Provider Overview

Anthem provides health insurance coverage to individuals and families in various states across the U.S.¹ Anthem is part of Blue Cross Blue Shield, a federation of independent health insurance companies that provide health insurance plans.¹ As such, Anthem plans may be able to help one cover some or all of the costs of treatment for substance use disorders (SUDs), also known as addiction.

This page is intended to be a general overview of how Anthem covers addiction and mental health services, not a comprehensive guide on the subject. For specific questions about your plan and Anthem coverage for addiction treatment contact an Anthem representative directly and learn about how to pay for rehab.

Does Anthem Cover Drug & Alcohol Addiction Treatment?

Yes, Anthem offers coverage for substance use disorder treatment and other behavioral health concerns. However, the amount of coverage you may receive can vary based on several factors, including the type of plan you have. If you are a member of Anthem and are looking to obtain treatment for a substance use disorder, calling and speaking with an Anthem representative can help you identify the benefits and limitations of your plan prior to entering into a treatment program.

Which Types of Addiction Treatment Does Anthem Cover?

The addiction treatment coverage you receive under Anthem depends on the specific plan you have. It is crucial to confirm your insurance coverage before seeking treatment, as each health plan is unique.

Here are types of rehab or treatment services that may be covered under your Anthem insurance benefits:

Medical detox. Typically, the initial step in treating addiction involves detoxification or “detox”. Detox entails the removal of substances from the body and is frequently performed under medical supervision to assist in managing the symptoms of withdrawal.²
Inpatient treatment. Inpatient care refers to treatment provided in a facility where the patient resides for the duration of their care. Inpatient rehab programs entail patients receiving 24-hour medical supervision throughout their stay.³
Partial hospitalization programs for addiction: Often referred to as a PHP, these programs provide the highest level of outpatient programming for those recovering from a substance use disorder. They typically require a significant time commitment, where patients attend treatment for 4-8 hours each day for at least 3 months.⁴
Intensive outpatient addiction treatment programs: IOPs are also a form of outpatient addiction treatment, however patients participate in treatment anywhere from 9-20 hours per week over the course of 2 months to a year, depending on their needs.⁴
Outpatient addiction treatment programs. Outpatient care refers to treatment where the patient visits a facility once or twice a week to receive services without staying overnight. Common services provided in outpatient care include group meetings and therapy sessions.³
Aftercare or sober living. Aftercare is the term used for care provided after completion of rehab. An instance of aftercare is sober living, where patients reside in a home free from substances with other individuals in recovery.⁴

Substance use disorder treatment can vary in length, with common options including 30, 60, or 90 days of treatment. It is important to note that insurance coverage for treatment may depend on the length of the treatment, as well as the intensity and location of the treatment.

Does Anthem Cover Co-Occurring Disorder Treatment?

In addition to covering substance use disorder treatment, the Affordable Care Act (ACA) requires all health insurance plans to provide some degree of coverage for the treatment of mental health disorders.⁵ This is a valuable benefit for many patients entering into treatment, considering many may also be experiencing a mental health condition alongside their substance use disorder.

How to Use Anthem for Addiction Treatment Rehab

If someone is seeking treatment for a substance use disorder and has Anthem health insurance coverage, it is important to understand how it can be used to cover some or all of the cost of treatment. Start by contacting your benefits provider to learn more about coverage. Many rehab centers may be able to verify coverage for treatment at their facility.

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If you or a loved one is ready to seek rehab for a substance use disorder, explore your options and reach out to a rehab center using our rehab directory tool today!

Additional Resources

Other Options to Pay for Addiction Treatment

While the ACA requires health insurance plans like Anthem to provide some degree of coverage for the treatment of mental health and substance use disorders, there may still be out-of-pocket costs associated with treatment that are not covered by insurance.

It is important for patients to communicate with both the treatment facility and their insurance company to determine what costs they may be responsible for. Patients can also ask the treatment facility if they offer payment plans or sliding scale fees based on income to help cover the cost of treatment.

Additionally, there are other ways to cover out-of-pocket costs for mental health and substance use disorder treatment. Some patients may choose to pay for treatment out-of-pocket or through private insurance. Others may be eligible for scholarships or grants to help cover the cost of treatment. Some treatment facilities may also offer financing options, such as loans or payment plans, to help patients cover the cost of treatment.

It is important for patients to understand that the cost of treatment should not deter them from seeking help. There are resources available to help cover the cost of treatment, and patients should explore all options to ensure that they receive the care they need to achieve recovery.

Anthem Insurance Coverage for Drug & Alcohol Rehab