/ Addiction Information / Insurance / Anthem Blue Cross Blue Shield

Anthem BCBS Insurance Coverage for Drug and Alcohol Rehab

Written by: Goeffrey Andaria, Mental Health Writer

Reviewed by: Dr. Carl Williams, Ph.D., LCADC

About 25.9 million Americans regularly drink alcohol, and another 10.9 million periodically use other drugs. Moreover, they all report taking these substances "a bit more or much more" than before the COVID-19 outbreak.

Sadly, many Americans battling drug or alcohol addiction are not getting help for their condition. One of the reasons for this is that they are concerned about how they will be able to afford rehab.

However, many people are unaware that there are now many health insurance policies that will pay for drug and alcohol rehab charges. This represents a significant shift, given that most insurance plans refused to cover rehab costs a few years ago. Anthem Blue Cross Blue Shield is a widely-used insurer that now covers drug and alcohol rehab services.

What is the cost of rehab services with Anthem BCBS?

Choosing between Anthem's in-network and out-of-network facilities

What rehab services does Anthem Blue Cross Blue Shield cover?

Anthem BCBS plan types

Anthem BCBS Federal plan types

Getting started on your path to recovery

What To Know About Your Anthem BCBS Insurance

Our Admissions Experts Will Help You Navigate This Difficult Information.

Co-Insurance

Deductibles

Co-Payment

Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.

The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.

Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.

What Is The Cost Of Rehab Services With Anthem Blue Cross Blue Shield?

Costs associated with health insurance policies may differ wildly based on a variety of variables, including:

Premium

Premiums are the regular payments made to your health insurance provider. The more comprehensive your policy, the higher your rates will be.

Deductible

The deductible is the portion of medical expenses you are responsible for paying out of pocket before your insurance company begins to cover any costs. Premiums for health insurance are reduced in proportion to the deductible amount.

Copay

You'll have to pay a copayment when you see a doctor or other medical professional. Copayments are set sums that may or may not change depending on the kind of service received.

Coinsurance

Once your deductible is met, you will be responsible for a particular portion of any additional costs. Coinsurance is the part of your total medical costs you will be liable to pay depending on your health insurance policy.

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Choosing Between Anthem's In-Network and Out-of-Network Treatment Facilities

Many health insurers have contracts with specific facilities, vendors, and specialists to help keep a lid on the expenses of addiction and physical and mental health treatments. These service providers are regarded as part of the network; if not, they are known as out-of-network providers.

You may or may not have coverage for drug addiction and mental health treatments depending on whether the provider you choose is in your insurance network.

What Rehab Services Does Anthem Blue Cross Blue Shield Cover?

Addiction is as individual as the people suffering from it. Although many patients have shared experiences with substance abuse and mental health disorders, each is treated in a manner that best meets their unique requirements. Anthem BlueCross BlueShield provides coverage for various addictions and related therapies.

Anthem BCBS covers many rehabilitation programs and services, including:

General outpatient programs
Intensive outpatient programs
Partial hospitalization programs
Inpatient programs
Residential programs
Aftercare programs
Medication-Assisted Treatment

Essential health benefits are covered by all of Anthem BCBS' plans as mandated by the Affordable Care Act (ACA). This implies that you have access to drug abuse treatment regardless of the plan you choose to buy.

The following is a list of some of the most common drugs that cause addiction for which your plan may provide coverage:

Opioids
Alcohol
Prescription drugs
Amphetamines
Benzodiazepines
Cocaine

Depending on your Anthem BCBS plan, your treatment costs may be reimbursed with small out-of-pocket payments. You may get in touch with your rehab facility if you have any questions regarding what is and is not covered by your BlueCross BlueShield plan, or you can get in touch with Anthem BCBS if you have any questions about the plan itself.

The following are the four primary categories under which Anthem BCBS plans fall:

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Anthem BCBS

Anthem BCBS covers many addiction treatment services.

Rolling Hills Recovery Center accepts a variety of Anthem BCBS insurance coverage.

Medically Reviewed:

Dr. Carl Williams Ph.D., LCADC

Rolling Hills Recovery Center

Expert Contributor

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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Anthem BCBS Plan Types

Bronze 60 Plan

Plans with a bronze classification have the lowest premiums per month but the largest deductible. As a result, those who do not anticipate significant medical needs and who will make fewer annual doctor visits may benefit significantly from this package. A bronze plan typically pays for around 60% of your medical costs.

Silver 70 Plan

Silver plans have lower annual deductibles and comparable monthly costs than bronze packages. However, the silver plan requires you to pay at least some of your inpatient and outpatient care costs. Silver plans typically pay for around 70% of your medical costs and expenses.

Gold 80 Plan

The monthly cost for a Gold plan is higher than for Silver and Bronze packages, but the deductible for doctor or rehab visits is lower. As a result, the "gold plan" will cover around 80% of your medical expenses.

Platinum 90 Plan

Platinum packages provide the highest level of coverage but come with significantly higher monthly rates. As a result, people with more extensive healthcare demands may benefit from these plans. Generally, there are no deductibles for platinum packages.

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Anthem BCBS Federal Plan Types

Anthem Blue Cross Blue Shield covers about 70 percent of the Federal Employees Health Benefits Program enrollees. This includes active and retired federal employees as well as their families. Federal workers and retirees may pick from three different plans:

Standard

With this plan, you may see either in-network or out-of-network providers and still pay a small copay or deductible.

Basic

With this plan, you may see your favorite specialist without worrying about a deductible, but you'll have to pay more in co-pays.

FEP Blue Focus

This more recent plan offers coverage from in-network providers, a smaller deductible, and reduced out-of-pocket costs.

These are the typical levels of protection. However, they vary by provider, service, and state. You can contact Anthem Blue Cross's customer support to learn more about your policy details. In addition, the admissions staff here at Rolling Hills Recovery Center are insurance consultants who can help you make sense of your policy.

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In a nutshell, Anthem BCBS provides addiction therapy coverage, mainly via the in-network agreements they have with rehab facilities. However, costs will be associated with providing the treatment, including deductibles, coinsurance, and copayments.

If you or someone you know is battling addiction and needs guidance on overcoming it, please call for help immediately. Discuss things with a rehabilitation counselor at Rolling Hills Recovery Center, and the two of you can devise a plan for moving forward.