On this page, you will learn about Anthem health insurance coverage for substance abuse treatment and how to confirm what benefits are available under your specific plan.
If you or a loved one are experiencing a medical emergency, call 9-1-1 immediately.
Finding treatment for a drug or alcohol addiction is necessary to begin recovery. Some people may delay treatment because they are unsure about insurance options. However, it’s always best to move forward with an addiction treatment program sooner rather than later. Whether you need medical detox, intensive outpatient treatment, inpatient treatment, or something else, you can access your Anthem insurance for drug and alcohol addiction treatment coverage.
This page will help you understand how you can use your Anthem insurance health plan to obtain the best treatment options for your substance abuse needs. Plans are available for individuals and families.1 You may qualify for an Affordable Care Act (ACA) marketplace plan. Anthem also offers catastrophic and Medicaid plans.1
Please note: While American Addiction Centers (AAC) strives to provide you with the most updated information on each carriers’ addiction insurance coverage, policy changes and errors do occur. This is meant to be a brief overview of how Anthem insurance covers addiction treatment and not a comprehensive guide. Please check with your insurance carrier directly or call 1-888-744-0069 to confirm coverage levels.
Levels and Plans
Mental Health & Addiction
Levels of Care
Anthem Insurance Coverage Levels and Coverage Plans
Anthem offers a wide range of medical and mental health solutions for its members.2 They operate as an independent licensee of the Blue Cross and Blue Shield Association, meaning members can access services in the following states:2
Anthem lets you select from different types of individual or family plans when accessing substance use treatment. These plans are categorized as follows:3
Health Maintenance Organization (HMO). An HMO plan enables you to receive services from Anthem’s network of doctors. You also may need to choose a primary care physician from the HMO network with certain plans. This physician provides general care and if you need a specialist, they will give you a referral.
Preferred Provider Organization (PPO). A PPO plan allows you to choose your care inside or outside of a provider network. If you decide to use out-of-network providers and facilities, you have to pay extra. The use of in-network providers will be covered by your insurance. With a PPO plan, you don’t need a referral to visit a doctor.
Higher Deductible Health Plan (HDHP). This type of plan is ideal for people who don’t anticipate incurring many health expenses in the upcoming year. It costs less per month but has a higher deductible.
Catastrophic Plans. Sometimes a catastrophic health plan is best if finances are limited. This plan will help protect you in case of a large, unexpected illness or accident.
Exclusive Provider Organization (EPO). With this type of plan, you will work with a select network of care providers. You can also see a specialist without a referral if they are in the network.
Point of Service (POS). When you have this plan level, you can go outside the network, but it may pay less in benefits.
If you are over the age of 65, you may wonder about Medicare and whether you can get an Anthem Medicare plan.4 Anthem health insurance works with Medicare Advantage Plans. When selecting this option, you can receive all three parts—A, B, and D.4 Additionally, you can get supplemental Medicare to fill in any gaps not covered by your insurance.4 If you opt for Original Medicare, you can access basic health coverage and benefits, such as hospital stays and check-ups.5
You may wish to verify your insurance benefits with the facility before seeking rehab to ensure that your insurance is accepted for addiction treatment coverage. You can also call the number on the back of your insurance card to find out where you can go to find treatment for a substance use disorder. Sometimes, traveling to another location might be the best decision to get the Anthem drug rehab care you need.
Does Anthem Cover Mental Health and Substance Abuse Treatment?
When seeking mental health and substance abuse treatment, it’s helpful to understand your options and rights for coverage. Fortunately, you don’t have to worry about being denied service due to a substance use disorder. The ACA mandates that insurance providers cover treatment for mental health and substance abuse.6 These services are considered essential benefits that all Marketplace insurance plans must include.6 Some of the specific mental and behavioral health essential benefits that are covered include the following:7
Psychotherapy and counseling for behavioral health.
Substance use disorder treatment.
Does the Anthem Health Plan Cover Inpatient and Outpatient Rehab?
You may wonder what type of addiction treatment is the right one for you. Do you need inpatient or outpatient care, or maybe a bit of both? The level of treatment you need depends on many factors—what substances you were using, how long you used them, how much you were using, and so on. A health professional will go over the specific addiction treatment options you may need when you begin your recovery. Some of the different types of rehab treatment programs they may discuss with you include:
Inpatient or residential rehab treatment program. At an inpatient treatment program, you’ll receive around-the-clock rehab, including detox services and therapy.
Outpatient rehab. During outpatient therapy, you will participate in treatment about once or twice a week.
Intensive outpatient programs (IOP). IOP is on an outpatient basis, but you attend therapy more regularly.
Partial hospitalization programs (PHP). This program is similar to an inpatient program except you go home at night.
Your Anthem insurance coverage for drug rehab treatment varies depending on your plan level and the type of service you receive. Plans typically cover outpatient services, including office visits for substance use issues. A coinsurance cost would apply if you use an in-network provider. In most cases, you would not be covered if you select an out-of-network provider. Inpatient services are also usually covered. A copay and coinsurance cost would apply for each admission. Like outpatient services, if it’s out-of-network, it is not covered.
It’s always a good idea to verify your insurance first before going to a rehab facility. This can help save you time and hassles.
How Do I Check My Anthem Plan to See if Addiction Treatment is Covered?
It’s best not to put off seeking help for a substance use disorder. The first step is to verify your insurance. Finding the proper treatment is simple with an Anthem insurance plan, and you can begin your journey to recovery using Anthem’s addiction rehab treatment coverage. Reach out for assistance by checking your Anthem health insurance mental health and substance abuse coverage. You have options with Anthem health insurance, and your well-being is worth it.
To find out more about drug or alcohol addiction treatment or what your insurance policy covers, contact an admissions navigator at 1-888-744-0069 , use the Verify Your Insurance portal, or fill out the form below.
Check Your Policy Coverage
With the form below you can quickly and privately check your insurance benefits to see if you're covered for addiction treatment services. We’ll be able to tell you if your policy is in-network at an American Addiction Centers location.
Verification of Benefits Form
Please fill out the form below to verify your insurance coverage.
How to Read Your Insurance Provider Card
1Insurance Provider Name
2Policy Member's Full Name
3Policy Membership/Subscriber ID
Learn more about our treatment facilties
American Addiction Centers (AAC) owns and operates facilities at various locations nationwide to provide you or your loved one addiction and mental health care.
By filling out and submitting this form, you will instantly receive results confirming if your insurance provider is actively covering addiction related services and treatments or not. If your insurance is in network with American Addiction Centers (AAC) you will be notified by our admission navigators.
What are the next steps?
You will be contacted by an American Addiction Centers (AAC) admissions navigator who will provide you with information to help you make an informed decision about addiction treatment. Our admissions navigators are available to answer any questions you may have as you consider whether treatment with AAC is right for you.
Which treatment centers can I go to?
American Addiction Centers (AAC) has multiple locations across the country. Depending on your insurance coverage, our admission navigators will provide information about which location will best cover your treatment and fit your treatment needs. See our loactaions.