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Anthem Blue Cross Blue Shield will generally cover alcohol and drug rehab, but how much depends on your particular insurance plan.
Anthem Blue Cross is one of the nation’s largest health insurance companies that often provides drug rehab insurance and coverage for alcohol rehab. That doesn’t mean there won’t be out-of-pocket costs, but Anthem Blue Cross will likely cover at least some addiction treatment costs.
Anthem is the parent company of Anthem Blue Cross and Blue Shield. Anthem has more than 70 million patients through its affiliated companies. It’s estimated that one in eight people in the U.S. have a healthcare plan associated with Anthem.
Anthem Blue Cross Blue Shield will generally cover alcohol and drug rehab, but how much coverage you have depends on your particular insurance plan and your healthcare provider or the treatment center you choose.
Typically, coverage for addiction treatment is part of behavioral and mental health treatment. The coverage options are usually broken into three categories.
If a rehab center or treatment provider accepts your insurance, whether with Anthem BCBS or another company, it’s described as in-network. If you go to treatment with an in-network provider, the rehab center has agreed to accept an approved amount for services. If you go to a provider or treatment center that’s not in-network, you’re responsible for paying the difference between the provider’s full charge and the approved amount for your plan.
The Affordable Care Act requires that any public or private insurance plan covers ten essential health benefits, including behavioral and mental health disorder treatment. Within that larger coverage category is the treatment for a substance use disorder.
If you have an insurance plan through Anthem or Anthem Blue Cross Blue Shield, you will probably have some benefits for mental health and substance abuse treatment. Your specific insurance plan dictates how much coverage and out-of-pocket costs will be. Expect that coverage for drug or alcohol rehab will differ depending on your state.
The insurer might authorize that you can go to treatment for a certain time, and you determine specific benefits and coverage by calling the number on the back of your insurance card.
Medication-assisted treatment can be an important part of an addiction treatment plan. With MAT, FDA-approved medications, behavioral therapy and other treatment approaches are used to help someone stop using drugs and alcohol. Medication-assisted treatment is used primarily for alcohol and opioid use disorders. These medications can reduce cravings and help with withdrawal symptoms. Anthem covers MAT in most cases, although, again, coverage can differ.
Suboxone is a brand-name medication combining buprenorphine and naloxone used for treating opioid use disorder. Since Suboxone is an FDA-approved treatment for certain substance use disorders, Anthem will likely cover it if it’s deemed medically necessary. In some states, Anthem Blue Cross Blue Shield doesn’t require prior authorization for an initial couple of weeks of Suboxone treatment to reduce barriers to addiction treatment.
Methadone is an approved MAT for opioid use disorder. Some insurance plans with Anthem Blue Cross Blue Shield cover the cost of methadone. Depending on your insurance plan and healthcare provider, you might need to get a pre-authorization for Suboxone. Less expensive generic versions also exist.
Disulfiram is a medication used to treat alcohol use disorders. This medication causes adverse side effects if a person drinks even a small amount of alcohol while on it. It’s not an alcoholism cure but it can discourage drinking during treatment. Anthem may cover disulfiram if its use is indicated by your healthcare provider or treatment team.
Many variables will play a role in the length of treatment Anthem covers. Things that will factor into your coverage include the rehab center and type of program you will participate in, your state of residence and whether you’re choosing a rehab center that’s in-network or out-of-network.
The insurance company will determine the length of stay they think is appropriate in any given situation, considering the type of substance you’re addicted to, how long you’ve been using a substance and whether or not you’ve faced legal consequences yet. Co-existing mental health diagnoses are relevant in determining the length of your stay, and it’s also considered whether you’ve previously tried other types of addiction treatment.
The Recovery Village at Palmer Lake is a Colorado addiction treatment center in-network with most major insurance plans, including Anthem Blue Cross Blue Shield. If you want to know whether your plan will cover addiction treatment, contact our team, and we can help you verify benefits. We can also discuss other options if you don’t have insurance.
Contact our Recovery Advocates today to take the next step toward freedom from addiction.