Does Anthem Insurance Cover Drug or Alcohol Rehab?

If you or your loved one struggles with a substance use disorder, or disorders, you are probably looking into and considering enrolling in a drug and alcohol rehab center, to receive addiction recovery treatment. That is great news, and we here at St John’s Recovery Place (SJRP) are glad to hear that you are taking some of the first steps necessary to begin your treatment.

Getting ready to attend drug and alcohol rehab can be overwhelming, you are probably excited, nervous, anxious, scared, and your mind is most likely buzzing with the huge amounts of new information you are taking in. Not to worry, this is normal. Huge, life-changing decisions like this always come with a little discomfort and confusion to start, but it won’t last forever. Still, you probably have a lot of questions, like, “how am I going to pay for drug and alcohol rehab?” And, “do drug rehabs accept insurance?”

Let us begin to help ease some of your worries, and answer some of your questions. To start, yes. Many different types of insurance companies, policies, and plans will work with you so that you can receive the treatment that you need, substance abuse recovery programs included. But not every insurance company and policy is made the same; there are bound to be differences. So, what about your Anthem insurance coverage, will it cover your substance abuse treatment costs?

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Anthem’s Brief History

Originally formed in 2004, after WellPoint Health Networks and Anthem Inc. merged, the WellPoint Inc. insurance company was not known officially as Anthem insurance until 2014 when the company rebranded and changed its corporate name. Even though the merged form of Anthem is relatively new, it is still believed that the company is one of the leading, largest health benefits companies in the U.S. Maintaining headquarters in Indianapolis, Indiana, Anthem insurance works across more than several states across the U.S.–including New York, California, New Hampshire, Kentucky, Virginia, Colorado, and more.

Anthem is considered to be an independent branch/licensee of Blue Cross and Blue Shield. Through its affiliated healthcare packages and plans, the company works to deliver a number of leading health benefit solutions in a broad portfolio of:

  • Integrated health care plans and related services
  • Life insurance
  • Disability insurance
  • Dental
  • Vision
  • Behavioral health benefit services
  • Flexible spending accounts
  • Long term care

Anthem is thought to be one of the most well-known, and trusted health insurance companies in the U.S. Its foundation is built on trust, and quality treatment through its affiliated health plans.

What Does My Anthem Insurance Policy Cover?

Anthem is a healthcare network, dedicated to bettering the lives of individuals and communities, and making healthcare simpler. Through the company and its affiliate names, Anthem works to serve more than 106 million people. The company knows it has the ability to impact many, and works hard to be one of the most innovative, valuable, considerate, compassionate, and inclusive insurance partners out there for the American people. That is wonderful, but you are probably wondering, “what exactly does my Anthem insurance cover?”

Like many other insurance companies, Anthem policies and plans cover a multitude of different conditions and expenses for each of their consumers. Depending on what state you live in, and what state you are attempting to receive drug addiction treatment in, the amount of coverage you receive from your insurance company and personal policy can change. In order to understand exactly what your personal policy with Anthem, or Anthem insurance affiliates, will cover in terms of your treatment, you must double-check your personal policy coverage by either calling the company, or the affiliate you use, or checking on one of the insurance company’s online member portals. This can be a bit confusing, as you want to be sure you have the right affiliate website portal that you are covered by, in order to find your exact insurance policy and coverage benefits.

Once you have ascertained what type of coverage you have with Anthem, it is then time to ask whether or not the treatment center you would like to attend will accept the policy that you have. At SJRP we accept many different types of insurances, and we work hard to be in-network providers for many different healthcare companies. In order to ensure that we can accept your insurance to be used at one of our facilities, you will want to call ahead to check if the specific insurance you have can be accepted by our center. It is an easy call, and will only take you a few minutes so that we can check your insurance policy’s compatibility with our program, and give you an estimate of what you might need to pay for your treatment, before you enroll.

