In your search for an alcohol rehab in Northern California, having insurance is an enormous blessing and comfort. Thanks to the Affordable Health Care Act (ACA), insurance companies must provide coverage for those with substance abuse and mental illness issues. If you have Anthem Blue Cross Blue Shield (BCBS), the main question is, does Anthem BCBS cover alcohol rehab?
Does Anthem BCBS cover alcohol rehab?
While you may have Anthem BCBS and have coverage for alcohol rehab, do you know the extent of that coverage? Knowing precisely what is and isn’t covered makes a considerable difference in the rehab you choose and the quality care you will receive while in treatment. This article will take a deeper dive into whether Anthem Blue Cross Blue Shield covers alcohol rehab, how to verify coverage, and where you can find a rehab that accepts Anthem BCBS.
What is Anthem Blue Cross Blue Shield?
Before we look into the nuts and bolts of Anthem BCBS insurance, we need to look at the company itself. Anthem is one of the leading health companies in the United States. The company serves approximately 118 million Americans, with 45 million under their health insurance plans. Blue Cross Blue Shield is considered a subsidiary of Anthem and under the Anthem umbrella.
While Anthem and BCBS are essentially the same or similar regarding the insurance plans that are carried, they differ in the states they cover. This is important to know if you may be considering an alcohol rehab in another state that may not have Anthem BCBS coverage.
Anthem Blue Cross Blue Shield can be offered in the workplace as part of an employer’s healthcare package. Anthem BCBS can also be purchased directly from their website or available on the Healthcare Exchange.
Does Anthem BCBS Cover Alcohol Rehab?
To answer the question does Anthem BCBS cover alcohol rehab, the simple answer is yes. However, the amount of coverage you receive depends on your plan, the specific level of coverage you have, and whether the rehab is in or out-of-network with your insurance.
In general, Anthem Blue Cross Blue Shield will cover residential alcohol rehab if facility staff develops an individual treatment and aftercare program. The following services are generally covered provided treatment professionals act within the scope of their license:
- Individual and group psychotherapy
- Medication management
- Psychological testing
- Office and clinic visits
Additionally, the following services would also be covered:
- Semiprivate room and board
With in-network alcohol rehabs, there is usually an admission co-pay plus a percentage of the plan allowance. The amount of the co-pay and percentages are dependent on the plan. If a rehab is out-of-network, there may be covered, but it would be limited at best. There would be services that would not be covered and you would have to pay out-of-pocket. If services are covered, you may pay higher deductibles and co-pays.
Regarding outpatient alcohol rehab, Anthem BCBS generally provides coverage as long as services are provided and billed by a covered facility. The services covered would be the same as those found in residential treatment and would be a percentage of the plan allowance and the deductible. However, there would be services not covered under Anthem Blue Cross Blue Shield plans no matter inpatient or outpatient, and can include the following:
- Marital, family, educational, or other counseling or training services
- Services performed by a non-covered provider
- Services performed or billed by schools, halfway houses, group homes or members of their staffs
- Residential therapeutic camps such as wilderness camps, Outward Bound, etc
- Some holistic therapies such as equine therapy
How to Verify Your Anthem BCBS Coverage
Verifying your Anthem BCBS coverage for alcohol rehab is a two-step process. First, you need to review the plan brochure Anthem provides when you receive coverage. Carefully review your coverage for alcohol rehab and contact an Anthem BCBS representative if you have questions. Call the prospective alcohol rehab and talk to that admissions specialist with that knowledge at hand.
It is crucial that you know whether the rehab you are looking for is in or out of network. When you know this information, you will know 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. For the most part, network facilities will cover most services fully, or significant portions of services will be covered under your plan. In the event the rehab is out of network, you may have limited coverage—or services may not be covered at all.
How to Find an Anthem BCBS Alcohol and Drug Rehab in Northern California
The last thing you need to worry about is paying for the services that you need to get sober. Singing Trees Recovery Center is a premier Northern California drug and alcohol treatment facility that features evidence-based services that will give you the tools and support you need to break the vicious cycle of addiction.
Most importantly, we work with those with Anthem BCBS. Our experienced admissions team will thoroughly review your insurance and work to get up to 100% of your expenses covered. Give us a call today and take the first step on the road to lasting recovery.