Wellpoint Alcohol And Drug Rehab Insurance Coverage

Wellpoint insurance plans offer behavioral health benefits, which may pay for addiction treatment programs. Treatment options vary by individual plan, but could include coverage for inpatient treatment, outpatient programs, detox programs, and more.

Wellpoint insurance company is a spinoff of Blue Cross of California. More commonly known as Anthem, this health insurance network provides insurance benefits to 42 million people through its affiliate insurance carriers.

While the coverage amounts and services associated with alcohol and drug treatment may vary by plan, Wellpoint will typically cover portions of costs for outpatient and inpatient treatment programs and facilities.

This also may include helping with expenses such as medications and counseling services.

For those struggling with drug or alcohol addiction and seeking treatment, it may be helpful to understand a few of the following about drug rehab programs and your insurance policy:

  • what type of programs, treatment services, and treatment facilities are covered by your Wellpoint plan
  • what will the out-of-pocket expenses be for the needed treatment programs
  • how to verify insurance coverage before getting drug or alcohol treatment, and before leaving for a residential treatment center

Insurance plans like Wellpoint and many others are welcomed at a number of rehab centers throughout the state of Massachusetts and Greater New England.

Wellpoint Insurance For Massachusetts Drug Rehab

One of the most common types of recovery centers are alcohol and drug rehabs, and under these types of centers are various treatment options. Some addiction treatment programs will be designed for inpatient treatment, while others might be geared toward outpatient treatment and services.

The type of coverage available through Anthem insurance policies for each type of treatment program will vary depending upon each individual coverage plan.

Using Wellpoint Insurance To Pay For Addiction Treatment

The simple fact that recovery saves lives, restores families, careers, and rebuilds reputations is worth every penny of paying for treatment. That is also why using insurance to help with addiction treatment is not only smart but also far less costly than the other options.

The reality, however, is that drug rehab can also be a costly necessity. With insurance to help with the cost of treatment, medication, and services, addiction treatment can be made more affordable.

These are a few considerations that can help people get the most from their Wellpoint insurance and policies:

  • deductible rates
  • out-of-pocket expenses
  • in-network coverage options
  • copayment rates

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

In many cases, your Wellpoint insurance plan will likely cover the costs of in-network treatment, yet this will always depend on your specific policy and plan. PPO and HMO plans, for example, have a network of treatment providers for substance abuse treatment services.

That means that it is a good idea to try and stay with an in-network option as this will improve the likelihood of being covered by your insurance company.

Out-Of-Pocket Costs For Substance Abuse Treatment

The out-of-pocket costs that can arise from drug rehab services can vary, not only depending on the services but on your policy and plan structure. Out-of-pocket costs that can typically be incurred include copayments, deductible rates balances, and other behavioral health services that may fall outside your coverage plan.

If a deductible amount hasn’t been fulfilled for the calendar year, for example, then the balance of admissions cost for an addiction treatment center will become an out-of-pocket expense. This could potentially delay drug or alcohol treatment until the deductible is met.

For this reason and others, it’s important to go over your health insurance plan and find out what it covers.

How Do I Find A Massachusetts Rehab Center That Accepts Wellpoint?

The good news for those with Wellpoint insurance is that they are in-network with many different alcohol and drug rehab facilities across the United States.

This means that chances are good that you can find a quality drug and alcohol rehab center that accepts your plan. Contacting your insurance adjuster or talking to a Spring Hill treatment representative is a good place to start if you have questions.

Does Wellpoint Cover Inpatient Rehab Programs?

One of the most common types of centers for addiction treatment is residential treatment facilities. These inpatient treatment programs are also one of the more commonly accepted treatments by insurance plans. This is also a win-win as inpatient treatment generally addresses acute and serious cases of addiction. Having help with expenses during times like these couldn’t mean more when it is needed most.

Is Alcohol And Drug Detox Covered By Wellpoint?

