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Reviewed by Anthem, a leader in the healthcare industry, stands as one of the largest providers in the U.S., offering essential support to nearly 47.5 million Americans.
Now operating under Elevance Health, Anthem has seen significant growth over the past decade. As the largest for-profit managed healthcare company within the Blue Cross Blue Shield Association, Elevance Health provides comprehensive health services.
Among these are crucial offerings in addiction treatment, including coverage for drug rehab and alcohol rehab programs. Whether you’re a policyholder or simply exploring your options, read on to discover how Anthem BCBS can support your journey to recovery.
Table Of Contents:
Anthem Blue Cross Drug Rehab Coverage
A significant step forward in addiction treatment came with the Affordable Care Act (ACA). This legislation mandated parity between mental health and substance abuse services and medical coverage.
This means that health insurance plans, including Anthem Blue Cross, must offer comparable benefits for addiction treatment as they do for physical health conditions. While specific coverage details can vary based on your plan, Anthem Blue Cross substance abuse treatment generally covers a range of addiction treatment services.
These services may include:
- Inpatient Treatment: Provides 24/7 care in a structured environment.
- Partial Hospitalization (PHP): Intensive outpatient program with daily structured treatment.
- Intensive Outpatient Program (IOP): Less intensive outpatient care with regularly scheduled sessions.
- Outpatient Treatment: Flexible treatment with individual and group therapy sessions.
- Drug Detox: Medically supervised withdrawal from substances.
- Medication-Assisted Treatment (MAT): Combines therapy with medications for opioid or alcohol addiction.
- Co-occurring disorder treatment: Addressing both substance abuse and mental health conditions.
Anthem Blue Cross Alcohol Treatment
Alcohol addiction falls under the umbrella of substance use disorders, which are recognized medical conditions requiring appropriate treatment.
Rehabs covered by Anthem are required to include alcohol use disorder services as part of their addiction treatment catalog. This means that if you have an Anthem health plan, you may be eligible for rehab coverage that includes various forms of alcohol rehab, from inpatient rehab treatment to outpatient, counseling and support.
Rehab coverage specifics can vary depending on your plan, so it’s essential to verify your benefits and understand your options.
Does Anthem Cover Suboxone?
Suboxone is a medication combining buprenorphine, an opioid substitute, with naloxone to deter misuse by those with opioid addiction.
This medication is a very important component of addiction treatment as it has been shown to lower the risk of fatal overdoses by approximately 50%.ย Anthem often covers Suboxone. However, you may need to get pre-authorization and a confirmation from your doctor that it is medically necessary.
You can get a prescription for Suboxone from a rehabilitation center or Suboxone clinic qualified to treat patients with said medication. If approved, the quantity limit is set at Suboxone films/SL tabs: Max 24 mg/6 mg per day, strength-dependent (2 to 12 films/SL tabs per day).
Anthem Insurance Therapy Coverage
Mental health issues like depression, anxiety, and bipolar disorder often coexist with addiction. These conditions can intensify each other, making recovery difficult. For instance, depression can hinder treatment adherence, while anxiety might trigger compulsive substance use.
Under the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA), mental health disorders receive equal coverage as physical health conditions. This means Anthem policyholders now have broader access to a range of therapeutic services, including:
- Cognitive-behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Eye movement desensitization and reprocessing (EMDR)
- Psychodynamic therapy
- Acceptance and commitment therapy (ACT)
- Mindfulness practices
- Child-parent psychotherapy
- Medication management for prescription and monitoring of psychiatric medications
- Individual therapy with a psychologist
- Group therapy sessions
- Talk therapy
- Family therapy
Anthem drug rehab covers mental health disorders identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), such as depression, anxiety, bipolar disorder, and post-traumatic stress disorder (PTSD).
If you are unsure about your Anthem plan’s coverage for therapy or virtual visits or need help finding an in-network therapist or mental health professional, you can use the Sydney Health app or anthem.com for a convenient chat. You can also contact a representative through the phone number on your health plan ID card.
Anthem Blue Cross Rehab Centers
Anthem Blue Cross offers access to a network of high-quality facilities to meet your needs. Below is a list of Anthem Blue Cross rehab facilities that provide comprehensive care and support.
