Anthem Insurance for Alcohol & Drug Rehab

Need Help Paying for Rehab With Anthem Insurance?

Our admissions team is available 24/7 to help verify your insurance and assess your coverage for rehab

If you or a loved one is struggling with substance use and have Anthem insurance, you may be eligible for addiction treatment services in rehab.

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South Coast Behavioral Health’s specialty program for veterans and first responders offers an innovative approach to substance use disorder treatment.

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Getting treatment for substance abuse can be costly, which may deter some people from even looking for help. Finances shouldn’t prevent anyone from receiving care for mental health or addiction treatment. These issues are widely covered by insurance plans. Many people are surprised how little they need to pay for rehab through their policy. If you have coverage through Anthem insurance, many services surrounding addiction and mental health treatment will be at least partially covered. But when making a plan for substance abuse rehab, you want all of the information upfront so there aren’t surprises. You’re in the right place. We will walk you through using Anthem insurance for addiction treatment to help you determine what your plan offers.   

What Is Anthem?

Anthem Blue Cross Blue Shield (or Anthem for short) is connected to the Nationwide insurance provider Blue Cross Blue Shield. BCBS operates across the United States by partnering with different insurance companies around the country. Anthem is BCBS’s largest provider in its network, serving 14 states. Since its founding in 2004, Anthem now covers over 78 million members with healthcare plans. As one of the largest insurance providers in America, Anthem is a good choice for individuals looking for complete coverage. It provides comprehensive coverage for healthcare, dental, and vision through its many policy options.

It offers individual, family, and group plans, as well as Medicare for those over 65 and Medicaid for low-income clients. Figuring out your plan can be stressful, which is why you’re wise to turn to the admissions team at South Coast Behavioral Health for advice. You’re taking the right step by breaking down the ins and outs of Anthem insurance.

Markedly, Blue Cross Blue Shield insurance is separate from Anthem coverage. Anthem is an independent licensee, so to find the details of your plan, you’ll need to go through Anthem’s databases.

Understanding Anthem Insurance Policies

With a large nationwide insurance company like Anthem, exploring the many different policies can be especially overwhelming. However, it can be simplified by breaking plans into categories.

Anthem offers many healthcare insurance options. These are separated by:

Anthem has a variety of plans for individuals and families, as well as employer-sponsored benefits programs. These are split into small business and mid to large business plans. Additionally, they offer the Anthem Enhanced Choice health insurance plan for those who don’t have coverage through an employer.

The company breaks policies into tiers, with different costs and coverage per level. Anthem plans fit into the following basic tiers:

Bronze: Bronze tier plans are the cheapest option, with the lowest possible monthly costs but higher deductibles for expenses. They are best recommended for those mainly looking for coverage for emergencies.

Silver: The silver tier provides mid-level plans for monthly payments on the low end of the spectrum but with higher deductibles. They are recommended for those with average health needs.

Gold: Plans in this tier have higher monthly payments than the lower tiers but also more coverage for routine medical costs. Deductibles are less for lower out-of-pocket expenses with services.

Platinum: Platinum-tiered plans offer the most coverage for medical expenses but also have the greatest monthly payments. The deductibles are generally zero dollars, and they often have low flat-rate costs for services like doctor’s visits.

Depending on what your coverage looks like, you may have higher or lower deductibles for substance abuse treatment specifics. So which policies provide for addiction rehab?

What Anthem Policies Cover Addiction Treatment?

Many Anthem insurance policies cover substance addiction rehab, including their employee programs, individual and family plans, Medicare, and Medicaid plans. Under the United States’ Affordable Care Act (ACA), substance abuse treatment is considered one of ten essential health benefits. Therefore, you likely have coverage for some aspects of addiction treatment. Although insurance plans are required to offer addiction help, your level of coverage for each rehab service may vary. The ins and outs of expenses all depend on your policy. It will also look different depending on whether you’re covered by an on-exchange plan or an off-exchange plan like Anthem.

