Anthem Rehab Coverage
Anthem insurance offers rehab coverage. Anthem insurance is one of many independent insurance providers under the national network of Blue Cross Blue Shield (BCBS) insurance companies.
Anthem BCBS health insurance plans offer healthcare throughout the nation, but residents must live or work in one of the following states:
- New Hampshire
- New York
All Anthem BCBS health insurance plans cover some mental health and drug addiction treatment services. Nevertheless, the amount covered varies between healthcare providers and can depend on your location, chosen plan, the treatment methods you’re considering, and other variables.
Do you need to find an insurance plan for yourself or a loved one that covers the cost of drug abuse treatment? If you need help to understand your insurance benefits, especially as they apply to addiction treatment, Zinnia Health is in-network with Anthem insurance. Learn more about Zinnia Health’s treatment facilities by calling (855) 430-9439. Our helpline is completely free and available 24 hours a day.
Does Anthem Blue Cross Blue Shield Insurance Cover Alcohol Rehab?
Yes, Anthem covers alcohol treatment services.
The Affordable Care Act established certain essential benefits for insured individuals, and alcohol rehab and substance abuse treatment are considered essential care services. All insurance carriers in the Marketplace, including Anthem BCBS, must cover at least a portion of the costs associated with alcohol rehab and substance abuse and substance use disorders (SUDs). Some companies may only cover evidence-based — and not experimental — therapies.
Often, entering alcohol rehab requires detox before entering a residential treatment facility or beginning an outpatient program. With outpatient rehab, you may need to consider expenses like per-visit copays. There may also be a limit on the number of visits per policy period. If you exceed your visits, you may have to pay out of pocket.
Does Anthem Blue Cross Blue Shield Insurance Cover Substance Abuse Treatment?
Yes, Anthem BCBS covers substance abuse treatment.
Anthem Blue Cross Blue Shield plans offer insurance benefits to cover both inpatient and outpatient substance abuse treatment programs. If you don’t yet have coverage or want to find a provider in your area, you can use Anthem’s free Find Care tool.
Substance abuse treatment often involves an inpatient program, but it’s important to consider exclusions and restrictions. For instance, the rehab center may need to request prior authorization before providing services. It’s a good idea to verify what your policy covers — not all plans cover rehab facilities offering experimental (or experiential) treatments.
Your actual coverage could be as high as 90% of your total treatment costs, but this varies by plan.
Does Anthem Blue Cross Blue Shield Cover Mental Health Treatment?
Yes, Anthem covers mental health treatment services and other behavioral health care.
Anthem Blue Cross Blue Shield plans cover mental health disorders and related treatments. However, coverage for substance abuse and mental health services is in the same category and share coverage on your plan, so this might mean that drug rehab could reduce your coverage for mental health services. Health benefits generally reset at the start of a new policy period.
Anthem BCBS Inpatient Coverage
The level of coverage provided by Anthem BCBS for inpatient treatment options depends on your plan. However, your insurance will pay some portion of your inpatient treatment costs. There is no out-of-network care for some plans, such as an Anthem BCBS Gold level HMO.
Many health insurance providers, including Anthem Blue Cross and Blue Shield, cover drug abuse treatment but may limit coverage of certain services. For instance, experimental treatment methods, such as hypnotherapy, or experiential treatment methods, like those at outdoor or wilderness camps — even if the program is for helping people with mental health or substance use disorder — may not be covered.
Anthem BCBS Outpatient Coverage
Outpatient treatment is covered for those with an Anthem health insurance plan, but the coverage level depends on your plan type. If you don’t have a plan yet, several Anthem Blue Cross Blue Shield plan types exist.
When assessing plan benefits, it’s important to consider coverage caps. For instance, some plans may not cover any out-of-network doctor visits at all, while others may have a cap on the number of visits or “stays” per policy period.
Intensive outpatient treatment programs or partial hospitalization programs (PHPs) may:
- Require prior authorization for coverage.
- Demand several appointments each day or week.
If you forget to obtain your primary care provider’s authorization or the demands of your chosen program don’t align with your policy benefits, you could be looking at potentially high out-of-pocket costs.
If you need assistance finding your insurance coverage information, reach out to a compassionate admissions specialist at Zinnia Health by calling (855) 430-9439. With your permission, we can contact your insurance company on your behalf and find out your exact levels of coverage.
Rehabs That Accept Anthem Blue Cross Blue Shield Insurance Near You
Regardless of its state of origin, BCBS coverage applies across the nation. If you’re looking for an in-network facility that accepts Anthem Blue Cross Blue Shield insurance, look for an inpatient or outpatient rehab facility operated by Zinnia Health.