Anthem Coverage Plans and Levels

Since one of Anthem’s affiliate networks is Blue Cross and Blue Shield insurance, the companies have very similar breakdowns available to understand their coverage plans and packages. Of course, it is important to remember that Anthem does not operate in every state the same way, and therefore the levels of care and treatments covered by the insurance company and its affiliates are likely to change based on your location.

Anthem insurance plans work to cover families, individuals, and providers while also working through different providers and healthcare plans to be offered to the community at large. Typically Anthem works to provide Medicare services but also has the opportunity to offer clients with Medicaid coverage in specific states. The basic Anthem coverage plan can fall into 3 separate categories:

Bronze Coverage

These types of coverage plans offer consumers the lowest premiums but normally have the highest copays and deductibles. This type of insurance plan allows for up to 60% of a client’s medical expense (depending on the type, location, specific plan, etc.) to be covered by Anthem insurance.

Silver Coverage

These types of coverage plans and policies offer clients the opportunity to choose a plan that has a higher monthly premium than a bronze plan, but lower deductibles and copays overall. This type of Anthem insurance plan allows for the company to cover up to 70% of treatment cost, again depending on the individual, the treatment needed, location, and so on.

Gold Coverage

These types of insurance coverage plans have the highest monthly premiums out of all three categories but also sport the lowest deductibles and copays. A client who has gold-level coverage with Anthem can expect up to 80% of their overall cost of treatment covered with their insurance, again depending on their personal plan, needs, and other variables.

Does Anthem Cover Drug Rehab?

Many different insurance policies in the U.S. allow for some type of cost coverage when it comes to substance abuse treatment. Anthem is an insurance company that will help to cover the cost of drug rehab and substance abuse treatment. Like Aetna insurance, Anthem and Anthem affiliates run on an in-network and out-of-network healthcare basis. Anthem has taken a great deal of time to collect providers, locations, treatments, and some types of specialists to make up their comprehensive treatment coverage, as an Anthem in-network treatment center, Saint John’s Recovery Place (SJRP) can accept your policy plan, and charge accordingly.

If you stick to in-network treatment options for your drug rehab services, you will most likely only need to pay a copay, cost depending on your personal policy. If you decide to pursue other out-of-network treatment options, Anthem can still help cover the cost of your treatment, but your out-of-pocket expenses will be higher. If you still have questions about your personal Anthem insurance policy, and what types of substance abuse treatment options and benefits your plan will cover, you can always call the number on the back of your insurance card, or website, to speak with a company representative about their plan details more specifically.

Otherwise, yes. Anthem does help to cover the cost of drug rehab. As long as you choose an in-network provider like SJRP, your out-of-pocket costs of treatment will be lower, and you may have just as many treatment options and providers available to you as out-of-network treatments. The most common aspects of substance abuse treatment Anthem will cover include:

  • Bbehavioral health inpatient services
  • Behavioral health outpatient services
  • Inpatient services
  • Outpatient services
  • Prescription drugs
  • Emergency services

Does Anthem Insurance Cover Methadone Maintenance Treatment?

Over 10.3 million people misused prescription opioids in 2018, resulting in over 130 opioid-related overdose deaths occurring every day of that year. Opioid misuse is a growing and dangerous epidemic in the U.S. that has caused many people to seek addiction treatment. Opioid addiction treatment often requires the use of medication-assisted treatments, oftentimes including the use of methadone maintenance treatment.

Methadone maintenance treatment involves the use of medication to aid clients who suffer from opioid misuse disorders to ease off of the drug. The use of this treatment helps clients to fight cravings more effectively, aids in managing chronic pain and blocks opioid receptors in the brain. Methadone maintenance is normally distributed in a clinic setting, so although Anthem insurance policies normally cover the cost of prescription medications, the cost of methadone treatment may not be fully covered by your personal policy plan.

In order to receive methadone maintenance treatment, you must be referred by your primary care physician upon evaluation of your substance misuse condition. To find out if your personal policy will help to cover the cost of methadone maintenance treatment, call the Anthem phone number on the back of your insurance card, or visit your member portal for more information. Anthem works hard to fight against the opioid epidemic in the community, hoping to restore lives and communities.