Anthem Referral for Rehab

Some insurance policies necessitate a referral from a healthcare provider for services. If this is the case, you’ll need a referral from your primary physician to qualify for benefits towards your rehab. However, Anthem states that most of their plans do not require referrals for meetings with specialists. When it comes to prescriptions and intensive care, you’ll need to explore your policy more in-depth. Fortunately, we are happy to look into your plan on your behalf if you reach out!

Anthem Pre-authorization for Rehab

Pre-authorization refers to receiving permissions regarding your eligibility for services. This is a safeguard put in place to ensure individuals only receive the care that is right for them. For example, you may need your physician’s certification that you require a certain prescription for the maintenance of SUD symptoms. Some Anthem insurance coverage obligates prior approval. It’s best to be aware in advance to arrange the necessary steps.

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Looking for quality substance abuse treatment that’s also affordable? South Coast accepts most major insurance providers. Get a free insurance benefits check now.

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Rehab Programs Covered by Anthem Insurance

The good news with a comprehensive coverage provider like Anthem insurance is most addiction treatment services are at least partially covered. As mentioned, the specifics of how many days and which programs have coverage depend on your policy. Most important is that you receive the help you need to overcome your battle with addiction. If you have concerns about not being able to afford treatment, please reach out. We want to work with you to share options and help you overcome any barriers to care.

Anthem Coverage for Detoxification

Detoxification, also called detox, is the first stage of recovery for those actively using substances. To enter the next levels of healing, you need to start from a baseline of sobriety. Because sobriety is much more than merely removing toxins from the body, clients move into intensive treatment after detox. Many Anthem plans include coverage for medical detox.

Anthem Coverage for Residential Treatment

In general, Anthem insurance plans cover residential inpatient treatment, at least in part. Residential inpatient treatment is an intensive plan where individuals live in an addiction rehab center and get around-the-clock care. Anthem offers an Anthem Enhanced Choice health insurance for individuals and families. This plan covers hospital indemnity insurance for those needing to have an extended hospital or intensive care stay. Your plan may qualify you to receive cash payments during treatment. You will need to explore the specifics of your policy to see how residential inpatient care is covered.

Anthem Coverage for Partial Hospitalization

Partial hospitalization (PHP) is a level of care for those requiring flexibility in treatment. Clients don’t live in-center but spend roughly seven hours per day in treatment. It is the most intensive level of outpatient care. Anthem has coverage for PHP for those who meet the requirements. You may require preauthorization to be eligible for PHP through your policy, so be sure to find out ahead of time.

Anthem Coverage for Intensive Outpatient Treatment

Intensive outpatient (IOP) treatment is one step down from partial hospitalization programming. Weekly hours in treatment are reduced from roughly five to seven in PHP to three to four in IOP. It is another flexible outpatient option for those needing to live outside of a treatment center but still receive near-daily rehab. Programming includes therapy, counseling, and case-by-case medication management. Some Anthem insurance policies have benefits for intensive outpatient treatment for substance addiction.

Anthem Coverage for Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) is a recovery program for those with substance use disorders (SUD), mental disorders, or co-occurring disorders. There are standard FDA-approved medications for the treatment of alcohol and opioid addiction that your insurance policy likely covers.

For alcohol addiction, they are:

FDA-approved drugs for the treatment of opioid use disorder include:

You may also be recommended medications for mental illness symptom management. Especially with co-occurring mental disorders and SUD, medication for one or both issues could be recommended. When it comes to MAT, you might have set co-pays for prescriptions. Also, you may need preauthorization for medication, a safeguard put in place to help moderate prescription drug usage.

Using Anthem for Mental Health Treatment

Mental health issues often go hand-in-hand with substance abuse struggles. Substance disorders and mental disorders can actually exacerbate each other. We recognize that mental wellness is an imperative aspect of overall health. As such, our SUD programs take a holistic focus to incorporate mental healing, along with physical, emotional, and spiritual. Anthem insurance includes services for mental health in many plans. You may have coverage for counseling, therapy, and medication management. However, you may need preauthorization for services, so overview your plan for the specifics.

