Anthem Insurance Coverage: Addiction & Mental Health

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 health plans may help pay for care for drug or alcohol use. They may also include benefits for mental health care. Depending on your plan, this may include medical detox, drug rehab, alcohol rehab, therapy, and other care. This guide explains Anthem insurance coverage and how Anthem benefits may apply to addiction and mental health treatment across the United States.

Anthem insurance coverage can vary from one plan to another. Your plan may pay for some types of care, while other services may not be covered. The amount you pay can also be different from what another Anthem member pays. Each plan has its own benefits, rules, and costs.

You may have a deductible, copay, or coinsurance. Your total cost may also depend on the type of care you receive and where you get treatment. Some Anthem plans may require approval before certain care begins. If you have costs that your insurance does not cover, ask about available payment options. This may help you plan for your treatment costs.

If you need support for addiction or mental health, We Level Up Treatment Centers can help you explore your treatment choices. Our team can also review your Anthem insurance benefits and explain what your plan may pay for. Call (844) 597-1011 to check your coverage and learn more about your care options.

Check Your Anthem Insurance Benefits

Checking your insurance before treatment can help you know what to expect. You can call We Level Up at (844) 597-1011 for help with your Anthem benefits. Our team can review your plan and help you understand what it may cover for addiction or mental health treatment.

An insurance check does not mean your care will be fully covered. Your Anthem plan sets the coverage, limits, and costs that apply to your treatment.

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What Is Anthem Insurance?

Anthem is a health insurance company that offers health plans in the United States. An Anthem health plan may include benefits for doctor visits, hospital care, mental health care, and other health services.

Some Anthem plans may also include benefits for substance use treatment. This may include care for alcohol use, drug use, or both addiction and mental health needs. The benefits you have depend on your specific plan.

Your Anthem plan may have rules about where you can get care and what steps you need to take before treatment starts. Check your plan to learn what benefits may apply to you.

Anthem Health Insurance Plans

Anthem health insurance plans are not all the same. Your plan may have its own benefits, costs, network rules, and care limits. It may help pay for doctor visits, mental health care, or addiction treatment. You may also need to pay a deductible, copay, or coinsurance.

Your Anthem plan may not work the same way as someone else’s plan. Before you start treatment, check your benefits to see what your plan may cover and what you may need to pay.

What Does Anthem Insurance Cover?

So, what does Anthem insurance cover? The answer depends on your plan. Some Anthem plans may include benefits for addiction treatment and mental health care. Depending on your plan and care needs, benefits may include medical detox, inpatient rehab, residential treatment, partial hospitalization, intensive outpatient treatment, therapy, or other behavioral health care.

Your plan may not include every type of care. It may also have rules about where you can get treatment and whether you need approval before care starts.

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Anthem Insurance Benefits for Addiction Care 

Anthem insurance coverage may include different types of addiction treatment. The care you may use depends on your plan and your treatment needs.

Medical Detox

Medical detox helps you stop using drugs or alcohol in a safe setting. Medical staff can watch you during withdrawal and provide care when needed. Your Anthem plan may include benefits for detox. Check your plan before starting care.

Inpatient Rehab

Inpatient rehab is treatment where you stay overnight at a treatment center. Care may include medical care, therapy, group support, addiction education, and recovery planning. Your plan may have rules about when this type of care may be covered.

Residential Treatment

Residential treatment lets you stay at a treatment center while you work on recovery. It may include therapy, support, and other recovery care. Your Anthem benefits may depend on your plan, your needs, and the treatment provider.

Partial Hospitalization

Partial hospitalization programs, also called PHP, provide care for several hours during the day. You may not need to stay overnight. Care may include therapy, support, and other behavioral health services. Your plan may have rules for this type of care.

Intensive Outpatient Treatment

Intensive outpatient programs, or IOPs, provide regular treatment while you live at home or in another setting. Care may include individual therapy, group therapy, recovery support, and mental health care. Your Anthem plan may include benefits for IOP based on your plan rules.

Mental Health Treatment

Addiction and mental health concerns can happen at the same time. Anthem plans may include benefits for mental health care. Treatment may include therapy and other behavioral health services. Ask about your mental health benefits before starting care.

Anthem Blue Cross Benefits

Anthem Blue Cross benefits can vary by plan and location. Your plan may include benefits for medical care, mental health care, and substance use treatment. Your benefits may also include different costs for in-network and out-of-network care. You may have a deductible, copay, or coinsurance.

Check your plan to learn what benefits may apply to addiction treatment, mental health care, detox, therapy, and rehab.

