Does Anthem Health Insurance Cover Addiction Treatment?
Anthem Blue Cross Blue Shield insurance plans typically provide coverage for substance abuse treatment, including drug and alcohol rehab programs. The extent of coverage depends on the specific Anthem plan and the individual’s policy details. Anthem partners with various healthcare providers to offer in-network addiction treatment options for those seeking recovery from substance use disorders.
Anthem insurance coverage for addiction treatment services may include inpatient treatment, outpatient programs, medication-assisted treatment, and therapy for co-occurring mental health disorders. The level of coverage and out-of-pocket costs will vary depending on the specific Anthem plan tier and the individual’s benefits.
Anthem Plan Tiers for Addiction Treatment Coverage
Anthem offers different tiers of coverage for addiction treatment, each with varying premiums, deductibles, and co-pays. The three main tiers are Bronze, Silver, and Gold. Bronze plans have the lowest monthly premiums but higher deductibles and co-pays, covering approximately 60% of addiction treatment costs. Silver plans have higher premiums than Bronze but lower deductibles and co-pays, covering around 70% of substance abuse treatment expenses. Gold plans have the highest premiums but the lowest deductibles and co-pays, with Anthem covering about 80% of drug and alcohol rehab costs.
Medicaid and Medicare Coverage for Addiction Treatment
Anthem also provides Medicaid coverage plans for addiction treatment in certain states, including Indiana, Kentucky, Virginia, and Wisconsin. In California and Nevada, Elevance Health (formerly Anthem) offers Medicaid coverage to eligible individuals seeking substance abuse treatment. For Medicare beneficiaries, Anthem offers hospital, medical, and prescription coverage for addiction treatment in a single plan, with some plans having no premiums and providing additional benefits like hearing, vision, and dental coverage.
Anthem’s Network and Out-of-State Coverage for Addiction Treatment
Anthem members may have access to the nationwide network of Blue Cross Blue Shield providers, allowing them to seek addiction treatment outside their home state. Additionally, Anthem offers a guest membership option for eligible members staying in another area for 90 days or longer, enabling them to join an affiliated HMO plan in that region and receive coverage for substance abuse treatment.
Covered Addiction Treatment Services Under Anthem Plans
In addition to inpatient treatment, Anthem health insurance typically covers various outpatient addiction treatment services, such as partial hospitalization programs, intensive outpatient treatment, individual therapy, group therapy, and family therapy. Anthem also tends to offer coverage for specific therapeutic modalities like cognitive-behavioral therapy and dialectical behavior therapy, which are effective in treating substance use disorders and co-occurring mental health issues.
Verifying Anthem Coverage for Addiction Treatment
To verify Anthem coverage and benefits for addiction treatment, individuals can call the number on their insurance card and speak with a customer service representative. Representatives can assist in locating in-network drug and alcohol rehab centers and therapists. Anthem members can also create an online profile at Anthem.com to view their benefits information and use tools to estimate treatment costs.
