Anthem BCBS Insurance Coverage for Rehab

Get Anthem Rehab Coverage In Network at Icarus Nevada

Did you know that only about 10% of people who need rehab successfully get treatment?

For many, health insurance coverage is the deciding factor in choosing whether to attend rehab or continue living with an addiction or mental illness. If you don’t have insurance or lack sufficient coverage, it’s harder to commit to getting help. Plus, your mental health and drug and alcohol rehab options may be limited because of your health insurance provider.

Fortunately, major insurance companies like Anthem Blue Cross Blue Shield have vast networks of providers who can cover as much as 100% of the cost of treatment if you stay in your network – and Icarus Behavioral Health Nevada is one of them.

Our facilities are proud to accept Anthem BCBS insurance coverage for rehab and offer effective, evidence-based programs.

At Icarus Nevada, we help people from Las Vegas, across Nevada, and other states get the mental health and addiction treatment they need. We’re proud to offer personalized treatment plans that span behavioral and mental health, including substance abuse disorder and PTSD, as an in-network provider for Anthem Blue Cross Blue Shield.

Our goal is to make treatment as accessible as possible, so if you have Anthem BCBS insurance, keep reading to see how we can help you.

What Is Anthem Blue Cross Blue Shield Insurance?

Anthem Blue Cross Blue Shield Insurance

Anthem Blue Cross Blue Shield (BCBS) is a national health insurance provider licensed by Blue Cross Blue Shield to operate in 14 states, including Nevada. It is worth noting that Anthem has assumed a new brand name as of 2022, and is now commonly referred to by its proper name, Elevance Health, though many still use the Anthem name as well.

Their comprehensive coverage applies to most types of medical expenses, including medication, testing, hospitalization, mental health, and rehabilitation programs.

Anthem BCBS Insurance Coverage for Rehab: Do All Anthem Insurance Plans Cover Rehab?

Anthem offers health insurance through the Healthcare Marketplace, which requires all plan providers to cover mental health services as part of the Affordable Care Act (ACA). However, the amount of treatment covered isn’t regulated, so your costs may vary, especially depending on whether you have an HMO or PPO.

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What’s The Difference Between Anthem BCBS HMO and PPO

Anthem Blue Cross Blue Shield offers health insurance plans for both health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Both cover similar treatments and procedures, but the percentage of care each covers depends on where you go.

HMOs require you only to see in-network providers. They cover more of your in-network care than PPOs, but you don’t get coverage for providers that are out of your network. For example, you may pay 10% of your bill at Icarus Nevada with Anthem Blue Cross Blue Shield but must pay 100% of care at another out-of-network treatment center.

PPOs allow you to be seen by any provider, but usually to a lesser extent than in-network doctors and facilities. They often cost more and have lower coverage rates than in-network providers on HMO plans, but you can choose your preferred providers to give you the best chance at recovery. For example, you may be able to attend Icarus Nevada with a PPO plan from Anthem BCBS for 25% of the cost because it’s in-network, but you’ll pay 50% at an out-of-network treatment center.

What Types of Treatments Are Covered By Anthem Blue Cross Blue Shield?

Medical Detox Coverage

Mental health and addiction treatment services are a crucial part of your overall health insurance coverage, but what exactly does Anthem BCBS cover when it comes to rehab? Fortunately, most of it.

Medical Detox Coverage

Medical detox is an often essential step before you receive treatment for an addiction. Certain drugs like benzodiazepines and alcohol can create a dependence that causes dangerous withdrawal effects if you quit suddenly. And since you can’t have any active addictions during rehab, you’ll have to quickly detoxify yourself so you can focus on treatment.

Medical detox uses medication-assisted treatment to help curb the side effects of withdrawal and make you more comfortable. You’ll be at a treatment center under a doctor’s supervision who can prescribe drugs like Suboxone for opioid withdrawal or lorazepam for alcohol withdrawal to avoid seizures.

Once you’ve completed a medical detox, you can begin your treatment program.

Inpatient Treatment Coverage

Inpatient addiction treatment takes place entirely at your drug abuse and alcohol rehab center. For the 30, 60, or 90-day programs you’ll usually undergo, you live and sleep at rehab instead of going home. It’s the most intensive form of addiction treatment and mental illness care, which usually consists of group and individual therapy, alternative therapies, and medication management. Some treatment centers also organize activities within the community to give you more exposure to the world after rehab.

Inpatient treatment is also the most expensive type of care because your insurance plan has to pay for around-the-clock care. Many insurance companies will cover at least one inpatient stay at a covered treatment center. However, your insurance provider may try to limit your coverage by requiring additional authorizations for care, which we’ll help you navigate.

Outpatient Treatment Coverage

Outpatient care comes in two primary forms: outpatient treatment and intensive outpatient programs (IOP).

Outpatient programs often consist of visiting your mental condition and addiction treatment center once a week to a few days per week. You may attend individual or group therapy or talk to a psychiatrist about your medication, but you aren’t required to maintain a strict schedule.

Intensive outpatient treatment is more frequent than outpatient programs and has more restrictions. You’ll generally need to attend treatment for a certain number of hours or on a certain number of days per week to remain enrolled, but the treatments themselves are similar.

