While every health plan and situation differs, using your Anthem health insurance plan first involves speaking with a doctor, usually your primary care physician, regarding your treatment needs.
From there, your doctor will create an individualized treatment plan for you, which might involve inpatient treatment or outpatient treatment of some kind. After you know which level of treatment you’ll need, you can either contact Anthem directly or speak with an AAC admissions navigator who can help you find an in-network facility that offers the treatment you need.
You will want to verify the details of your coverage and benefits, including the number of sessions that will be covered and any out-of-pocket costs you may owe. Be sure to check your coverage before seeking treatment whenever possible to avoid surprise medical costs.
What Types of Addiction Treatment Are Covered by Anthem in Connecticut?
Anthem can cover all levels of addiction treatment in Connecticut, but the exact amounts of coverage will vary based on the plan you have and where you seek care (i.e., whether the provider is within your plan’s network). Additionally, the level of care that you receive, which will be determined by a doctor based on your specific needs for treatment, will affect whether they are covered by your insurance plan through Anthem.
Common levels of care may include the following:
- Detox: Depending on your situation, a provider may recommend that you undergo medical detox, which is the process by which you’ll rid your body of substances (e.g., drugs and/or alcohol).3 Detox is generally done in a medically supervised setting to manage withdrawal symptoms.3
- Inpatient care. If a provider recommends that your treatment path include inpatient care, this will generally involve you residing at a treatment facility 24/7 for the duration of your treatment.4
- Outpatient care. If a provider recommends that your treatment path include outpatient care, you will generally need to visit a facility once or twice a week to receive care (e.g., therapy or group meetings) and then return home after the session.4
- Aftercare. If a provider recommends aftercare, which is a term used for the continuation of care following a successful rehab program, you may need to live in a sober living home or attend therapy, a 12-Step program, or group meetings.5
Does Anthem Cover Co-Occurring Addiction and Mental Health Disorders?
Per the ACA, your Anthem plan may be federally mandated to provide some level of coverage for mental health disorders, including co-occurring addiction.1 In addition to the ACA, under the Mental Health Parity and Addiction Equity Act, your Anthem health plan must cover any mental health or substance use disorder treatment services (e.g., addiction treatment) in a similar fashion to how it treats physical health (e.g., doctor’s visits).6
However, the exact amounts of coverage will depend on many factors, such as your specific plan, the type of care you need, where you seek care, and how long that care may need to last. Work with your provider to determine what types of treatment you may need for your mental health disorder, substance use disorder, or co-occurring disorder. From there, you can contact an Anthem health insurance representative or the rehab center directly to determine your coverage details.