Anthem California Drug Rehab Coverage

Get Accessible Treatment Options with Anthem at South Shores

When someone has the goal of attending addiction treatment, cost is always one of the primary concerns. And with many users who suffer from poor mental health and require drug or alcohol rehab, having access to quality insurance is all that’s required to receive addiction treatment services.

Unfortunately, being caught in the rat race of addiction means you rarely have time for anything other than using – and this means following up with information regarding your insurance. Anthem California, or Anthem Blue Cross Blue Shield, is a primary provider and one of the leading health insurance companies in the Orange County area.

Sadly, many recipients aren’t even aware of the fact that Anthem Blue Cross Blue Shield provides coverage for alcohol rehab or other forms of addiction treatment at South Shores Detox and Recovery. A simple phone inquiry is put on the back burner, and another day goes by that could have been used to enroll in addiction treatment services.

If you have Anthem Blue Cross Blue Shield in Orange County, this article breaks down your access to treatment coverage, and what you can expect when you go through the admissions process when getting help at South Shores Recovery!

Does Anthem Blue Cross Blue Shield Cover Addiction Treatment?

The short answer to this question is yes. Anthem Blue Cross Blue Shield absolutely provides coverage for drug and alcohol rehab. Since the adoption of the CARES Act, every insurance provider is required by law to provide some level of coverage for addiction treatment and care for other mental health conditions as well.

Figuring out your specific amount of coverage depends on your insurance company and the specific plan you’re under. Luckily, the plans available through Anthem Blue Cross Blue Shield are simple to understand and only give clients three options for coverage.

Anthem Blue Cross Blue Shield Insurance Coverage Options

Normally Anthem insurance company provides plans that fall under one of three umbrella forms of coverage. Refer to the following:

• Bronze: The Bronze Plan requires the smallest monthly premium amount, but demands the highest deductible and co-payments. With this plan, about 60% of your medical expenses are covered.
• Silver: Under the Silver Plan, the monthly premiums are higher than the Bronze Plan, but there are lower deductibles and co-payments. You can expect about 70% coverage with this plan.
• Gold: Gold brings the highest monthly premiums, but also the lowest deductibles and co-pays. With the Gold Plan, 80% of any medical treatment is paid for.

It’s possible you still reap the benefits of the Anthem umbrella, even if you’re in another state and your insurance card has a different company name. Anthem provides Medicaid plans in other regions of the country in the form of one of its subsidiary companies.

When you’re a recipient of Anthem, you’ll also reap the benefits of a national network of BlueCross BlueShield Providers. This comes in handy if you ever need to seek treatment outside of your state of residence. In addition, if you plan on staying for a period of 90 days or more, you can enroll in an HMO Plan from a partner of Anthem in what’s known as a guest membership.

What Types of Addiction Treatment Does Anthem Cover?

If you’re seeking drug and alcohol rehab, Anthem insurance coverage typically covers multiple levels of care, along with mental health therapy at a substance abuse treatment facility.

You can expect at least partial, if not full coverage for each of the following care levels:

Medical Detox as a Part of Drug and Alcohol Rehab

If you’re attending a treatment facility for opioid, alcohol, or benzo addiction – it’s vital that you have access to medical detox. The withdrawal period from the latter is known to cause deadly side effects, including seizures and more.

Going through medical detox helps you avoid the most severe side effects of detox and withdrawal, and eventually prepares you to transfer to inpatient or outpatient drug and alcohol treatment. Attending medical detox increases your chances of success and avoiding relapse by a large percentage.

Inpatient Treatment for Alcohol and Substance Use Disorders

After successfully completing medical detox, you’ll have the option of transferring to inpatient treatment for drug or alcohol addiction. Insurance coverage for this option varies, depending on whether you’ve opted to stay for 30, 60, or 90 days.

Many drug or alcohol addiction facilities will recommend over 30 days. In these cases, your insurance provider might require what’s known as a prior authorization form.

This is a letter from the treatment provider stating why receiving any specific form of therapy is in your best interests and gives you the best chances for successful recovery. If such verification is needed for your preferred substance use disorder treatment program at South Shores, we are happy to help assist in gaining pre-authorization for services covered by Anthem.

Outpatient Treatment for Drug and Alcohol Addiction

Outpatient treatment is the exact opposite of inpatient – you’re not required to remain at the facility overnight. In fact, you only spend around 4 to 6 hours weekly at the alcohol and drug treatment facility.

The specific treatment available is in large part the same as inpatient, albeit less intensive. However, you can still expect elements like group therapy, one-on-one counseling, and behavior treatment options to exist as part of an outpatient program. If you relapse during outpatient – or need a stepping stone between inpatient and outpatient, there are two additional levels before committing to full inpatient rehab.

Intensive Outpatient Treatment: IOP Programs for Drugs

Many drug and alcohol rehab centers offer intensive outpatient, which is also eligible for insurance coverage. During this level of care, the 4 to 6 hours per week of standard outpatient is increased to 6 to 10 hours.

Again, this level is generally reserved for those who have attempted outpatient and had a slip-up, or when someone graduates inpatient but would prefer to take baby steps before making a full return home without specialized care.

Partial Hospitalization Programs or PHPs

Partial hospitalization, or PHP, is usually the step right before full-on inpatient therapy. The intensity levels of therapy during PHP are generally equal to those you would experience during inpatient treatment. Your health insurance provides coverage for partial hospitalization, although a prior letter of authorization may be required.

During PHP, clients attend treatment during the day from about 8 AM to 4 or 5 PM and return home in the evening to sleep and take care of home or employment commitments. This is an effective form of treatment for those who can’t arrange long-term leave from work, or some other obligation exists that doesn’t allow extended stays in rehab.

Aftercare Planning and Sober Living Support

In some cases, your health insurance coverage may extend to aftercare programs. This includes halfway houses and residential options that continue to build on successful recovery.

These are normally standard residential homes that are shared with other individuals in recovery, with someone who overlooks the house and ensures the residents stay clean and remain productive members of society.

Coverage for these situations is far more rare, although it does happen, especially with a strong recommendation from the treatment facility.

Find Out More Regarding Anthem and South Shores Detox

At South Shores Detox, we work with insurance agencies like Anthem on a regular basis. If you have additional questions about coverage, eligibility, out-of-pocket expenses, or other inquiries, please contact a member of our staff today.

There’s no reason to prolong your recovery when the right team has your back – call us today and get proven programs of support for you or your loved one now!

FAQs on Anthem California Drug Rehab Coverage

Will I need money for a large copay before detox or inpatient rehab?

This depends on your specific level of coverage. Different variations of Anthem insurance may require payment on your behalf before coverage kicks in.

Several factors influence these decisions, including your employment, home situation, and other items. Contact South Shores Detox for answers to these questions today.

Will Anthem cover medication-assisted treatment?

In most cases, as long as the medication-assisted treatment is part of your rehab stay – the answer is yes. However, many clients continue medication-assisted treatment long after they finish rehab. When this happens, you’ll likely continue the prescription through your primary care mental health specialist.

This will almost always require a prior authorization form, which is easily obtained from your mental health counselor. They fax the signed form to your insurance company, and approval is generally granted momentarily.

Does Anthem cover holistic treatment?

Yes. Anthem covers any therapy associated with your stay at rehab. This is based on your specific plan, and not the type of therapy. Depending on your plan, you’ll receive the same dollar amount in coverage regardless of the type of therapy you receive – as long as the facility you attend accepts Anthem and Anthem allows you to attend said facility.

In certain cases, there are unorthodox forms of therapy that may not be included in your standard insurance coverage. This is a matter you must discuss with your treatment provider and insurance agency.