Addiction treatment and its cost to you can be influenced by health insurance more than you may think. Depending on health insurance plans and specific benefits, the potentially enormous cost of rehab can be mitigated and become much more manageable for you and your family’s finances. When health insurance is comprehensive in coverage and options, your ability to seek out the most effective addiction care is within close reach.
The key is to understand what your Anthem benefits are and to be able to most effectively apply for those benefits in a program that accepts your insurance, and one that is the most effective for your specific drug-treatment needs. Anthem, combined with Blue Cross, is one of the five largest health insurance providers in the United States, and by many measures, second only to Humana.
Anthem provides insurance plans on numerous levels, including Medicare, Medicare supplemental plans, Medicaid, and individually funded plans, for millions of members across the United States. Anthem Insurance plans can vary widely, and understanding the specifics of your medical plan and benefits can get complicated.
A very common occurrence with insurance plans is the requirement of pre-authorization to receive any benefits for inpatient addiction-treatment services. Pre-authorization, or prior authorization, refers to the process taken by health insurance companies to determine the medical necessity for a certain procedure, prescription, or service. As Anthem informs, getting a pre-authorization is not a guarantee of payment for treatment, rather a notice of authorization for treatment. Payment will depend on your individual plan and available benefits.
Despite insurers’ best efforts to be clear and transparent, your Anthem health insurance can get complicated and difficult to understand, to the point where you cannot accurately estimate your out-of-pocket costs. This is why it is particularly important to consider all aspects of treatment from detox to aftercare, and understand how your health insurance addresses each.
The specific aspects of addiction treatment to consider include:
Many insurance companies will not cover some experiential and nonevidence-based therapies on their own, but the therapies may be fully covered when they are a part of an eligible addiction treatment program.
Like many other health insurance companies, Anthem offers a case management program, in which individuals with behavioral health and substance abuse issues can work with their doctors and case managers to optimize benefits and promote the most effective use of available resources.
This process includes the following:
It is not a new idea that health insurance can be complicated to understand. When dealing with addiction treatment, health insurance benefits can become a labyrinth made up of your individual plan, where you live, where you want to attend addiction treatment, and any other benefits you may have already used in the calendar year, just to name a few. The reality is that the vast majority of Anthem plans, including those for Medicare and Medicare supplemental plans, provide impressive addiction treatment benefits that can significantly reduce or eliminate out-of-pocket expenses. This is why it is a good idea to start with your health insurance benefits when looking into addiction treatment options.
AllTreatment.com can help you to understand and use Anthem health care benefits to find the best addiction treatment for yourself or your loved one. At AllTreatment.com, we aim to provide information on all things addiction, treatment, and recovery, which include the inner workings of health insurance and the benefits it provides. We are able to verify your insurance benefits and discuss exactly how they can work to your greatest advantage for addiction treatment. You know yourself and what you need. We know addiction treatment and how your health insurance benefits can help get you to the program that fits your financial and recovery needs.
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