Typically considered a vital part of any recovery program, in particular when medical assistance is suggested or needed, detox programs are often covered by Wellpoint plans. Drug and alcohol detox programs are generally part of inpatient treatment, but not exclusively, as some outpatient programs can include detoxification services.

Does Wellpoint Cover Outpatient Drug Rehab?

In many situations where addiction treatment is needed, Wellpoint policies will cover portions of outpatient drug rehab program services. Each individual plan will vary, and some outpatient treatment costs (e.g. medication) may include copays or other out-of-pocket expenses.

Are Partial Hospitalization Programs Covered Through Wellpoint?

Some recovery programs, such as those that require a medically supervised detox process, for example, may include partial hospitalization services.

Wellpoint insurance plans can help with partial hospitalization programs (PHP), or day treatment. Talking to a Spring Hill treatment representative can be a good place to start to find out more about what types of outpatient treatment programs for drug and alcohol abuse can be covered.

Are Intensive Outpatient Programs Covered By Wellpoint?

People who struggle with alcohol or drug addiction may benefit from the help and support of intensive outpatient programs (IOP).

Intensive outpatient treatment will often require more addiction services and offer help such as medication-assisted treatment (MAT) options. IOP program costs are treatment expenses that your Wellpoint plan can help to offset.

Does Wellpoint Cover Medication-Assisted Treatment?

Medication-assisted treatment options may be part of an intensive residential rehab or outpatient treatment program. Certain prescription medications, such as methadone or buprenorphine (Suboxone) can be the bridge that leads to the road of addiction recovery. In many situations, Wellpoint or Anthem insurance plans may cover MAT programs.

Does Wellpoint Cover Methadone?

Methadone maintenance therapy may be employed for those with substance use disorders involving opiates. Costs like these may be covered by Wellpoint plans if a person shows medical necessity.

Will Massachusetts Wellpoint Cover Suboxone Therapy?

Along with other types of medication used in MAT programs, Suboxone therapy is another cost that may be covered by Wellpoint plans. Checking your pharmacy benefits under your Wellpoint policy could help you find out more information about specific coverage for particular prescription drugs.

Does Wellpoint Cover Sober Living Home Costs?

If you are a Wellpoint policyholder, sober living costs that are part of a recovery program or outpatient treatment plan may be covered. How these sober living facilities are viewed, either as forms of treatment or housing, will depend greatly on your city, county, and state of residence.

Does Wellpoint Cover Aftercare?

Aftercare programs associated with alcohol and drug treatment may be covered by your Wellpoint plan. It is also possible that medications that are part of a recovery/aftercare program may be included in coverage as well. Your insurance adjuster or admissions personnel for treatment facilities can often be a resource for help and direction.

Verifying Your Wellpoint Insurance for Addiction Treatment

If you or a loved one has made the decision to get help for alcohol or drug abuse, know that this will be one of the smartest and toughest steps you will ever take. Now that the decision to get help is made, it is time to find that help. This process will be made easier by beginning with reviewing your insurance coverage.

Looking at your Wellpoint insurance policy will help you learn what types of treatments, rehab facilities, and recovery options are available under your plan.

The caring team at Spring Hill Recovery Center wants to help, not only with getting you the recovery you need but also with your insurance questions. You have made the decision, now make the call to Spring Hill Recovery Center’s helpline, and take the first step toward sobriety today.

  1. Anthem, Inc.—Customer segments https://www.antheminc.com/AboutAnthemInc/CustomerSegments/index.htm
  2. Anthem, Inc.—WellPoint Health Network, Inc. https://www.antheminc.com/AboutAnthemInc/CompanyHistory/PW_D015003.html
  3. Substance Abuse and Mental Health Services Administration—Buprenorphine https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine
  4. U.S. National Library of Medicine: MedlinePlus—Opiate and opioid addiction https://medlineplus.gov/ency/article/000949.htm

Written by Spring Hill Recovery Editorial Team

© 2024 Spring Hill Recovery | All Rights Reserved

* This page does not provide medical advice.

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