Does Anthem Cover Rehab?

Yes, Anthem covers drug and alcohol rehab in most states. To learn about specific coverage, read our guide below.

Published On: Jun 29, 2023


Anthem's Coverage For Rehab

Anthem is a major health insurance provider in the United States, covering millions of members across the country. One of the most important aspects of health insurance is knowing what services are covered under a particular plan, and this is especially true when it comes to addiction treatment.

Substance abuse is a widespread problem in the US, and it's important to know whether your insurance will cover the cost of rehab for alcohol and drug addiction. In this article, we will explore whether Anthem covers alcohol and drug rehab, and what services are available to members seeking addiction treatment.

First, it's important to understand that Anthem offers a variety of health insurance plans, and the coverage for addiction treatment can vary depending on the plan.

However, all Anthem plans are required to provide coverage for mental health and substance abuse treatment under the Affordable Care Act (ACA), also known as Obamacare. This means that all Anthem plans are required to cover addiction treatment to some extent, but the specifics of the coverage can vary.

Anthem offers several types of plans, including HMO, PPO, and POS plans. HMO plans typically have more limited networks of healthcare providers, while PPO plans offer more flexibility in choosing providers. POS plans are a combination of HMO and PPO plans. Depending on the plan, members may have to meet a deductible before coverage for addiction treatment begins.

Anthem covers a range of addiction treatment services, including detoxification, inpatient treatment, outpatient treatment, and medication-assisted treatment.

Detoxification is the process of removing drugs or alcohol from the body, and it can be dangerous and uncomfortable without medical supervision. Inpatient treatment involves staying at a residential facility for a period of time to receive intensive treatment for addiction.

Outpatient treatment allows individuals to receive treatment while living at home, and medication-assisted treatment involves using medication to help manage withdrawal symptoms and cravings.

It's important to note that not all addiction treatment facilities are covered by Anthem, and members may need to choose a facility that is in-network in order to receive the maximum coverage. Out-of-network providers may be covered, but members may be responsible for a larger portion of the cost. Members can use Anthem's provider search tool to find in-network addiction treatment providers.

In addition to covering addiction treatment services, Anthem also offers resources and support for members seeking addiction treatment. This includes access to a 24/7 hotline for mental health and substance abuse concerns, as well as online tools and resources for managing addiction and finding treatment.

Getting Anthem Coverage For Rehab

To get Anthem coverage for rehab, members should first review their plan's benefits to determine what services are covered and at what cost. Members may need to obtain prior authorization from Anthem before receiving certain addiction treatment services, such as inpatient treatment.

It's also important for members to select an addiction treatment provider that is in-network with Anthem in order to receive the maximum coverage. Members can use Anthem's provider search tool or call customer service for assistance in finding in-network providers.

Once a member has selected an in-network provider, they should contact the provider to schedule an assessment and discuss the recommended course of treatment. The provider will work with Anthem to obtain any necessary authorizations and coordinate payment for services.

Members should also be aware of their financial responsibility for addiction treatment services. Depending on the plan, members may be responsible for a deductible, co-payments, or coinsurance for addiction treatment. It's important to review the plan documents carefully and ask questions if anything is unclear.

Overall, obtaining Anthem coverage for rehab involves understanding your plan benefits, selecting an in-network provider, obtaining necessary authorizations, and being aware of your financial responsibility for addiction treatment services.

Summary

In conclusion, Anthem does cover alcohol and drug rehab, but the specifics of the coverage can vary depending on the plan.

All Anthem plans are required to cover addiction treatment under the ACA, but members may need to meet a deductible, choose an in-network provider, or pay a portion of the cost for out-of-network providers.

Anthem covers a range of addiction treatment services, including detoxification, inpatient treatment, outpatient treatment, and medication-assisted treatment. Members can also access resources and support for managing addiction and finding treatment.

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