Anthem Insurance Coverage For Drug And Alcohol Rehab

Specifically, you may be wondering if Anthem covers rehab treatment. The answer is yes, Anthem does cover rehab treatment.

Published On

December 11, 2023

Dove Recovery's Team

Anthem Insurance Coverage For Drug And Alcohol Rehab

If you or a loved one is struggling with addiction, you may be wondering if your health insurance plan covers rehab treatment. Specifically, you may be wondering if Anthem covers rehab treatment. The answer is yes, Anthem does cover rehab treatment. However, the specifics of what is covered may vary depending on your plan and the state you live in.

Anthem is one of the largest health insurance companies in the United States, with plans available in 14 states. The company offers a range of health insurance plans, including those that cover addiction treatment.

Under the Affordable Care Act (ACA), also known as Obamacare, all health insurance plans are required to cover addiction treatment. This means that if you have an Anthem plan that is compliant with the ACA, you should have coverage for addiction treatment.

What Does Anthem Cover for Rehab Treatment?

Anthem offers a variety of plans that may cover rehab treatment, including HMO, PPO, and POS plans. The specifics of what is covered will depend on your plan and the state you live in. However, in general, Anthem plans typically cover the following:

Inpatient rehab treatment

This is when you stay at a rehab facility for a period of time to receive treatment. Anthem plans may cover the cost of room and board, as well as medical care and therapy services.

Outpatient rehab treatment

This is when you receive treatment while still living at home. Anthem plans may cover the cost of therapy services, medication, and other medical care.

Medication-assisted treatment

This is when medication is used to help manage withdrawal symptoms and cravings. Anthem plans may cover the cost of medication-assisted treatment, such as methadone or buprenorphine.

Partial Hospitalization Programs (PHP)

Partial hospitalization programs (PHP) offer structured programming during the day while allowing individuals to return home at night. PHPs are ideal for individuals who require intensive care but do not need 24-hour supervision.

Intensive Outpatient Programs (IOP)

Intensive outpatient programs (IOP) provide more hours of therapy per week than traditional outpatient programs, making it an ideal option for individuals who need more support than traditional outpatient care but cannot attend inpatient or PHP programs due to various reasons such as work or family obligations.

It is important to note that even if your Anthem plan covers rehab treatment, there may still be out-of-pocket costs. You may be responsible for paying a deductible, copay, or coinsurance. The amount you pay will depend on your specific plan.

Does Anthem Cover Mental Health and Substance Use Treatment?

Yes, Anthem covers mental health and substance use treatment. This is because the Affordable Care Act (ACA) requires all health insurance plans to cover behavioral health services, including mental health and substance use treatment. If you have an Anthem plan that is compliant with the ACA, you should have coverage for these services.

Anthem provides a comprehensive suite of behavioral health services to help individuals manage their mental and emotional well-being. Some examples of these services include:

Therapy and counseling

Anthem offers therapy and counseling sessions with licensed mental health professionals. These sessions can help individuals cope with a range of mental health conditions, such as depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), and more.

Substance use treatment

Anthem covers various forms of substance use treatment, including detoxification services and ongoing treatment for addiction. This may include inpatient or outpatient care, medication-assisted treatment (MAT), and counseling or therapy.

Overall, Anthem's behavioral health services are designed to provide individuals with the support they need to manage their mental health and addiction-related challenges effectively.

How to Find a Rehab Facility That Accepts Anthem Insurance

If you or a loved one is struggling with addiction and have Anthem insurance, it's important to find a rehab facility that accepts your insurance. Here are some steps you can take to find a rehab facility that accepts Anthem insurance:

1. Check Your Insurance Plan

The first step is to check your Anthem insurance plan to see what addiction treatment services are covered and what facilities are in-network. You can do this by calling the customer service number on the back of your insurance card or by logging into your online account.

2. Search Online Directories

Once you have an idea of what facilities are in-network, you can use online directories to search for rehab facilities in your area. Some popular directories include SAMHSA’s Behavioral Health Treatment Services Locator and Psychology Today's directory.

