like addiction services offered by Anthem, your aftercare treatment services will be covered based on your plan. As addiction can often lead to additional health complications, your continued medical visits will likely be covered. You will also require continued therapy as part of your aftercare services. As part of the Anthem behavioral services offerings, therapy of all types is typically covered in most plans.

It is often recommended that you continue with mindfulness activities, exercise and healthy eating as part of your aftercare routine. Some health care plans by Anthem offer financial assistance with gym memberships and other alternative health maintenance and prevention programs. This will also vary based on state and by insurance plan. In some states, you can also be reimbursed for healthy food programs and nutritionists.