Anthem BCBS Alcohol And Drug Rehab Insurance Coverage

Anthem BCBS is one of the largest medical insurance providers in the nation, and has many plans to help coverage for addiction and substance abuse treatment. Which types of behavioral health services your Anthem Blue Cross Blue Shield policy covers for substance abuse treatment depends on your individual plan.

Anthem BCBS Insurance Coverage For Addiction Treatment

Anthem BCBS is a managed healthcare insurance provider that operates under the umbrella of the Blue Cross Blue Shield insurance company. It has over 40 million members, making it one of the most extensive insurance carrier options in the United States.

Currently, Anthem provides many different policy options for drug and alcohol treatment and mental health services. The insurance coverage for inpatient treatment and outpatient treatment will vary based on this company’s needs and your state.

Here is what to expect if you’re using your Anthem policy to pay for addiction treatment and how they can help cover treatment costs so you can beat your addiction for good.

Anthem BCBS Insurance Coverage For Massachusetts Drug And Alcohol Rehab

Insurance coverage for Massachusetts residential treatment is often quite diverse, depending on your plan and your state. Typically, Anthem operates using the BCBS metal-tier plan choice option. These levels include Bronze, Silver, and Gold. However, platinum plans may be available in select states.

Plans like these are available on the healthcare marketplace at reasonable prices that make it easy to find one that works for your needs. Each Anthem BCBS insurance policy covers a certain amount, based on the tier you choose.

The different insurance coverage options for your insurance plans include:

  • Bronze: covers 60 percent of your healthcare costs
  • Silver: pays for about 70 percent of your needs
  • Gold: manages about 80 percent of your substance abuse treatment payments
  • Platinum: could cover up to 90 percent of your addiction treatment care

However, you may have to plan for copayments, deductibles, and premiums as well. These amounts vary depending on your policy and can be adjusted in a few different ways. For example, paying more in your premium each month may decrease your copay amount.

Using Anthem BCBS Insurance To Pay For Addiction Treatment

Beating drug or alcohol addiction often requires working with an insurance company that can provide payments that manage rehab costs. Typically, Anthem is an insurance company that offers expansive policy options that should keep you from paying too much for your drug or alcohol rehab program or other behavioral health care.

Using this type of insurance coverage can lessen your costs for care and help you avoid financial difficulties. While you may still have some out-of-pocket costs and other factors to consider before you start your treatment process, you should be in good hands with Anthem BCBS when beginning drug and alcohol treatment.

Do I Have To Stay In-Network To Use My Anthem BCBS Insurance For Drug Rehab?

Anthem splits up its policies into HMO and PPO plans. These two options vary depending on your needs. For example, a PPO is usually a more expansive network that may allow you to choose your provider. An HMO is generally less expensive but limits where you can get treatment and may even deny coverage if you go outside of your HMO treatment network.

However, if the rehab center you’re considering accepts Anthem Blue Cross Blue Shield, you can likely go there to recover and use your insurance.

Note that some plans do decrease your benefits if you do get care out of network. While it is possible to get residential treatment from outside your insurance carrier network, it may not be economical for you to do so.

What Will Be My Out-Of-Pocket Costs For Rehab?

Most of the time, you’re only going to have to pay your deductible for your drug rehab program. This amount varies depending on your policy. You may have to cover more if you get bronze than you do gold plans, for example. Don’t forget you’ll need to include your copayment amounts in planning for overall treatment costs.

These payments typically center on medications that you may use in rehab, such as various types of withdrawal help. If you have already met your deductible for the year, there’s a good chance that you may not have to pay as much for this rehab service.

Beyond that, you may also want to seek out treatment centers with sliding scale fees, grants, scholarships, or other payment options. Doing so can decrease your treatment costs even further.

How Do I Find A Massachusetts Rehab Center That Accepts Anthem BCBS?

The best thing about Anthem BCBS and other providers under the BCBS umbrella is how widely they are accepted. There are very few rehab facilities that do not take Anthem for drug and alcohol treatment.