We Are In-Network With Aetna, Anthem, & Cigna Health Insurance Plans

South Coast Behavioral Health is proudly an in-network provider of substance abuse and dual diagnosis treatment services for BlueCross BlueShield Anthem, Aetna, and Cigna health insurance plan members.

Aetna Insurance Logo- We accept Aetna Insurance Plans

We also accept most major insurance providers

Tricare insurance
Providence Health

If you are ready to recover, please reach out to speak with one of our admission coordinators.

Should I Use Anthem Insurance for Rehab?

If you have coverage through Anthem, there are probably options for mental health and addiction treatment. Financial instability is one of the main reasons people don’t get addiction care. That’s why insurance is so helpful. 

South Coast Behavioral Health teaches individuals how to live fulfilling lives of sobriety. Not only do we help clients safely detox from toxins, but we also teach coping skills for when the desire for substances returns.

If you or a family member is struggling with substance abuse, it’s important to seek help from a qualified and approved provider of Anthem rehab services.  With Anthem, you have access to affordable and effective treatment options that can help you on your journey toward recovery today. We encourage you to reach out to our team by calling 866-881-1184 for more information on our treatment services and locations in your area.

Verify Your Anthem Coverage Now

To get started, simply fill out the insurance verification form available on our website. This form is your initial step toward peace of mind, as it allows us to gather the necessary information to verify your insurance coverage for addiction treatment services.

You can also learn more about your plan or explore policies on Anthem’s website. Either log in with your Anthem account information or use the first three values of your member ID. You’ll be directed to see which providers are included in your plan.

Finding an Anthem Rehab Near Me in Orange County, California

South Coast Behavioral Health is an Anthem insurance rehab provider located in Orange County, California. We are proud to offer evidence-based treatment programs for substance abuse and mental health disorders specifically tailored to meet the needs of military service members, veterans, and their families.

Our substance use disorder treatment centers are located in several cities throughout Orange County, California including:

South Coast is honored to provide specialized treatment for veterans and first responders within each of our drug and alcohol rehabs in Orange County, CA. Our Valor Program provides personalized treatment founded on trauma-informed care.

At South Coast’s Anthem approved rehab facilities, our clinicians understand the unique challenges faced by those who serve our country. Throughout our addiction treatment programming, we provide compassionate care and support throughout the recovery process.

During treatment, veterans gain access to a variety of vital addiction treatment services such as medication management, behavioral therapy, and addiction counseling.

In addition to traditional therapies, we also offer expressive arts therapy which allows clients to explore their feelings through creative outlets. This can be especially beneficial for veterans who have difficulty verbalizing their emotions.

We also provide dual diagnosis treatment for co-occurring mental health and substance abuse disorders, and medication-assisted treatment (MAT) for those struggling with addiction.

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TRICARE Insurance

Paying for Rehab with Anthem

Insurance takes a great amount of financial stress out of substance abuse recovery. We believe those battling addiction or mental health must receive the help they need. Our addiction treatment programming puts individuals first, which is why we help clients figure out how to pay for rehab. Above all, the most important is that you or your loved one receive prompt care. Fees and insurance confusion shouldn’t interfere with treatment. Reach out today and let us tell you exactly what your plan includes. You will be one giant step closer to recovery.  

South Coast Behavioral Health is here every step of the way to support you through this process with compassion and expertise. To learn more about our veterans rehab program or receive help in paying for rehab with Anthem, reach out to us at (866) 881-1184.

If you or someone you know is struggling with addiction, please don’t hesitate to reach out to us.

We are here to help because we’ve been there.

The Treatment Experience at South Coast

What Our Alumni Have to Say

This place truly saved my life. I'll be forever grateful for the opportunity to get and stay sober here... Everyone was great. This experience definitely paved the way for a real future for me and for my son. Thank you.

J.C. Alumni of SCBH
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