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Anthem Drug and Alcohol Rehab Coverage

Anthem Behavioral Health Insurance

What is Anthem?

Anthem is a subsidiary of Blue Cross Blue Shield, therefore their large, extensive in-network web of facilities and healthcare professionals is one in the same. It’s specified towards behavioral health ailments including alcoholism and drug addiction. They’re the second most used behavioral health insurance provider in the country servicing over 13 million members nationwide.

When it comes to substance abuse and alcoholism treatment, many insurance providers will offer only limited coverage for inpatient residential facilities and/or outpatient rehab programs. Complying with the government regulations, Anthem provides varying degrees of unspecified mental healthcare. Substance abuse and alcoholism falls under the umbrella of mental health and is defined as a disease according to the American Medical Association.

Anthem’s Network

Anthem has different approaches and conduct for covering addiction treatment. Often they can go above and beyond the industry standard. Within their network of behavioral health professionals there are doctors, psychiatrists, psychologists and social workers familiar with working their policies. In addition, a broad network of facilities such as hospitals, inpatient rehab centers and intensive outpatient program offices also accept their coverage plans as payment. Anthem can cover portions of all of the typical levels of treatment including detox, inpatient rehab, partial hospitalization programs (PHP), and intensive outpatient and standard outpatient programs.

Coverage Policies

Depending on the health insurance plan you have differing procedures may apply. The duration of treatment and the level of care necessary will factor into determining the specific coverage. These factors are assessed relating to the severity of the addiction and a medical necessity for treatment. Individuals using Anthem will have their claims approved on a case-by-case rationale. Based on criteria the insurance company will qualify a recipient for the level of treatment that best speaks to the specifics of their condition and illness. Working with a physician, ongoing assessment of the issue will note the effectiveness of the treatment and whether or not a medical necessity is still evident. As progress is achieved over time during the rehabilitation process the intensity of services may be reduced and the level of coverage for said services will reflect this.

For more information visit Anthem’s website. Speak to a representative on the phone by dialing their toll free number listed on the back of your insurance card. Ask questions and learn about what your particular insurance plan will cover.

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