Anthem is an insurance company that directly provides health insurance coverage to millions of Americans. The company has a presence in many states directly and through subsidiaries. Through a series of mergers and acquisitions starting in 1992, the company grew its representation and coverage across the country. Today, it has over 10,000 employees.
Policies offered by Anthem provide add-on insurance coverage for addiction treatment.
Knowing whether your health insurance policy covers addiction treatment is important. Currently, the United States is in the middle of what the CDC dubbed an opioid-related overdose epidemic in 2011.
The 2017 National Survey on Drug Use and Health gave more insight in terms of substance use among Americans:
- 74% of adults suffering from a substance use disorder in 2017 struggled with an alcohol use disorder.
- 1 out of every 8 adults struggled with both alcohol and drug use disorders simultaneously.
s drug use and attitude toward drugs contributes as well. Among youth, especially those who attend college, peer influences are major environmental factors as are community attitudes toward drugs and poor academic achievement. Groups that struggle with mental disorders are a risk group as well with teenagers being the most vulnerable.
Someone who has prior substance abuse in their genealogy is encouraged to double-check if their insurance policy covers addiction treatment. In this case, coverage is an investment.
The 2017 NSDUH also found the following treatment statics:
- 4 million people, 19%, who needed treatment received it.
The Bronze-level plan is usually the most affordable in all the states where it can be acquired. The monthly premiums are the lowest. To balance it out, the deductible and co-pays are higher than the other plans. This is similar to vehicle insurance. It is like deciding if you want to pay more or less up front. At the Bronze level, it is estimated that 60% of medical costs are paid by Anthem.
With the Silver-level plan, the monthly premiums are higher than bronze plan. To balance things out, the deductible and co-pays are lower than the Bronze plan. If you pick this policy, you can expect Anthem to cover an estimated 70% of medical costs.
If you pick the Gold-level plan, the monthly premiums are the highest. This allows you to have the lowest deductible. Co-pays are also less than other plans. With this policy, it is estimated that 80% of medical costs are paid by Anthem.
If you qualify, Anthem does its best to provide Medicaid coverage plans in specific states including California, Indiana, Kentucky, Nevada, Virginia and Wisconsin. Medicaid is also heavily regulated at the federal level. If this is something you want to know about, it is a good idea to speak with an insurance representative.
When a company in a heavily regulated field does not do business directly due to state laws, it often partners with other companies that already have a setup. In Anthem’s case, a client has the opportunity to take advantage of the nationwide network of BCBS providers. There are times when you may have to seek treatment in a facility outside of your home state. This is not uncommon for someone who needs to enter a rehab program. Although these are centers in all states, the one that best fits a patient’s needs may be in the New England area as opposed to the Midwest.
For these cases, Anthem may offer coverage outside of the state, or you can exercise the guest membership option. The membership gives an Anthem client the ability to join an affiliated HMO in another area if they are staying there for 90 days or longer. If this is something that interests you, you are encouraged to call Anthem directly to speak with one of their representatives. You can double-check your eligibility as well as out-of-state coverage before making any concrete decisions.
Checking Your Insurance Benefits
When you purchase an insurance policy for anything, you are always encouraged to check the benefits before signing on the dotted line. Insurance policies have complex language because they are abiding by several sets of laws and regulations. An agent is the best person to ask about a policy’s bullet points. Usually, a client needs to know payment due dates as well as the start and end date of the policy. At that time, you can ask for an outline of the bullet points of your policy.
If you believe that at some point you may need substance misuse treatment, you have to make sure that it will be covered. There are times when a client simply needs to pick out the right policy among several options. The more benefits a policy provides, the higher its overall cost, so if you believe that you are paying for coverage for certain benefits, be sure that they are there in the policy.
Once you have acquired your policy, if you have questions down the road, you can always call the number on your insurance card. Once an agent answers your call, they are equipped to look up your account and answer your questions. Anthem Standard
FEP Blue Focus
These plans are similar to the standard plans in the sense that you get to pick your deductible. Based on your choice, the other fees are determined so that things more or less balance out as far as out-of-pocket expenses and up-front fees.
Those who are eligible for Medicare can receive hospital, medical and prescription coverage in a single plan through Anthem.
Does Anthem Cover Addiction Treatment?
Anthem BCBS insurance plans do offer substance abuse and mental health coverage benefits. How much your policy covers depends on the type of coverage you pick. Usually, if a service is deemed to be medically important, it will be covered. Alcohol, benzodiazepines and opioid detox are often covered. There may be limits, though, so before you make any arrangements, check your benefits.
The relapse rate for substance use disorders is estimated to be between 40% and 60%. This rate is similar to rates of relapse for other chronic diseases such as hypertension or asthma, which makes treatment vital for a person’s future when they are struggling.
A person dealing with addiction is encouraged to seek help. First and foremost, seeking help puts a person back in control of their own life. You should know that you are not alone, and you have options for treatment. Your insurance policy may be able to help with the costs, so don’t delay treatment.