Does Anthem Cover Addiction Treatment?
Please note: While American Addiction Centers (AAC) aims to provide the most accurate and up-to-date information on each carrier’s addiction insurance coverage, policy changes and errors do occur. Please double-check with your insurance provider directly to confirm your coverage levels. AAC is not affiliated with or endorsed by Anthem Insurance or any of its licensees.
About Anthem, Inc.
In 2004, WellPoint Health Networks Inc. and Anthem, Inc. merged and became WellPoint, Inc. until 2014, when the name was changed to Anthem, Inc. Anthem, Inc. is one of the top health insurance companies in the United States. As an independent licensee of the Blue Cross and Blue Shield (BCBS) Association, Anthem provides coverage in 14 states, although members are also able to take advantage of BCBS providers outside of their home state. Since plans and coverage can vary based on state, it is strongly suggested that you check with your plan to determine coverage details that may be specific to your state.
Coverage Levels and Coverage Plans (Health Fund)
Since Anthem is part of BCBS, the coverage options are broken down similarly, although certain plans and tiers vary based on state. The basic plans fall into 3 categories:3 p2-4; 4
- Bronze: This plan has the lowest monthly premiums, but the highest deductible and co-pays. About 60% of medical costs are paid by Anthem.
- Silver: This plan has monthly premiums that are higher than bronze, with a lower deductible and co-pays. About 70% of medical costs are paid by Anthem.
- Gold: This plan has the highest monthly premiums, but the lowest deductible. Co-pays are less than other plans, and about 80% of medical costs are paid by Anthem.
Another benefit of Anthem is that you may be able to take advantage of the nationwide network of BCBS providers. Some people prefer to seek treatment in a facility outside of their home state. Anthem may offer coverage outside of the state, but there is an option called a guest membership as well. This allows eligible members to join an affiliated HMO in another area if they are staying there for 90 days or longer. If you have questions about eligibility or out-of-state coverage, you can call Anthem directly.
Checking Your Insurance Benefits
If you have questions about your coverage and benefits, you can call the number on your insurance card and speak to a customer service representative. As a customer, you can visit Anthem’s website and create a profile where you can view your benefits information by clicking on “my plan” and then selecting “benefits.” Anthem also offers a tool to help estimate the costs of different treatments.
Anthem BCBS provides benefits to more than 66% of federal employees, retirees, and family members who are covered under the Federal Employees Health Benefits Program (FEHBP). Coverage is provided through BCBS’ 36 local member companies to make it easier to access care. There are 3 plans for federal employees or retirees to choose from:
- Standard: This plan covers both in-network and out-of-network providers with a low deductible.
- Basic: This plan covers preferred providers and has no deductible, but out-of-pocket expenses consist mainly of co-pays.
- FEP Blue Focus: This is a newer plan that covers preferred providers and has a low deductible, with lower co-pays for care.
If you’re eligible for Medicare, Anthem also offers hospital, medical, and prescription coverage in a single plan. It’s convenient and affordable, with some plans having no premiums and providing benefits that Medicare doesn’t, like hearing, vision, and dental coverage.
Does Anthem Cover Addiction Treatment?
Anthem BCBS insurance plans offer substance abuse and mental health coverage benefits. The level of coverage is dependent on your specific insurance plan. Many services are approved if they are medically necessary; therefore, alcohol, benzodiazepines, and opioid detox should be covered. Your plan may authorize only a specific amount of time in treatment, so it is important to check with Anthem to see what is covered. Checking your benefits through the member services website or calling the number on the back of your insurance card are the best ways to find out what services will be covered.
Anthem is a well-established provider of healthcare coverage that offers benefits not only in specific states, but access to a nationwide network of BCBS providers. They offer various plans and levels of coverage through employers, Medicaid, Medicare, and for current or retired federal employees. Checking your benefits can be done easily by contacting the company by telephone or through the member login website. While Anthem does offer coverage for addiction treatment, it’s best to confirm what your benefits will cover so that you can focus on your recovery.
Please note: American Addiction Centers (AAC) aims to provide the most accurate information on insurance coverage for addiction treatment, but policy changes and errors do occur. Always confirm your coverage with your insurance carrier directly. AAC is not affiliated or endorsed by Anthem, Blue Cross and Blue Shield (BCBS), or any of its licensees.
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