If you or a loved one is considering seeking treatment for a substance abuse problem, you may have concerns regarding the cost and insurance coverage of treatment. Our article on ‘Rehabs that Accept Anthem Insurance,’ has been written specifically to answer your questions on this crucial issue.
Members of Anthem insurance healthcare plans may be curious about Anthem’s drug treatment, mental health, and out-of-network services coverage. This article will provide answers to some frequently asked questions concerning Anthem’s drug addiction treatment and insurance coverage, as well as providing free insurance verification from our expert team at Find Addiction Rehabs.
You are not alone if you are unsure about what treatments are available in a substance abuse treatment facility and which ones are covered by insurance. It might be difficult to navigate the worlds of substance abuse treatment, mental health, and health insurance, but it doesn’t have to be.
What is Anthem Insurance?
Anthem, Inc., one of the country’s major health benefits organizations, offers a wide range of health services through a diverse portfolio of integrated health care plans and related services.
Anthem, Inc. is a Blue Cross and Blue Shield Association independent licensee. It is a healthcare firm that employs over 70 million people through its linked enterprises, and one out of every eight persons in the United States is covered by Anthem-related policies.
People in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin, as well as specialty plan members in other states, have access to Anthem insurance.
Does Anthem Insurance Cover Mental Health & Substance Abuse Treatment?
- 1 Does Anthem Insurance Cover Mental Health & Substance Abuse Treatment?
- 2 Using Your Anthem Insurance Plan to Cover Drug And Alcohol Treatment
- 3 How Much Does Anthem Insurance Cover?
- 4 How do I Know What My Anthem Insurance Will Cover?
- 5 I Just Lost My Job, How Do I Know if I am Still Covered?
- 6 How Can I Pay the Costs Not Covered by My Insurance Plan?
- 7 How Can I Get Anthem Insurance Coverage for Detox and Rehab?
- 8 How Long Will Anthem Insurance Cover Rehab?
- 9 Finding Drug Rehabs That Accept Anthem Insurance
- 10 Will Anthem Insurance Cover Out of State Rehab?
- 11 Do Treatment Centers Need to be In-Network?
- 12 Definition of General Insurance Terms Used in this Article:
- 13 Finding Addiction Services That Are Covered by Anthem Insurance
Anthem does provide certain rehab coverage, largely through its Blue Cross Blue Shield subsidiaries, albeit, as with other insurance companies and policies, the type and extent of coverage is dependent on the policyholder’s location and the specifics of their plan.
Anthem or Anthem Blue Cross is also a part of several state exchanges that are accessible through the Affordable Care Act. Insurance companies are mandated to cover mental health care as an essential benefit under the ACA’s provisions.
Anthem’s behavioral health and drug dependence programs are designed to take a comprehensive approach to policyholders’ overall health. This insurance covers many of the therapies needed for persons with mental diseases like anxiety and depression, in addition to drug abuse treatment alternatives.
Using Your Anthem Insurance Plan to Cover Drug And Alcohol Treatment
It’s always a good idea to double-check your healthcare benefits. You don’t want to be taken aback by unanticipated financial expenses. If you’re wondering whether Anthem covers addiction treatment, the only way to know for sure is to check your Anthem health plan coverage. Knowing what Anthem plans cover can provide you and your loved one peace of mind while in recovery. You can focus on getting sober and keeping sober without having to worry about unforeseen bills or financial difficulties.
You are not alone if you are unsure about what treatments are available in a substance abuse treatment facility and which ones are covered by insurance. It might be difficult to navigate the worlds of substance abuse treatment, mental health, and health insurance, but it doesn’t have to be. Call us now for a complimentary verification of benefits and know your coverage now!
Because of the complexity of Anthem insurance coverage from state to state, Find Addiction Rehabs can aid you in locating the best level of care at the lowest cost. In less than five minutes, one of our admissions representatives will contact Anthem on your behalf and explain what you can expect when utilizing your plan to cover addiction treatment.
