By We Level Up | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: March 13, 2023

Anthem insurance may help cover care for drug use, alcohol use, and mental health needs. Depending on your plan, your benefits may include medical detox, inpatient care, residential treatment, therapy, partial hospitalization programs (PHP), and Medication-assisted treatment. The care you can use and the amount you may pay can vary by plan.

Before you start treatment, it is helpful to check your Anthem benefits. You can sign in to your Anthem member account or call the number on your Anthem ID card. Ask about the care you need, your plan costs, network rules, and any approval you may need before treatment starts. This can help you understand your options before choosing a program.

We Level Up can also help you review your insurance details and discuss treatment options. Call (844) 597-1011 to speak with our team about your plan and the care you may need. An insurance check does not promise payment or coverage because your Anthem plan decides what benefits apply to your treatment.

Anthem Health Insurance Plans

Anthem plans can have different rules for treatment and provider networks. Common plan types include HMO and PPO plans, but plan names and rules can vary by state. An HMO plan often uses a set network of doctors and facilities. Out-of-network benefits may be limited or not available under some HMO plans.

A PPO plan may give you more choices and may include out-of-network benefits. However, using an out-of-network provider can cost more. Your plan documents show the rules that apply to your care. We Level Up works with some HMO plans, but acceptance depends on your specific plan and the facility. We do not claim to accept all Anthem HMO plans or that every We Level Up facility is in-network with Anthem HMO.

What Does Anthem Insurance Cover?

Anthem plans may help pay for different types of addiction and mental health care. Depending on your plan, benefits may include medical detox, inpatient care, residential treatment, PHP, IOP, outpatient care, and therapy. You may also have benefits for one-on-one therapy or group sessions. If you have both a mental health condition and a drug or alcohol problem, dual diagnosis care may help address both needs.

Not every Anthem plan covers the same services. Some services may need approval before care starts, and plans may have limits on covered care. Check your benefits before treatment so you know what your plan may pay for and what costs you may have.

Anthem Insurance Benefits for Addiction Treatment

Anthem health plans may help cover care for drug use, alcohol use, and mental health. Your needs, health, and level of support can help guide the right type of care.

• Medical Detox: We provide medical help for people who need support during drug or alcohol withdrawal.
• Inpatient Treatment: Our inpatient care gives you a place to stay while receiving treatment around the clock.
• PHP: PHP gives you care during the day while you return home or to a safe place at night.
• Residential Treatment: At our residential programs, you can live on-site while taking part in daily care.
• IOP: IOP lets you attend treatment sessions while keeping your home and daily routine.
• Mental Health Treatment: Our mental health services can help people who need care for mental health or substance use.

Anthem may cover some of these treatment options. Your plan sets the rules for covered care and costs.

Anthem Precertification for Treatment

Some Anthem plans require precertification before certain services begin. Precertification means the health plan reviews a service before treatment to see if it meets the plan’s requirements. Anthem provider resources show that behavioral health services can require precertification, but the exact rules depend on the plan and state.

Ask whether your planned treatment needs precertification before care starts. You should also ask which services need approval and whether the treatment provider must meet specific network rules. Precertification does not guarantee payment. Your plan still has its own benefits, limits, exclusions, and cost rules.

In-Network and Out-of-Network Anthem Care

Your Anthem network can affect where you receive treatment and how much you pay.

What Can Affect Anthem Treatment Costs?

The amount you pay for care can depend on your Anthem plan. Your plan may have different costs and rules for each type of treatment.

• Deductible: What you pay before your plan starts to pay.
• Copay: A set amount you pay for a covered service.
• Coinsurance: The part of the cost you pay after your deductible.
• Out-of-pocket maximum: The most you pay for covered care in your plan year.
• Network status: In-network care may cost less than out-of-network care.
• Type of treatment: Different care may have different costs.
• Length of care: More days of care may mean higher costs.
• Covered services: Your plan may not cover every type of care.
• Precertification: Some care may need plan approval before treatment starts.