Check some of the available rehabs that take Anthem:
- River Oaks Treatment Center in Florida offers evidence-based rehabilitation with hotel-like accommodations.
- Laguna Treatment Hospital in California with experiential therapies and recreational activities.
- Greenhouse Treatment Center in Texas provides specialized treatment and medication management.
- Oxford Treatment Center in Mississippi follows a clinical-based therapy offering medical detox and co-occurring disorder care.
While this list provides a couple of rehabs covered by Anthem, always verify insurance coverage directly with the facility before starting treatment.
Anthem Blue Cross Drug Rehab Coverage Levels
Health plans on the Marketplace are categorized by โmetal levelsโ: Bronze, Silver, Gold, and Platinum. These tiers determine how you and your insurer share costs, not the quality of care. All plans cover the 10 essential health benefits outlined by the ACA.
| Plan | Bronze | Silver | Gold | Platinum |
|---|---|---|---|---|
| What your plan pays | 60% | 70% | 80% | 90% |
| What you pay | 40% | 30% | 20% | 10% |
Anthem offers Medicaid plans in California, Indiana, Kentucky, Nevada, New York, Ohio, Virginia and Wisconsin. Anthem members can access a nationwide network of Blue Cross Blue Shield providers. This is particularly beneficial for those seeking out-of-state care.
Remember that choosing the right plan depends on your health needs, budget, and risk tolerance. Consider your past medical expenses to estimate your coverage needs, but remember, costs can fluctuate, and unexpected health issues can arise.
How to Check Anthem Blue Cross Coverage?
There are several ways to check your Anthem Blue Cross coverage:
- Visit the Anthem Blue Cross website and log in to your account for details about your benefits.
- Download The SydneySM Health app to find care, share your digital ID card, and check your claims.
- Refer to the policy document for specific details.
- Contact Anthem’s member services if you cannot find the information online or through the app.
If you are unsure about a specific service or procedure, checking your coverage before receiving treatment is always a good idea. Keep a copy of your insurance card handy for doctor appointments.
Anthem Blue Cross Rehab Coverage โ Bottom Line
The extent of your benefits depends on your specific plan, so you need to verify coverage details before starting any treatment.
Anthem offers various plans, including Medicaid options, in certain states and provides access to a vast network of providers. By contacting Anthem directly or logging into your member account, you can clearly understand your benefits. This knowledge empowers you to make informed decisions about Anthem drug rehabs.
Take the first step towards a healthier future by contacting a local rehab center to learn about your drug rehab coverage.
People Also Ask
Who is Anthem now?
Anthem is now Elevance Health, Inc., the largest for-profit managed healthcare company under the Blue Cross Blue Shield Association. It serves around 47.5 million medical members with diverse health plans and services.
What does my insurance cover Anthem?
Anthem insurance covers various services, including medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans. Specific coverage depends on your plan. Review your policy details.
Does Anthem cover weight loss?
Anthem Blue Cross Blue Shield (BCBS) may cover weight loss programs and discounts as part of their wellness programs. Coverage varies, so check with Anthem directly to confirm what’s included in your policy.
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Page Sources
- Statista. (2023, March 10). Total medical membership of Elevance Health 2011-2022. https://www.statista.com/statistics/214533/total-medical-membership-of-wellpoint/
- Isola, S., & Reddivari, A. K. R. (2023, July 10). Affordable Care Act. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK549767/
- Grinspoon, P., MD. (2024, August 8). 5 myths about using Suboxone to treat opioid addiction. Harvard Health. https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496
- ย Mancher, M., & Leshner, A. I. (2019, March 30). The Effectiveness of Medication-Based Treatment for Opioid Use Disorder. Medications for Opioid Use Disorder Save Lives - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK541393/
- Hot Tip: MAT for Opioid Use Disorder. Anthem. https://providers.anthem.com/docs/gpp/NY_ABC_CAID_Rx_HotTip-MATOpioids.pdf?v=202312311456
- Understanding metal levels. Anthem.com. https://www.anthem.com/individual-and-family/insurance-basics/health-insurance/understanding-metal-health-insurance-plans
- Medicaid. https://www.anthem.com. https://www.anthem.com/medicaid