How Much Does Anthem Insurance Cover?
A wide range of treatments in the field of addiction and substance abuse treatment may be appropriate for you. You and your substance addiction treatment provider will work together to develop a treatment plan that is tailored to your specific requirements. While each treatment plan is unique, many people receive the same services when they opt to enter a substance abuse treatment facility; these services vary in intensity, duration, and cost. The following are examples of common treatment services:
It is the mechanism of removing substances from the body. It is intended to address withdrawal’s harmful and acute bodily and psychological effects. Depending on the person’s health concerns, the sort of substance taken, the duration of substance use, and other considerations, this experience can be dangerous and unpleasant. As a result, many people prefer to detox in the safe environment of a substance abuse treatment center.
It’s critical to remember that detox is merely the first stage in a long rehabilitation journey. The psychological, emotional, social, and other elements that contribute to addiction are not addressed during detox.
Following detox, the work of rehabilitation is often done in the safe confines of an inpatient or residential treatment center. Relapse is an unavoidable part of the rehabilitation process; studies show that between 72 and 88 percent of opioid users relapse after finishing a detoxification program.
Because of its limited nature, inpatient/residential therapy can be a deterrent to recurrence. You are not allowed to leave the institution, and you are cared for by qualified addiction and medical professionals 24 hours a day, seven days a week.
Outpatient treatment refers to substance abuse treatment that takes place outside of a hospital and does not need the patient to live on-site.
Outpatient therapy focuses on treating addiction by teaching people a range of skills, such as how to cope with stresses and triggers, how to avoid relapse, how to communicate, how to solve problems, and how to manage stress. After detox and inpatient treatment, outpatient treatment is usually the next step in the recovery process.
Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs) – PHPs and IOPs seem to be less limiting than an inpatient/residential treatment. Depending on the service provider and your treatment plan, you can expect to spend 3–5 days a week at a PHP or IOP and 6–30 hours a week there.
Medication-Assisted Treatment (MAT) is a type of treatment that combines medication and counseling to manage substance abuse problems. Medications may also be used to help with medical detox and withdrawal symptoms associated with some types of substance abuse. Patients may endure unpleasant and sometimes hazardous withdrawal symptoms during the detoxification process, which can be mitigated by specific drugs.
Types of Anthem Insurance Plans
Depending on the state in which you live and the plan in which you are presently enrolled, the level of coverage available to you under Anthem may differ. Anthem offers coverage for a variety of situations and plans to meet individuals, including workplace group plans, Medicare and Medicaid, and individual and family insurance. The insurance plans are divided into the following groups:
Health Maintenance Organizations (HMOs) are a type of health maintenance organization. An HMO plan restricts a person’s access to treatment centers and doctors in a specific geographic area. In comparison to other plans, more of the expense of your healthcare is covered. Either an Independent Practice Association or a participating medical group of providers are available to you. You can also designate a member of the group as your primary care physician.
Preferred Provider Organizations (PPOs) are a type of Preferred Provider Organization (PPO). PPO plans are more versatile since they allow consumers to choose doctors and treatment centers outside of their network. However, PPO plans are more expensive. The PPO, which comprises physicians and hospitals in the same network, contracts with medical providers. By engaging providers in the network, members can save money on their addiction treatment.
Anthem Insurance’s Metal Tier System:
Anthem’s health insurance policies are divided into the following tiers in compliance with the Affordable Care Act:
- Bronze: This is the plan with the lowest monthly rates, although it also has the largest deductible and copays. Anthem covers roughly 60% of medical expenses.
- Silver: Although the monthly rates are greater than bronze, the deductible and copays are lower. Anthem covers roughly 70% of medical expenses.
- Gold: While the monthly premiums are greater than Bronze and Silver, the deductible is lower. Anthem pays around 80% of medical costs, so co-pays are lower than with other plans.
- Platinum: This plan offers the most expensive monthly premium and the smallest deductible. Anthem covers approximately 90% of medical expenses.
