Addiction Treatment Coverage
Using Anthem Health Insurance

There are many reasons to seek professional treatment for addiction. Addiction is a progressive condition, meaning when left untreated the symptoms associated with addiction continue to worsen in severity. Within a matter of months or years, you can lose everything to your substance use disorder — your interpersonal relationships, your career, your drive and ambition, your sense of self. Not only does seeking professional help ensure you will not suffer any more consequences at the hands of your addiction, but most reputable treatment programs focus on helping you regain what you have lost.

At The Plymouth House we provide our guests with an integrated and highly individualized program of recovery. We focus on physical, mental, emotional and spiritual healing while preparing our clients for continued success in sobriety. If you have been suffering from an addictive disorder of any type or severity, you are not alone. Addiction affects millions of people across the country; people of all ages, personal backgrounds and walks of life.

Unfortunately, the majority of people in need of professional help fail to seek addiction treatment of any kind. This is not because help is unavailable. In most cases, it is because people mistakenly believe addiction treatment is unaffordable, or because they don’t realize health insurance often covers drug and alcohol rehab. At The Plymouth House we remain dedicated to providing accessible substance use treatment to those in need by working closely with most major regional and national health insurance providers, including Aetna. If you are currently insured through Anthem or any other major provider, there is a good chance some or all of the addiction treatment services we offer are covered partially or in full. Contact us today to learn more about using Anthem health insurance for rehab, or for a free, no obligation insurance benefit check.

Does Anthem Insurance Cover Drug or Alcohol Rehab?

Anthem is the largest for-profit managed healthcare company in the Blue Cross Blue Shield network. Anthem had roughly 40 million members in the year 2018, and was known as Wellpoint, Inc. prior to 2014. This specific health insurance company first began in Indianapolis, Indiana, and now offers health insurance to individuals, families and employees in over 10 states nationwide. As a major health insurance provider, Anthem covers behavioral and mental health services — including drug and alcohol rehab. If you currently live in New Hampshire or anywhere else on the East Coast and you are insured through Anthem, you will likely be able to seek treatment while paying very few (if any) out-of-pocket costs or copays.

The Affordable Care Act and Behavioral Healthcare Services

In 2010 the Obama Administration passed the Affordable Care Act, or the ACA. Under the ACA, all major health insurance providers must offer comprehensive coverage for residential inpatient rehab and other types of addiction treatment. Your specific benefits will depend on several factors, including the state you live in and the plan you choose. However, because substance use disorders are considered a pre-existing medical condition, your insurance provider cannot deny you coverage for inpatient treatment services, therapeutic intervention or medication assisted treatment options. The U.S. National Library of Medicine States, “The ACA enables states to address [addiction] through four primary mechanisms: insurance coverage expansions, regulatory insurance reforms that require inclusion of SUD treatments, enhanced parity, and opportunities to integrate SUD treatment and mainstream health care.” If you are currently insured through Anthem, there is a very good chance some or all of the treatment services provided by The Plymouth House are covered either partially or in full. Contact us today for a free, no obligation health insurance benefit check.

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Different Types of Anthem Substance Use Treatment

Anthem covers several different types of substance use treatment, from medical detox through outpatient treatment. The best level of care for you depends on several factors, though at The Plymouth House we recommend undergoing drug or alcohol withdrawal in a medical detox center before transitioning into our residential treatment program. If you would like assistance finding a medical detox center in New Hampshire or surrounding areas that accepts Anthem health insurance, we are happy to point you in the right direction.

Anthem Medical Detox Programs or Facilities

When it comes to addiction recovery, medical detox always comes as a recommended first step. While in medical detox you will undergo a safe and comfortable drug and/or alcohol withdrawal in a closely supervised setting. Symptoms of withdrawal will be treated as they develop with a combination of FDA-approved medication and evidence-based therapies. Once you have been physically stabilized you will transition into the next appropriate level of care.

Anthem Inpatient or Residential Treatment Centers

Most people who complete medical detox transition directly into a residential treatment center, where they undergo intensive addiction treatment for between 30 and 90 days. The duration of your stay in residential treatment depends on your personal needs. In most cases, major health insurance providers like Anthem cover some or all of the services provided by residential rehabs like The Plymouth House for a set period of time.

Anthem Partial Hospitalization Programs (PHP)

Partial hospitalization is a step down from residential rehab, seeing as clients return home in the evenings once the day of treatment concludes. While PHP offers slightly more flexibility than rehab clients still have access to the same comprehensive treatment services, including intensive psychotherapy, holistic modalities, medication assisted treatment and in some cases, a thorough education on the 12-Step model. This is an ideal option for those who require intensive treatment but prefer to return home (or to a sober living house) at night. Most major health insurance providers cover some or all of the costs associated with privately operated PHP programs, which are more cost-effective than inpatient treatment to begin with.