Understanding Your Anthem Coverage 

Anthem insurance coverage can be different from one person to another. Some of the main factors include:

• Your Anthem plan: Your plan may have its own coverage rules and benefits.
• Your deductible: You may have to pay a set amount before your plan starts to pay for some care.
• Your copay: You may pay a fixed fee when you get certain services.
• Your coinsurance: You may pay a share of the cost for covered treatment.
• Type of care: Detox, rehab, therapy, and outpatient care may have different coverage rules.
• Length of care: Your plan may set limits on how long you can receive treatment.
• Network provider: Your costs may be lower when you use a provider in your Anthem network.
• Prior approval: Some services may need approval from Anthem before care begins.

Your plan may also have medical necessity rules. This means the insurer may review the type and level of care you need.

In-Network vs. Out-of-Network Anthem Treatment

When looking at Anthem insurance coverage, it is important to know if the treatment provider is in-network or out-of-network. This may affect your benefits and what you may have to pay.

In-Network Treatment

An in-network treatment provider has an agreement with Anthem. Depending on your plan, using an in-network provider may mean lower out-of-pocket costs. Your plan may also have specific rules about which services you can use. Check if the treatment provider is in-network before starting care.

Out-of-Network Treatment

An out-of-network treatment provider does not have the same network agreement with Anthem. Your plan may still include some out-of-network benefits. However, your costs may be higher. Some plans may have limited or no out-of-network benefits for certain care. Check your plan to learn what rules apply.

Do I Need an In-Network Treatment Provider?

Anthem plans can have different network rules. Some plans may allow out-of-network care, while others may have different requirements.

Your plan may also require prior approval or other steps before treatment starts. Call Anthem or We Level Up at (844) 597-1011 to check your benefits.

Anthem Insurance and Treatment Costs 

There is no single price for treatment with Anthem insurance. The amount you may pay can change based on your plan, the type of care you need, and the treatment provider you choose.

Your cost may depend on:

• Your deductible: This is the amount you may need to pay before some plan benefits begin.
• Your copay: This is a set amount you may pay for a covered service.
• Your coinsurance: This is the part of a covered cost you may need to pay.
• Your plan benefits: Your plan may include some types of treatment and not others.
• Network status: Your cost may be different when you use an in-network or out-of-network provider.
• Type of treatment: Detox, inpatient care, residential care, outpatient care, and therapy may have different costs.
• Length of treatment: A longer stay may mean more treatment costs.
• Services you receive: The care you receive may affect your total cost.

For example, your cost for medical detox may be different from your cost for outpatient therapy. Your cost may also change if you move from one type of care to another.

The best way to learn what you may pay is to verify your Anthem benefits before treatment. Ask about your deductible, copay, coinsurance, network status, and any approval rules.

How to Verify Your Anthem Insurance Benefits

You can take a few simple steps to check your benefits.

1. Check Your Anthem Insurance Card

Look for your member ID and other plan details. Keep your card with you when you call about your benefits.

2. Call Anthem

Ask about your benefits for substance use treatment and mental health care. Ask if there are any rules you need to follow before treatment.

3. Use Your Member Account

You may be able to view your plan benefits through your Anthem member account. Look for information about mental health and substance use care.

4. Ask About Your Costs

Ask about your:

• Deductible
• Copay
• Coinsurance
• Out-of-pocket maximum
• In-network benefits
• Out-of-network benefits

5. Ask About Prior Approval

Some types of treatment may require prior approval or other steps before care starts. Ask your plan if approval is needed.

6. Ask We Level Up to Verify Your Insurance

You can also contact We Level Up at (844) 597-1011. Our team can help you review your insurance information and learn what treatment options may be available based on your plan. Insurance verification does not guarantee payment or coverage.

We Level Up Treatment and Anthem Insurance Coverage

We Level Up Treatment Centers provides addiction and mental health treatment services. Depending on your needs and insurance plan, treatment options may include medical detox, addiction treatment, mental health treatment, dual diagnosis treatment, residential treatment, and other levels of care.

Your Anthem insurance benefits and treatment options depend on your specific plan and the treatment provider. Our team can help you check your benefits and learn more about care that may be available to you.

Call (844) 597-1011 to verify your insurance and learn more about treatment options.

Why Verify Your Anthem Benefits Before Treatment?

Checking your benefits before treatment can help you understand your care and possible costs. It may also help you learn:

• What treatment your plan may include
• Which treatment providers may be in-network
• What you may have to pay
• Whether you need prior approval
• What benefits may apply to mental health care
• What benefits may apply to addiction treatment

Your insurance card may not show all of these details. A benefits check can give you more information before you start care.

Frequently Asked Questions

Get Help Verifying Your Anthem Insurance Coverage

Understanding your insurance can be hard. If you have Anthem insurance and are looking for addiction or mental health treatment, We Level Up can help you learn more about your benefits and care options.

Call (844) 597-1011 to verify your insurance and learn more about treatment. Your benefits depend on your individual Anthem plan, so always confirm your coverage before starting treatment.

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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.