What Rehab Programs Does Anthem BCBS Cover?

Addiction Treatment Programs

The ACA requires that insurance providers cover a wide range of mental and behavioral health conditions. So, your rehab treatment program is likely to be eligible for coverage no matter which category it falls into.

Mental Health Programs

Mental health conditions are just as real as physical health conditions, so it’s important that Anthem insurance covers treatment programs for mental illnesses. You might attend rehab for conditions like PTSD, OCD, eating disorders, intense anxiety, or clinical depression, where you’ll participate in individual and group therapy to discuss your feelings and learn coping skills to deal with the symptoms of your condition.

Primary mental health programs don’t usually involve a medical detox but can include inpatient, outpatient, or IOP treatments, depending on the type and severity of your condition.

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Addiction Treatment Programs

Addiction is a life-altering condition that can impact your mental and physical health, financial and professional success, and relationships. Its treatment is recognized as an essential form of mental healthcare, so most public insurance providers will cover drug and alcohol rehab.

Addiction treatment can consist of any combination of medical detox, inpatient, or outpatient programs, where you’ll usually attend group meetings, undergo cognitive-behavioral therapy, and receive medication-assisted treatment to stay safe.

Dual-Diagnosis Programs

It’s been shown that substance abuse and mental health conditions are commonly linked. Drug abuse or alcohol abuse can contribute to mental illnesses like depression or anxiety as they slowly take over your life. Alternatively, having a condition like PTSD may cause you to self-medicate with drugs or alcohol to cope with the impact it has, causing substance misuse.

Dual-diagnosis programs aim to address the root of the addiction to help overcome the resulting health condition or the condition that caused the addiction. These programs are therapy-heavy to help uncover triggers that can be addressed and also include medication management to address any mental illnesses that contribute to developing an addiction.

Like mental health and addiction treatment, dual-diagnosis treatments are often covered – especially because they can save insurance companies from paying for an additional treatment program by addressing both conditions at once.

How Much Does Rehab Cost with Anthem BCBS?

Rehab Cost with Anthem BCBS

If you’re considering getting help with a mental or behavioral health condition, one of your first questions will likely be asking how much it will cost you. While you can’t put a price on physical and mental health, knowing what to expect after you leave the program can make it easier to enter treatment.

Your Anthem Blue Cross Blue Shield plan will tell you what your coverage is, which can help you estimate treatment costs on your own. These values include:

  • Deductibles: You’ll have to pay a certain amount towards healthcare before your insurance coverage kicks in. Your deductible can be as low as $0 or as high as your maximum out-of-pocket cost.
  • Out-Of-Pocket Maximum: Your plan will likely limit the absolute maximum amount you’ll have to pay towards healthcare in a calendar year. Your treatment may be free if you’ve already exceeded it before attending rehab.
  • Coinsurance or Copay: The amount that you’ll have to pay for rehab will depend on your insurance coverage rates. If you have a 10% coinsurance, you’ll pay 10% of the total bill after your deductible.

You want the lowest deductible, maximum cost, and copay or coinsurance rate for treatment. The lower they are, the less you’ll pay and the closer you are to free treatment.

In most cases, these rates are also affected by whether the treatment facility you choose is in your network or not. If you have an HMO, you’ll have lower rates but fewer provider options. If you have a PPO, your rates may be higher for in-network providers but much lower for out-of-network providers.

How to Get a Quote for Rehab Costs

Cost of Outpatient Alcohol Rehab

While it’s possible to estimate your costs based on your insurance plan, the best way to get an accurate estimate is to call your chosen treatment centers. It can be hard to determine a total cost without knowing the treatment plan you’ll participate in, but you’ll have a better idea of what to expect.

At Icarus Nevada, we check your insurance plan to tell you your level of coverage for rehab programs and to give you the most accurate estimate possible. All calls are confidential, so please reach out in confidence to our caring Admissions team today!

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Use Your Anthem BCBS Insurance for Treatment at Icarus Behavioral Health Nevada

Anthem Blue Cross Blue Shield is a multi-state health insurance company that covers all types of mental health conditions, including addiction and mental illness. They offer both HMOs and PPOs to help you save as much as possible with your chosen rehab and cover the majority of treatment programs without an issue, making it easier to commit to getting help.

If you want the most seamless and stress-free rehab experience possible, we can help. At Icarus Behavioral Health Nevada, we work with a wide range of insurance providers, including Anthem BCBS, to make effective drug, alcohol, and mental health treatment affordable and accessible.

We create personalized treatment plans to help with a wide range of conditions like PTSD, in addition to offering rehab for many illicit and illegal substances, including alcohol addiction.

You deserve to be as physically and mentally healthy as possible. Give us a call today to see how we can help you get better.

References

  1. https://www.samhsa.gov/data/sites/default/files/report_2716/ShortReport-2716.html
  2. https://www.hhs.gov/answers/health-insurance-reform/does-the-aca-cover-individuals-with-mental-health-problems/index.html
  3. https://www.ncbi.nlm.nih.gov/books/NBK459126/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/
  5. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health