Anthem Outpatient Programs (IOP)

Intensive outpatient treatment is the most flexible level of clinical care, providing clients with the opportunity to fulfill personal responsibilities outside of treatment. Because most IOP programs meet for between three and five days a week for several hours each day, clients can work full-time or part-time, continue with their education pursuits or take care of other outside obligations. Because treatment groups meet less frequently, IOP also tends to be the most cost-effective option, and is ideal for those who are uninsured or underinsured.

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In-Network vs Out-of-Network Anthem Substance Use Disorder Treatment

If you are utilizing health insurance to cover the cost of rehab, it is a good idea to determine whether the rehab is in-network or out-of-network. If a healthcare provider is in-network, it means they meet a set of credentialing requirements and have agreed to provide their services at a discounted rate. If a treatment center is not in contract with a health insurance provider, they are considered out-of-network.

Using Anthem health insurance for drug and alcohol rehab

Out-of-network treatment centers can charge you full price for their services, but you have access to a greater range of addiction treatment options. If you are looking for the most cost-effective option, we recommend finding a rehab center which is in-network with your current provider. The Plymouth House is in-network with Anthem, meaning the majority of the treatment services we provide are covered partially or in full by this specific provider.

How to Check Your Anthem Rehab Coverage

How can you check to see if your current health insurance provider covers the treatment services provided by The Plymouth House? There are several effective ways to check your Anthem rehab coverage, including:

  • Call the toll-free number located on the back of your insurance card. You will be put in touch with an Anthem representative who will let you know which services you can expect coverage for.
  • Log-in to your online insurance account. Most health insurance providers, including Anthem, provide their policyholders with an online portal. You can easily check your current benefits by logging into this portal.
  • If you are insured through work and you feel comfortable speaking with a member of your HR department, you can ask them whether or not addiction treatment services are covered. This is also a good opportunity to explore which laws protect your career while you seek behavioral healthcare services (for example, the Family and Medical Leave Act, or FMLA).
  • Reach out to The Plymouth House directly. You will be put in touch with a Treatment Advisor who will provide you with a health insurance benefit check, which can be completed over the phone in a short matter or minutes. Just be sure to have your insurance card on hand or your policy number readily available.
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Finding an Addiction Treatment Center That Is Covered By Anthem

If you are currently covered by Anthem, how can you go about finding a drug and alcohol rehab that is in-network with this specific provider? First, we recommend finding the best rehab center for you and your personal needs. Ask yourself the following questions when choosing a rehab:

  • Would I benefit from attending a multi-phased treatment program, one that offers step-down levels of care?
  • Am I looking for a treatment center which offers demographic-specific treatment options?
  • If I have been diagnosed with an underlying mental illness will I have access to dual diagnosis treatment options?
  • Is the staff at the rehab center made up of licensed and experienced professionals?
  • Will I have on-site access to medical and therapeutic care?
  • Am I willing to travel out of state for drug and alcohol rehab?
  • Is the treatment program I’m looking into both licensed and accredited?
  • Does the treatment center offer highly individualized care, tailoring each treatment program to the unique needs of the guest?

Once you have found a treatment center which meets all of your needs, we recommend reaching out to the center directly for a health insurance benefit check. At The Plymouth House we are available to help you determine how much of our individualized treatment program is covered by your current provider. contact us today to learn more.

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If you have been struggling with a substance use disorder of any type or severity and you are looking for a comprehensive and personalized program of recovery, The Plymouth House is available to help. We understand how difficult it can be to reach out for help, especially when you have no idea what to expect from the addiction treatment process. As soon as you make initial contact you will be connected with one of our experienced and compassionate Treatment Advisors, who will walk you through our simple admissions process and answer any additional questions you might have. Our admissions process begins with a brief pre-assessment, which helps our clinical team determine which level of care is best suited for your unique case. At The Plymouth House we offer residential inpatient treatment and partial hospitalization — usually completed in succession as part of a multi-staged continuum of care. Once the assessment is complete we offer a free, no obligation insurance benefit check. If you are currently insured through Anthem or any other major provider, there is a good chance some or all of the services we offer are covered either partially or in full. If you are uninsured or underinsured we offer additional coverage options including self-pay and private pay. Finally, we arrange local transportation to our New Hampshire treatment center. Contact us today to learn more about using health insurance for drug and alcohol rehab, or to begin your own personal journey of addiction recovery.

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