3. Contact Rehab Facilities

After finding potential rehab facilities, it's important to contact them directly to confirm that they accept Anthem insurance and that their services align with your specific needs. You may also want to ask about the programs they offer, their success rates, and any other questions you may have.

4. Consider Location and Amenities

When choosing a rehab facility, it's important to consider factors such as location and amenities. For example, you may want a facility that is close to home so that family members can visit easily, or one that offers alternative therapies such as yoga or meditation.

By following these steps, you can find a rehab facility that accepts Anthem insurance and provides the support you need on your journey towards recovery.

Addiction Treatment Length Anthem Will Cover

Addiction treatment length is an important factor to consider when seeking rehab treatment. The length of time needed for addiction treatment will depend on the severity of the addiction and individual needs. Anthem plans may cover different lengths of addiction treatment, depending on your plan and state.

Generally, Anthem plans will cover 30-day, 60-day, or 90-day programs. In some cases, longer programs may be covered if deemed medically necessary by a healthcare provider. It's important to note that while shorter programs may be more cost-effective, longer programs have been shown to have higher success rates in achieving long-term recovery.

When determining the appropriate length of stay for addiction treatment, both the rehabilitation facility and the insurance company take various factors into consideration. These factors may include:

The duration of substance use

The length of time an individual has been using the substance can impact the recommended length of stay.

Type of substance

Different substances may require different treatment approaches and lengths.

Legal issues

If there have been legal consequences related to substance use, this may be taken into account.

Personal issues

Problems at home, work, or school can also influence the length of stay recommendation.

Mental health

Any coexisting mental health diagnoses are evaluated to determine how they may affect treatment and recovery.

Family history

A family history of addiction may indicate a need for more extended treatment.

Prior treatment attempts

Previous attempts at addiction treatment and their outcomes are also considered.

By considering these factors, the rehabilitation facility and insurance company can develop a personalized treatment plan that meets the specific needs of each individual seeking addiction treatment.

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

If Anthem won't cover the total cost of rehab, there are still options available to help you pay for treatment. One option is to look into financial assistance programs offered by the rehab facility. Many rehab facilities offer sliding scale payment plans based on income or have financing options available.

If you're seeking addiction treatment but are concerned about the cost, there are several options to consider. These include:

Grants and scholarships

Organizations such as the Substance Abuse and Mental Health Services Administration (SAMHSA) and The National Council on Alcoholism and Drug Dependence (NCADD) offer grants and scholarships to help individuals cover the cost of addiction treatment. These programs may have specific eligibility requirements, so it's important to research and apply early.

Non-profit organizations

Some non-profit organizations provide financial assistance for healthcare expenses, including rehab treatment. These organizations may offer sliding-scale fees or other forms of assistance to help individuals afford the care they need.

Health insurance

If you have health insurance, check your policy to see what addiction treatment services are covered. Many insurance plans provide coverage for rehab treatment, although deductibles and copays may still apply.

Payment plans

Some rehab facilities offer payment plans that allow you to spread out the cost of treatment over time. This can be a helpful option if you can't afford to pay for treatment upfront.

Alternative treatment options

If you're unable to find a way to cover the costs of traditional rehab treatment, there are alternative options that may be more affordable. These can include attending support groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), or working with a healthcare professional on an outpatient basis.

Regardless of which option you choose, remember that seeking help is possible and recovery is achievable.

Conclusion

If you or a loved one is struggling with addiction, it's important to know that help is available. Anthem insurance can provide coverage for rehab treatment, including inpatient and outpatient care, medication-assisted treatment, and partial hospitalization programs. While the specifics of what is covered may vary depending on your plan and state, the Affordable Care Act requires all health insurance plans to cover addiction treatment.

Remember that seeking addiction treatment is a courageous step towards recovery. By taking advantage of the resources available to you, including financial assistance programs and alternative treatment options, you can achieve long-term success in managing your addiction.