By: Nick
February 7, 2022

Does Anthem Insurance Cover Alcohol Rehab?

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If you are considering an alcohol rehab program, there are many things you need to consider. Perhaps the most critical factor in making your decision is whether your insurance plan will cover alcohol rehab. Many drug and alcohol rehabs accept many insurance plans, and one of the most popular insurance plans is Anthem (commonly known as Anthem Blue Cross Blue Shield).


While it is reassuring to know that many alcohol rehabs accept Anthem insurance, knowing what services are and aren’t covered is crucial in choosing an alcohol rehab center. Not knowing the extent of your coverage could create immense out-of-pocket expenses, or you may have to choose a level of treatment that may not fully address your needs. This article will explore what services Anthem Blue Cross Blue Shield covers for inpatient and outpatient alcohol treatment services.


Does Anthem Insurance Cover Alcohol Rehab Services?

Before committing to an alcohol rehab facility, you must see whether Anthem’s mental health and substance abuse benefits will cover your stay. As stated in the introduction, not knowing what services are and aren’t covered can make a big difference in the type of treatment you can afford. As with many insurance companies, Anthem Blue Cross Blue Shield will cover a myriad of alcohol rehab and other substance abuse services. It is important to note that coverage for these services are dependent on your plan, the state you live in, and the state where you are looking to receive treatment.


To determine if Anthem addiction services covers alcohol rehab, you first need to look through the Benefits Plan brochure that Anthem provides when you first receive coverage. There is a section of the brochure specifically outlining coverage for mental health and substance abuse. If you have questions on whether certain alcohol rehab services are covered, you can contact the insurance provider or talk to the admissions specialist at the treatment facility.


Additionally, it is important to know whether the alcohol rehab facility you are considering is in or out of network. This is extremely important because there will be differences in what goes to your deductible, what your co-pay may be for certain services, and whether services will be covered or not covered under your plan. In many instances, in-network facilities will cover most services fully, or significant portions of services will be covered under your plan. If the facility happens to be out of network, you may have limited coverage—or services may not be covered at all.


How Does Anthem Cover In-Network Rehabs

As a whole, Anthem insurance treatment covers a wide variety of services. The following services are covered when licensed treatment professionals are acting within the scope of their license:

  • Individual psychotherapy
  • Group psychotherapy
  • Pharmacologic (medication) management
  • Psychological testing
  • Office visits
  • Clinic visits
  • Home visits
  • Phone consultations and online medical evaluation and
  • Telemedicine


Regarding residential treatment facilities, a patient’s stay is covered if the staff at the facility develops a preliminary treatment and aftercare plan. A patient’s stay is also covered for the services listed in this section and where care is medically necessary. Other services covered include semiprivate room and board, meals, and covered charges as previously outlined. When in-network, there usually is an admission co-pay plus a percentage of the plan allowance. The amount of the co-pay and percentages are dependent on the plan.


Does Anthem Cover Outpatient Rehab

Regarding the question of whether Anthem covers outpatient alcohol rehab centers, the answer is yes as long as services are provided and billed by a covered facility. The following services are covered under Anthem insurance treatment:

  • Individual psychotherapy
  • Group psychotherapy
  • Pharmacologic (medication) management
  • Partial hospitalization
  • Intensive outpatient treatment
  • Diagnostic tests
  • Psychological testing


In general, outpatient rehabs that are in-network will cover a percentage of the plan allowance, and the deductible may apply. The percentage of this allowance is dependent on the plan.


What Services Are Not Covered?

Whether it is inpatient or outpatient, some services may not be covered under Anthem addiction insurance. These services may include the following:

  • Marital, family, educational, or other counseling or training services
  • Services performed by a non-covered provider
  • Testing for and treatment of learning disabilities and intellectual disability
  • Services performed or billed by schools, halfway houses, group homes, or members of their staffs
  • Services performed or billed by residential therapeutic camps (e.g., wilderness camps, Outward Bound, etc.)
  • Equine therapy


Contact your healthcare provider and/or drug treatment facility if you have further questions.


Do You Have Questions About Anthem Insurance and Treatment?

There is no doubt that insurance is an important thing to have when looking for alcohol rehab services. While insurance is invaluable, you may be unsure of what inpatient or outpatient services are covered. If you have questions on whether Anthem insurance covers alcohol rehab, call Multi-Concept Recovery today. Our knowledgeable admissions team will gladly review your Anthem addiction insurance and let you know what is and isn’t covered. In the event there is an out-of-pocket expense, underinsured, or even uninsured, the friendly admissions team at MCR will work with you and outline payment options that will fit your budget. Don’t let insurance confuse you. Call MCR toll-free right now and get the treatment you deserve.