Does Anthem Insurance Cover Suboxone Treatment?

What about if Anthem covers the cost of Suboxone treatment for opioid addiction? Anthem has proven to be one of the most flexible, and receptive insurance companies when it comes to the inclusion of medications like methadone, buprenorphine, and suboxone in opioid addiction treatment. Typically the insurance company works to provide their consumers with more behavioral and mental health services in fighting their addiction, but when they learned that drugs like suboxone can help to reduce cravings and the symptoms of withdrawal, the company worked to include the medication into their covered prescription drugs list.

Suboxone, a medication that contains both buprenorphine and naloxone (opioid fighting medications), helps to block the effects of opioids in the brain, reducing cravings and misuse as clients work to wean themselves off of opioids slowly but surely. The use of suboxone must be prescribed by your doctor, with the specific purpose of the drug’s use being in aiding you to taper off of opioid misuse. Suboxone use for opioid addiction recovery is considered to be covered under many Anthem and Anthem affiliate prescription drug lists, with strict rules for use and coverage.

Depending on your personal policy plan, the amount you pay for the drug, and the terms in which you received the medication is subject to change. In order to know exactly whether or not your Anthem policy covers the use of suboxone for opioid addiction treatment, call the number on the back of your insurance card, or visit your personal member portal on your associated Anthem website to acquire more specific information regarding your policy coverage.

Does Anthem Cover Alcohol Rehabilitation?

So, does Anthem insurance and its affiliates cover alcohol rehab? Like with drug rehab, Anthem and its affiliates will work to cover a good portion of the inpatient and outpatient behavioral treatments associated with drug and alcohol rehab. If you are involved with their prescription medication program, they will also cover a percentage of the medications you may need during medication-assisted therapies for rehab. So yes, Anthem will cover alcohol rehab in part, paying a certain percentage of your total cost based on your individual policy plan, your location, the facility you are looking to attend, and the types of treatment options you intend to participate in.

Here at St John’s Recovery Place (SJRP), we understand that trying to keep up with the ins and outs of your insurance policy and your treatment needs and be exhausting, and overwhelming. We are here to help answer any questions that you may have regarding our own insurance acceptance policies, if you are curious about which networks we are a part of, or even if you have specific questions about different types of treatment that we offer. If you are looking to have more specific questions answered about alcohol addiction recovery, and the services Anthem will cover in relation to this disorder, call the number on the back of your insurance card, or visit the Anthem member portal website to discover more information regarding your specific policy and coverage.

Anthem In-Network Services Vs. Out-of-Network Expenses

So, what is the difference between Anthem’s in-network care and out-of-network care? Like other health insurance companies, Anthem healthcare and its affiliates have worked to create a list of providers, health benefits, and associated facilities that align with their values of treatment for their consumers to choose from. The term “in-network” literally refers to a healthcare provider’s partnership with your healthcare network plan. This means that as long as you stay within that list that makes up the community for all of your healthcare needs, that the network’s partnership protects you, and is able to make treatments more affordable to you.

The term “out-of-network” refers to any provider or treatment that has not partnered with your healthcare plan, and is thus not part of the healthcare community that surrounds you, and gives you all of your treatment options. Of course, you are still able to choose for yourself which specialists, doctors, treatments, and facilities that you would like to receive or see. But, choosing an out-of-network provider, treatment, or facility can mean that you will have to pay more out-of-pocket costs. Out-of-network healthcare choices are generally more expensive than in-network options, as the out-of-network opportunities have not partnered with your healthcare system, and therefore generally does not accept your insurance, or does not accept much of your insurance.