The only difference between the plans is how you and your insurance company split the expense of care. Anthem insurance plans offered through your company may differ from those offered on the Affordable Care Act’s (ACA) marketplace.
Anthem and Medicare
Anthem and Medicare have a deal to provide treatment to people through Anthem Medicare. Anthem provides you with resources to help you stay well, perks to help you save money, and 24/7 nurse lines and pharmacy services once you’ve chosen a Medicare plan.
Medicare Advantage Plans (Part C) and Medicare Supplement Insurance Plans are available through Anthem.
How do I Know What My Anthem Insurance Will Cover?
Treatment for drug and alcohol addiction varies in price depending on the individual. It will be determined by the treatment center, the type of program attended, and the services provided.
Check your Anthem policy benefits before choosing a rehab center to see which charges are covered by your insurance and which you will have to pay out of cash. To find out how much you’ll need to fund in terms of copays and any deductibles that must be met before coverage for the treatments you need kicks in, call us now for a free verification.
Find Addiction Rehabs can also help you confirm your insurance coverage. Please give us a call. We’ll explain what your Anthem insurance entails, as well as the steps you’ll need to do to get started.
I Just Lost My Job, How Do I Know if I am Still Covered?
COBRA may be able to assist you if you’ve recently lost your job. Former employees and their families who lose health insurance have the right under the Consolidated Omnibus Budget Reconciliation Act (COBRA) to continue with group health benefits given by their group health plan for a set period of time and under specified conditions. For example, situations like losing a job or transitioning between jobs, a family member’s death, or even divorce.
This also applies to persons who were previously covered by their parents’ insurance but have recently turned 26 and thus no longer qualify for coverage under their parents’ policy.
How Can I Pay the Costs Not Covered by My Insurance Plan?
Covering the cost of treatment may feel like one of the biggest challenges for those seeking drug or alcohol treatment. Many facilities will work with you, however, to figure out how to access treatment and make it affordable.
There are other resources to help you cover the cost of rehab. You can check with the rehab facility for a sliding scale fee or payment arrangement. Additionally, many treatment facilities offer financial aid packages or outright scholarships for treatment, both options we can help you locate if needed. If those options aren’t available, you could arrange a loan from family or friends or other services that arrange for lower-cost lending related to healthcare.
How Can I Get Anthem Insurance Coverage for Detox and Rehab?
There are a variety of costs associated with drug rehabilitation. Getting the right insurance might help you get into the most effective drug rehabilitation program. The following options are available for Anthem insurance coverage:
- By way of the marketplace: The Health Insurance Marketplace is sometimes known as the “exchange” for health insurance. When you buy health insurance through the marketplace, you may be eligible for subsidies (also known as premium tax credits) based on your income and other health insurance coverage qualifications.
Even if you are eligible for insurance through your workplace, you can get ACA marketplace coverage, and it doesn’t hurt to shop around to see if you can find a better deal. If you have job-based coverage, however, you are unlikely to be eligible for subsidies.
On November 1, 2021, open enrollment for 2022 coverage begins. For coverage to begin on January 1, 2022, you must enroll by December 15th.
- By way of your employer: Anthem insurance coverage that includes detox and treatment may be available through your place of job in many cases. This is advantageous because the insurance is paid for by the company or group. The majority of employers contribute to their employees’ health insurance by either covering the entire cost or splitting it with them on a cost-sharing basis. As a result, employees will have easier access to healthcare benefits for themselves and their families.
- Purchasing insurance privately: Obtaining your own health insurance policy is more difficult than enrolling in an employer’s plan, but you do have some choice over the plan you receive. Your research will become easier if you’ve determined what you need and are familiar with the terminology used to describe health insurance policies. With so many possibilities, you’ll almost certainly be able to discover a plan that matches your and your family’s needs—as well as your budget.
- Through your parents: If you’re under the age of 26, you might be able to get health insurance under your parent’s plan if you are covered as a dependent. Even if you’re married, don’t live with your parents, aren’t in school, aren’t financially reliant on your parents, or aren’t qualified for it, you can stay on your parents’ health insurance plan until you’re 26.