Knowing these terms can help you understand your Anthem benefits and possible treatment costs before you begin care. For example, the cost of medical detox may be different from the cost of outpatient therapy. Your cost may also change when you use an in-network provider instead of an out-of-network provider.

Review your plan documents before treatment so you can better understand your benefits, possible costs, and any limits that may apply.

Anthem Insurance Coverage at We Level Up

We Level Up Treatment Centers has treatment centers in several states. We offer care for drug and alcohol use, mental health, and both needs at the same time. Care may include detox, inpatient care, residential treatment, PHP, and IOP.

Locations With Detox

We Level Up locations that offer medical detox include:

• California
• Washington
• New Jersey
• Lake Worth, Florida
• Texas

Locations With Inpatient Care

Inpatient care is available at:

• California
• New Jersey
• Lake Worth, Florida
• Texas
• Washington

Locations With Residential Care

Residential services are available at locations that include:

• California
• New Jersey
• Lake Worth, Florida
• Texas
• Washington, for residential mental health care
• Palm Beach, Florida, for mental health residential care
• Tamarac, Florida, for mental health residential care

Locations With PHP

Mental health PHP is available at:

• Lawrenceville, New Jersey

Locations With IOP

IOP services are available at:

• Lake Worth, Florida, for substance use
• Pompano Beach, Florida, for substance use
• Texas, for substance use and mental health

How to Check Your Anthem Benefits

Checking your benefits before treatment can help you understand your options and possible costs.

1. Find Your Anthem ID Card

Keep your Anthem ID card nearby. It includes your member information and the phone number you can use for plan questions.

2. Ask About Your Benefits

Ask if your plan covers the care you need, such as detox, rehab, therapy, PHP, or IOP. You can also ask if you need approval, if the provider is in-network, and what you may need to pay. This can help you know your benefits before you choose a treatment program.

3. Review Your Member Account

You may also be able to review your plan information online. Member tools may help you view benefits and search for behavioral health providers.

4. Verify Your Insurance With We Level Up

You can verify your insurance with We Level Up. Our team can review your insurance information and discuss treatment options that may fit your needs.

Insurance verification does not guarantee payment or coverage. Your Anthem plan decides which benefits apply to your care.

Anthem Insurance and Dual Diagnosis Treatment

Some people need help with both drug or alcohol use and mental health concerns. This is called dual diagnosis or a co-occurring condition. SAMHSA explains that these issues can happen at the same time and may need care for both conditions.

We Level Up provides dual diagnosis treatment in Lake Worth, FL; Palm Beach, FL; Tamarac, FL; Lake Elsinore, CA; Lawrenceville, NJ; Texas; and Washington. Care may include therapy, mental health support, recovery care, and other services based on each person’s needs. The goal is to help people work on both their mental health and substance use in one care plan.

Why Verify Anthem Coverage Before Treatment?

Knowing your insurance benefits before treatment can make the process easier. It can also help you understand what questions to ask and what costs may apply. You can find out which services may be covered, whether the facility is in-network, whether precertification is needed, and what deductible, copay, or coinsurance may apply. 

You can also learn if your plan offers out-of-network benefits and which treatment levels may fit your benefits. Because Anthem plans can have different rules, check the benefits that apply to your specific plan before choosing care.

Frequently Asked Questions

Verify Your Anthem Insurance Coverage

Anthem insurance may help pay for drug, alcohol, and mental health care. Your plan may cover different types of care, such as therapy, outpatient care, medical detox, residential treatment, and other treatment services. Your benefits and costs can vary based on your plan, the care you need, and the provider you choose.

If you have Anthem insurance, call We Level Up at (844) 597-1011. Our team can review your insurance details and help you understand your care options. We can also help you learn what steps to take before starting treatment. Insurance checks do not promise payment or coverage. Your Anthem plan decides what care and costs are covered.

Does Anthem Cover Therapy Video

Our team of admissions coordinators is here to assist you in the first step toward recovery and is available to answer any questions or concerns you have. We know taking the first step in anything can be difficult, especially when dealing with addiction. Our staff knows firsthand what you’re going through. We want you to know that you are not alone, and we are here to assist throughout the journey.