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Anthem Insurance Covering For Drug & Alcohol Rehab

Anthem Insurance Covering For Drug & Alcohol Rehab


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Disclaimer: We do strive to provide the most accurate and updated information about the addiction treatment insurance coverage of each provider. However, policy changes, as well as errors, do occur. So, confirm with your health insurance provider the level of your coverage.

Anthem Insurance

Do you want to seek addiction treatment but are worried about the costs? The good news is health insurance providers provide some drugs and alcohol rehabilitation benefits. One such provider is Anthem Insurance.

In this post, you will learn more about Anthem Insurance, their coverage for addiction, coverage levels, and how to check your benefits.

Anthem Insurance

Previously known as WellPoint, Anthem, Inc. is one of the largest healthcare companies in the US. This health insurance is the primary provider for Blue Cross and Blue Shield services in 14 states.

Anthem Insurance does provide addiction treatment services under behavioral healthcare plans. The level of coverage depends on your plan and can cover both inpatient and outpatient addiction treatment programs.

Coverage levels and plans

Primarily Anthem Insurance provides Blue Cross Blue Shield (BCBS) policies, which fall into the following categories:

  • Bronze: This policy has the least expensive monthly premiums. That also means high out-of-pocket expenses. Generally, the Bronze plan covers about 60% of expenses.
  • Silver: These plans cover about 70% of expenses.
  • Gold: A gold-level policy has more benefits, reduced co-pays, and generally covers 80% of the expenses.
  • Platinum: A platinum-level policy is expensive. But it has extensive coverage as it covers about 90% of expenses.

Perhaps the best thing about an Anthem health insurance policy is it allows you to take advantage of the nationwide network of BCBS providers. So, you can seek treatment at an out-of-state rehabilitation facility.

Anthem Insurance coverage  for addiction treatment

The types of addiction treatment services Anthem Insurance covers depend on your plan. Most plans will cover inpatient withdrawal management (detox) and treatment for substance use disorders. Other factors that might disqualify you from coverage include:

  • The medical necessity of treatment
  • Your history, specifically your other attempts to enter addiction treatment programs and their success
  • Co-occurring diagnoses that might require medical attention
  • The length of the treatment
  • The type of substance abused

Medical necessity is, by far, the most important factor. From a medical point of view, is the treatment necessary? A physician will deem treatment necessary if it will help you function properly and if there will be health and financial consequences if the addiction is not treated. For instance, if the addiction has ramifications on mental health, then treatment is deemed necessary.

The basic plans mostly cover inpatient withdrawal management programs and outpatient care. Generally, the coverage for outpatient is more extensive. Your individual needs do determine whether or not you need inpatient care.

The premium plans might cover the luxury services provided at executive treatment centers, such as complementary alternative treatment like art therapy, and spa services.

Addiction treatment falls under behavioral healthcare. And, according to information on their website, Anthem Insurance behavioral healthcare plans is comprehensive as it includes:

  • Access to acute healthcare facilities, clinics, and hospitals
  • Access to specialists, including therapists
  • Coverage for research-based programs offered by certified healthcare professionals

How to check the benefits of your Anthem Insurance policy

You can check the benefits of your policy provides by calling the number on your insurance card. Alternatively, you can visit the Anthem Insurance website, log in as a customer, and view your benefits by navigating to “my plan” then “benefits.”

On the website, you will also find a cost estimate tool that can help determine how much the treatment for addiction will cost you.

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