How Long Will Anthem Insurance Cover Rehab?
Successful substance abuse treatment outcomes are dependent on a number of things, according to research. These include starting treatment as soon as its available, treating both mental health and substance abuse problems at the same time, utilizing a variety of evidence-based treatment interventions such as medication and therapy, developing a personalized treatment plan based on the individual’s specific needs, and sticking to treatment for a sufficient amount of time.
Your treatment length will be determined by your particular needs, the treatment center you choose, and your insurance company. Remember that the longer you stay in therapy, the more likely you are to make a full recovery. More specifically, research shows that most persons with addiction need at least 3 months of treatment to quit and minimize their drug usage; longer treatment times produce the best results.
Because insurance plans come in a range of policies and degrees of coverage, the length of therapy covered by your insurer will vary depending on your plan.
Finding Drug Rehabs That Accept Anthem Insurance
When coping with addiction and the myriad treatment services available, it’s easy to feel overwhelmed. Knowing how to take advantage of insurance benefits, on the other hand, will make the procedure go more smoothly.
Allow the Find Addiction Rehabs treatment experts to help you with this. For more information on how to use Anthem Insurance to pay for alcohol and drug rehab, contact one of our team members now.
Will Anthem Insurance Cover Out of State Rehab?
After you’ve made the life-affirming decision to seek treatment, the next step is to choose the correct rehab center for you. Addiction treatment programs may be found all throughout the country, making it quite simple to choose a program close to home. However, it’s not uncommon to hear of someone seeking treatment in a different state.
The majority of Anthem policies include coverage for treatment outside of the state. While it may appear difficult or costly, receiving treatment in a new location has numerous advantages. It may be difficult to leave your family and friends behind in order to overcome an addiction, but it may be necessary for your long-term success as you change the environment in which the problems first occurred.
Do Treatment Centers Need to be In-Network?
In-network providers have a contract with the insurance company to deliver services at a predetermined cost. As a result, your out-of-pocket costs will be lower than if you go to an out-of-network facility. If you choose an out-of-network facility, you may be responsible for the entire cost of treatment.
Whenever possible, choose a facility that is part of Anthem’s network. If you can’t locate an in-network physician or prefer an out-of-network facility, you might be able to work out a payment plan with the facility to spread out the expense of treatment.
Definition of General Insurance Terms Used in this Article:
Health insurance provider network: a group of healthcare providers that have agreed to offer care at a reduced rate in exchange for reimbursement in full from a health insurance carrier.
In-network: Providers or health care facilities that are part of a health plan’s provider network with whom it has negotiated a discount.
Out-of-Network: When a doctor or physician is out-of-network, it indicates that your health insurance plan provider does not have a contract with them. This can occasionally lead to a price increase. Some health plans, such as HMOs, will not cover out-of-network care unless it is an emergency.
Deductible: the amount a policyholder must pay out of pocket before an insurance company will cover any expenses. In general, the term deductible refers to one of several types of clauses used by insurance firms to set a payment threshold for policies.
Out-of-pocket expenses: the costs incurred by a patient for medical bills not covered by their health insurance plan.
Copay/ copayment: after you’ve paid your deductible, you pay a set amount ($20, for example) for a covered healthcare service. It can be specified in an insurance policy and paid by the insured every time a medical service is used.
Finding Addiction Services That Are Covered by Anthem Insurance
Anthem’s coverage of some or all of your addiction treatment relieves a lot of the financial pressure that comes with seeking help. Many Anthem policies can lower or eliminate the cost of alcohol and drug rehab and therapies.
The expert staff and advisers at Find Addiction Rehabs will work with you one-on-one to ensure that you or a loved one get the treatment they require to overcome drug and alcohol addiction. Speak with one of our admissions representatives or a care professional now to learn more about your possibilities and find the right rehab that accepts Anthem Insurance today!