Zinnia Health offers convenient locations around the country. We’re an approved, in-network provider for Anthem health insurance. Our substance abuse treatment specialists are especially experienced with clients in need of dual-diagnosis treatment.
Our locations include:
- Rhode Island:
If you would like to speak with a treatment specialist who can help you find in-network drug and alcohol rehab programs in your area, reach out to Zinnia Health at (855) 430-9439 to learn more.
How to Check Your Anthem Blue Cross Blue Shield Coverage
With more than 30 independent providers in the national insurance network, speak directly with your Anthem Blue Cross Blue Shield insurance provider. Anthem BCBS also offers a quick video to help you learn more about the Anthem network of providers.
- Locate your insurance card. You will need to know the first three characters of the Identification Number shown on your card.
- Head to the Anthem insurance website. Follow Anthem’s login instructions.
- Find your information. Search for or compare plans as a guest or log in to your account on this page to view your benefits.
If you’re having trouble using this online service, consider downloading Anthem’s Sydney Health App from Google Play Store for Androids and Apple Store for iOS devices. Once you have Sydney, you can chat live with an Anthem representative to answer your questions.
Anthem can help if you haven’t received your card or you can’t find it. Medicare recipients receive a physical card in the mail, while all other plan types have the option of a physical card or Anthem’s digital ID card, which is stored in the Sydney Health app.
Types of Anthem Blue Cross Blue Shield Plans That Cover Addiction Treatment
All health insurance plans cover addiction treatment, but the coverage amount varies depending on the type of plan.
- Bronze plans typically cover 60% of the costs of most services, including mental health and substance use disorder treatment. This means you’re responsible for 40% of the costs.
- Silver plans typically cover 70% of the costs of most services, including mental health and substance use disorder treatment. Your responsibility will be 30% of the costs.
- Gold plans typically cover 80% of the costs of most services, including mental health and substance use disorder treatment. You’ll be responsible for 20% of the costs.
- Platinum members enjoy 90% coverage for most healthcare services and only 10% out-of-pocket costs.
These plan tiers align with the standards set by the Affordable Care Act. However, your plan may cover substantially more (or less), depending on variables like your deductible, your coinsurance costs (if any), and whether you have personal accident, vision, dental, or other care included in your plan.
In addition to checking your coverage, you also need to assess your annual deductible, out-of-pocket maximum, and access to out-of-network services. For instance, if your plan has a low annual deductible of $500, you only have to pay that amount for your care, and then your plan’s coverage takes over. But low deductibles mean higher monthly premiums.
The highest deductible means you’ll have the lowest premiums, but you’ll have to pay more before your coverage takes over. Once you’ve reached your policy’s out-of-pocket maximum, your insurance policy begins covering all your costs. Learn more about mental health and substance abuse treatment policies at Healthcare.gov.
Frequently Asked Questions
What Length of Stay Will Anthem Blue Cross Blue Shield Cover?
There are caps on how long you can stay in an inpatient facility and how many outpatient visits you can make each calendar year. These limits vary from one health plan type to the next, so it’s important to contact your local Blue Cross Blue Shield Association for more information about your benefits.
How To Pay for Costs Anthem Blue Cross Blue Shield Doesn’t Cover?
Insurance rarely covers 100% of treatment costs for drug and alcohol abuse, opioid treatment programs, or any other type of treatment. If you’re worried about covering the out-of-pocket expenses, like copays, deductibles, treatments that Anthem may not cover, or other terms of your policy, call and speak directly to the treatment facility you’re considering.
Many facilities offer payment plans and grants or can put you in touch with other programs that may cover your out-of-pocket expenses.
What To Do If Anthem Blue Cross Blue Shield Doesn’t Cover Rehab?
Anthem Blue Cross Blue Shield covers some costs of rehab, behavioral health, or mental health types of co-occurring disorders, and healthcare for other health conditions in most cases. However, it might not cover certain facilities, especially those that employ nontraditional techniques.
If you have chosen a treatment provider but are worried about the cost of drug or alcohol recovery, speak to the treatment center. A rehabilitation center can give you information on grants, payment options, and other alternatives to ensure you get the care you need.
Do Rehab Facilities Need to Be In-Network?
The type of health insurance plan you have determines whether an inpatient rehab center needs to be in-network. With HMO plans, you’ll only receive coverage if you see someone in your network. With PPO plans, you have some coverage for all providers, but you’ll have less coverage for those out of network.