This insurance company is one of the providers that has built trust with its clients and treatment providers over the years. Finding a Massachusetts rehab center that accepts your Anthem Blue Cross Blue Shield insurance policy shouldn’t be difficult.

To get started on this process, it may help to know what’s covered by your Anthem plan.

Does Anthem BCBS Cover Inpatient/Residential Rehab?

The critical importance of inpatient treatment for alcohol or drug addiction makes it very likely that Anthem will cover your treatment.

Most addiction treatment specialists agree that inpatient drug rehab provides the most comprehensive care. For this reason, many insurance carrier plans integrate inpatient treatment coverage into their policy options.

The amount that you pay for residential drug rehab will vary depending on the rehab program, whether you need detox, and how long you stay. Some patients may only need two weeks and a brief stint in withdrawal management. Others may need 90 days or more of care to ensure they have a better chance at remaining drug-free.

You can increase your stay length—and how much is covered by your insurance plan—by getting screened and tested before you go to rehab. This process verifies that you have a medical need for inpatient treatment. In this way, your Anthem coverage is much less likely to be denied for any reason.

Is Medical Detox Covered By Anthem BCBS?

Medical detox is often one of the most critical steps in the drug and alcohol treatment process. It starts by figuring out what kind of substances you have been abusing and then helps you slowly withdraw from them in a controlled manner.

If drug or alcohol detox is necessary for your recovery, Anthem is more likely to cover it, especially if it is offered as part of an inpatient rehab program.

Does Anthem BCBS Cover Outpatient Treatment?

Though Anthem is usually more likely to cover inpatient treatment, they do traditionally cover outpatient treatment. This option is an excellent choice for those who have a busy life and need to work addiction treatment around their other obligations.

Anticipate precertification being necessary for your insurance coverage. This step ensures that you have a medical need for drug or alcohol rehab.

Is Partial Hospitalization Covered Through Anthem BCBS?

In many ways, partial hospitalization is a middle ground between inpatient rehab and outpatient treatment programs. Most types of Anthem BCBS plans usually cover PHPs. Typically, those who have finished inpatient treatment but need extended care in recovery do well in these drug rehab programs.

Is Massachusetts Intensive Outpatient Treatment For Addiction Covered Through Anthem BCBS?
Anthem Blue Cross Blue Shield may cover intensive outpatient programs for those who no longer need medical supervision during recovery.

Does Anthem BCBS Cover Sober Living?

Anthem insurance plans may cover sober living if it is paired with a transitional outpatient rehab program. However, Anthem BCBS does not pay for housing costs outside of a treatment program.

Does Anthem BCBS Cover Medication-Assisted Treatment?

Medication-assisted treatment provides many benefits for those experiencing withdrawal symptoms from various types of drugs. This makes MAT essential for many in addiction recovery, and Anthem BCBS rarely denies coverage for this type of care.

Are Methadone Maintenance Therapy Costs Covered By Anthem BCBS?

If you and your rehab facility decide that methadone is essential for your recovery success, Anthem will likely pay for methadone costs. The amount of coverage will be outlined in your pharmacy benefits.

Will Anthem BCBS Cover Suboxone Medication Costs?

This medication can be critical for long-term recovery plans for those addicted to opioids, making its coverage crucial. Anthem often covers Suboxone therapy for patients experiencing withdrawal symptoms, helping them achieve better recovery results.

Verifying Your Anthem BCBS Insurance Coverage

Before you begin residential treatment, make sure that Anthem is an acceptable form of health insurance coverage in your state.

It is offered in many different areas, including:

If you or a loved one are looking for addiction treatment using your Anthem plan, please contact us at Spring Hill Recovery Center. We can verify your Anthem insurance plan, explain what’s covered by your policy, and give you an overview of our Massachusetts rehab center and addiction treatment services.

Written by Spring Hill Editorial Team

Published on: August 17, 2020 | Edited on: March 15, 2023

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This page does not provide medical advice.

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