Anthem Insurance Coverage for Veteran Drug & Alcohol Rehab
Veterans who have healthcare coverage through Anthem Blue Cross Blue Shield and struggle with substance use disorder may have all or at least part of their addiction treatment services covered by insurance. Anthem provides essential healthcare services, including care for substance use problems, for plan members, who may also be Veterans of the United States Armed Forces.1
Does Anthem Insurance Cover Veterans’ Addiction Treatment?
Yes, Anthem Blue Cross Blue Shield covers addiction treatment for Veterans, but the specific behavioral health benefits depend on the individual insurance plan, and coverage varies by state, policy, member, and provider.
The Affordable Care Act requires all Health Insurance Marketplace plans to provide coverage for mental health treatment, including the treatment for substance use disorder, but the specifics of what’s covered and for how long vary by plan.2
To understand what’s covered in your plan, you should verify your insurance before enrolling in a drug and alcohol rehab program. You can call the number on the back of your insurance card, or you can reach out to connect with an admissions navigator at American Addiction Centers (AAC), who can verify your benefits and explain your options.
Anthem Insurance Plan Options for Veterans
Anthem is a well-established healthcare coverage provider that offers coverage in specific states but also access to a nationwide network of BCBS providers. Anthem offers various plans and coverage through employers, Medicaid, Medicare, and for individuals and families. There are several Anthem insurance plans available to Veterans, and understanding the plan that makes the most sense for your needs can help you access the treatment that’s appropriate for your needs.
Generally speaking, there are 3 types of health insurance plans, including:3
Health Maintenance Organization (HMO). An HMO plan offers the lowest monthly premiums. HMOs typically require the selection of a primary care provider and referrals to see specialists—though most Anthem HMO plans do not. HMOs do, however, only cover services from in-network providers and emergency visits.
Exclusive Provider Organization (EPO). EPOs offer moderate monthly premiums, do not require the designation of a primary care provider, and do not require referrals to see specialists. In-network care and emergency visits are covered.
Preferred Provider Organization (PPO). PPO insurance plans cost the most with the highest monthly premiums. A primary care provider is not required and referrals aren’t needed to see a specialist. You’ll have access to both in-network and out-of-network providers, though the latter costs more.
These insurance plans are then offered at different metal levels. Regardless of the metal level, all Health Insurance Marketplace plans cover the same 10 essential health benefits, including mental health and substance use disorder services and behavioral health treatment such as counseling and psychotherapy.4
Anthem health benefits are available at various metal levels, including:5
- Bronze plans. Bronze plans feature low monthly payments and a higher deductible and co-pays. About 60% of medical costs are paid by Anthem in bronze plans.
- Silver plans. Silver plans have average monthly payments and a lower deductible and co-pay than bronze plans. About 70% of medical costs are paid by Anthem in silver plans.
- Gold plans. Gold health insurance plans have higher monthly payments but lower deductibles and co-pays than other plans. About 80% of medical costs are paid by Anthem in gold plans.
Anthem also offers Medicaid plans in specific states, including California, Indiana, Kentucky, Nevada, New York, Ohio, Virginia, and Wisconsin.6
Types of Addiction Treatment Covered by Anthem Insurance for Veterans
There are several different levels of care for addiction treatment. It’s important to consult your primary care physician, mental healthcare professional, or an addiction care specialist, who can provide an assessment and help determine the level of care and treatment plan that’s most appropriate for your needs.
Your treatment plan may include one or more levels of care, including:7
- Medical detox. Medical detox helps manage withdrawal symptoms and safely allows the body to rid itself of substances under the supervision of healthcare providers, who can keep you safe and as comfortable as possible. Detox is often the first step in a more comprehensive inpatient or outpatient drug and/or alcohol addiction treatment program.
- Inpatient rehab. During inpatient rehab, you’ll live at the treatment facility, where you’ll have access to around-the-clock care. The duration of treatment depends on your specific needs and may include a combination of individual and group counseling, behavioral therapies, psychoeducation, and medication (if necessary).
- Outpatient rehab. Outpatient treatment programs vary in levels of intensity and look very similar to inpatient programs in terms of services, but individuals in outpatient programs return home or to a sober living environment at the end of each day instead of staying at the treatment center.
- Medication for addiction treatment. Depending on the substance or substances used, care providers may recommend combining therapy with medication to support recovery.
- Aftercare programs. Aftercare programs or ongoing care help support recovery after formal treatment ends. Aftercare support takes many forms and may include living in a sober living residence, continuing counseling or therapy, participation in 12-Step programs like Alcoholics Anonymous or Narcotics Anonymous, and/or alumni group activities.
While Anthem does cover addiction treatment, it’s best to verify your specific benefits so you understand the details of exactly what’s covered within your plan. As previously mentioned, you can call the number on the back of your insurance card, or you can contact AAC to connect with an admission navigator, who can verify your insurance and help you understand your options.
Does Anthem Cover Inpatient and Outpatient Rehab for Veterans?
Yes, Anthem offers rehab coverage for Veterans in many states, including California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia, and Wisconsin.8 Depending on your specific plan, certain levels of addiction treatment, such as residential care, may require a pre-authorization from your insurance company. Additionally, there might also be caps on the daily amount covered for certain services like inpatient treatment.
In-Network vs. Out-of-Network Rehab Facilities
In-network providers have established contracts with insurance companies and have agreed upon a covered cost of treatment. An out-of-network provider, on the other hand, does not have a written agreement with the insurance company regarding the cost of treatment.
When you choose an in-network care provider, your in-network benefits apply, which can reduce the out-of-pocket costs of rehab.
AAC facilities, spread throughout the country, are in-network providers with Anthem insurance and offer the complete continuum of care to support your recovery.
What if Anthem Insurance Does Not Cover Rehab for Veterans?
If you have addiction treatment costs that are not covered by Anthem insurance, there are other options available to you. As a Veteran, you may be eligible for benefits through Veterans Affairs and/or TRICARE insurance. You may also consider exploring state-funded and free rehab options.
Additionally, there are other ways to pay for the cost of treatment not covered by insurance. Some of these include:
- Using cash, credit, or debit cards.
- Payment plans or other financing options so you can pay for treatment over time rather than all at once upfront.
- Sliding fee scales for eligible individuals, meaning the cost adjusts based on your ability to pay.
- Loans from family, friends, or financial institutions.
- Scholarships or grants available through the facility or local, state, or federal government.
The cost of treatment should not prevent you from getting the help you need. Talk with the facility about options that can help ease the financial burden of covering costs not covered by your insurance plan.
How to Check Anthem Insurance Benefits for Veterans’ Rehab
If you’re ready to learn more about drug and alcohol addiction treatment, AAC can help. Not only is AAC an in-network provider with Anthem, but AAC facilities offer a Veteran-specific addiction treatment program that is designed to address the unique needs and challenges of the Veteran community and support your lasting recovery with evidence-based care. Reach out to connect with an admissions navigator, who can listen to your needs, answer your questions, explain your options, and help you begin your path to recovery today.