Anthem Rehab Coverage

Anthem is the parent company of Anthem Blue Cross and Blue Shield. Anthem is a health care company that serves more than 70 million through its affiliated companies, and one in eight people in the U.S. receive health care through plans associated with Anthem.

Anthem does provide coverage for substance abuse rehab, including drug and alcohol therapy, as well as detox and other services related to this kind of treatment. Anthem’s behavioral health and substance abuse services are designed to address the complete health of policyholders on a holistic level. In addition to substance abuse treatment options, this insurance also covers many of the treatments required for people with mental illnesses like anxiety and depression.

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Does Anthem Have Rehab Coverage?

Anthem, primarily through its Blue Cross Blue Shield subsidiaries, does offer some rehab coverage, although as with most insurance companies and policies, the type and level of coverage depend on the location of the policyholder and the specifics of their plan.

Anthem or Anthem Blue Cross is also part of many state exchanges that are available through the Affordable Care Act, and under the stipulations of the ACA, insurance companies are required to cover mental health care as an essential provision.

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Anthem Mental Health

Anthem Blue Cross features comprehensive Behavioral Health programs that are designed to offer integrated care to policyholders. There’s a philosophy with coverage provided by Anthem that mental health and physical health aren’t separate from one another, so insurance coverage shouldn’t be either.

Anthem, like other health insurance providers, also covers mental health care the same way they do other medical care, for example regarding copay’s and coinsurance requirements.

Is Anthem Mental Health Covered By Insurance?

Anthem does have mental health coverage, and this includes access to an extensive network of specialty behavioral and mental health care providers, which includes physicians and therapists. Mental health coverage from Anthem also includes access to specialized facilities that have contracts with this insurance provider.

Care Managers are licensed and experts in their field, and work with policyholders to address their specific mental health needs and connect them with the services and facilities they need.

Anthem Behavioral Health

Behavioral health coverage from Anthem is classified in the same general category as mental health. When a policyholder with Anthem needs behavioral health services, they can contact Behavioral Health Care Managers, who specialize in coordinating this area of care with the person’s other healthcare providers to make sure there is integration between physical and mental health care services and treatments.

Is Anthem Behavioral Health Covered by Insurance?

Some of the specific features of behavioral health that can be covered by Anthem insurance are access to specialty providers that includes therapists but also physicians, as well as access to facilities including specialty hospitals and acute care.

Insurance from Anthem also provides the opportunity for a review that could allow policyholders to have access to mental health and substance abuse treatment facilities.

Network options also include partial hospitalization programs, intensive outpatient behavioral health programs, and a variety of residential treatment options.

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What To Expect From Anthem for Rehab

In many cases, Anthem does cover the cost of rehab, but the insured person may be responsible for meeting some out of pocket expenses, such as copays or coinsurance costs. There may also be deductible requirements that need to be met by the policyholder. All of these expenses can vary based on the specific plan a person has, as well as the state where he or she lives. To find these requirements out, the policyholder should review the details of their particular Anthem plan.

There are also many circumstances where a review and pre-authorization are required for the cost of an inpatient rehab stay to be covered by Anthem, so people with this insurance should always check into pre-authorization requirements before they make any other plans for rehab or substance abuse treatment.

It’s the role of Anthem’s dedicated Behavioral Health Care Mangers to coordinate with drug addiction treatment facilities and with policyholders to determine whether or not preauthorization can be obtained.

Precertification requirements vary as well. In most cases, preauthorization is required for all inpatient admissions, intensive outpatient programs, residential care and partial hospitalization programs that fall under the category of mental health and substance abuse.

Ultimately, the best course of action, if you’re wondering what to expect from Anthem for Rehab, is both to read your summary of covered benefits, and also contact a care coordinator or representative from the insurance company to find out options that pertain to you.

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  • Anthem of Colorado
  • Anthem of Nevada
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.