Anthem healthcare works hard to provide their consumers with a large in-network basis for treatment, making every attempt then can to provide their consumers with a large network of treatment options to choose from to suit their specific needs. Staying within your network plan will save you money, both in the short-term and the long-term. But, if you decide you want to try an out-of-network treatment provider still, it is important that you remember and know that you will be subject to other fees, and have to pay more out-of-pocket costs for your out-network treatments. The cost of out-of-network treatment varies, depending on:

  • The percentage of the cost your policy is allowed / subject to cover
  • The methods which your personal policy is set to “allow” or “recognize”
  • The medicare-based rates for service that are determined by the government

Emergency care does not count as out-of-network care. Anthem insurance plans work to cover what is called “reasonable” treatments for substance abuse disorders, and other health issues, and try to limit the number of services they cover that are considered “unessential”. Anthem insurance plans will cover most inpatient and outpatient behavioral health services and therapies in drug and alcohol rehab and will cover some medications. Otherwise, some of the treatments Anthem will not cover may include:

  • Luxury treatment facilities
  • Some over-the-counter medications
  • Extended (long-term) medication-assisted treatments
  • Private treatment facilities
  • New age treatment methods
  • Holistic, unscientifically proven treatment methods and therapies

Paying for Drug and Alcohol Rehab

If you or your loved one struggles with a substance use disorder, you are probably feeling very overwhelmed by the amount of information being introduced to you. You are learning more about chronic addiction and substance use disorders, learning more about yourself, your loved ones, the needs of others, your goals, and the stages of addiction treatment all while trying to balance how you will manage to pay for it all. Addiction is hard, and substance abuse treatment can be just as difficult. But, despite the difficulties getting started in treatment may pose to you, we promise you that the struggle to get help, and then work through treatment is 100% worth it.

You don’t want to live your life as a slave to an object or substance. You want to be able to follow your dreams, and live life in a healthy, happy, substance use free manner. At St John’s Recovery Place, we understand how overwhelming and stressful finding and getting ready to start treatment can be. Addiction recovery is not easy, but we assure you that we are here for you every step of the way, through the triumphs, the trials, and even the setbacks. With persistence and dedication, you can make it through this stage of your life, to where you again are living sober and free from the influence of outside substances and the craving to use them.

Anthem insurance is a well-known healthcare provider that spans the nation with its quality in-network care community. The company’s goal is to be trustworthy in supporting the health needs and goals of its individual members and community. If you have Anthem insurance, and you are worried about getting into a treatment program with us, there is no need to fear, as in-network partners, we work with your policy to get you the treatment you need, as affordably as possible. And if you don’t have Anthem insurance or your personal policy plan does not cover the types of treatment or medications that you need sufficiently, that is okay too. There are other ways to pay for treatment that can help you greatly, and there is no need to fear not being able to attend treatment for lack of funds. Some of the most common methods of obtaining funding for drug and alcohol rehab include:

  • Scholarships
  • Grants
  • Donations
  • Payment plans

There are many different types of funding options and opportunities available to you if you are looking to pay for drug and alcohol rehab and either do not have the sufficient funds to pay for treatment, or if you want to try an out-of-network service that would normally be too much for you to afford. At the end of the day, rehab facility insurance programs work very hard to make treatment affordable for you. This way, you don’t need to worry about all of the external affairs surrounding drug and alcohol rehab as much, and instead focus on healing. Drug and alcohol rehab is made with the intent that it can be readily available to anyone who needs it.

So, if you are looking into drug and alcohol rehab, and you aren’t sure if the facility you are looking into accepts your insurance, or that your insurance policy will cover the cost of your treatment in full or part, there is no need to fear. You can pay for treatment using a variety of methods. But, of you have more questions about your specific policy, make sure to call your insurance company (whether it is Anthem or another insurance provider) to determine where you need to be looking for treatment, and do not be afraid to reach out to the treatment center you are interested in to ask questions about the policies they work with and accept.

Addiction recovery can be difficult, complex, frustrating and time-consuming. Paying for addiction recovery, or at least starting the process of paying can also be difficult, but in the end, treatment is made to be affordable. Don’t put off the start of your recovery journey any longer, start today, or call us here at St John’s Recovery Place for more information about our services, accepted insurances, and what your next steps may be.