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Anthem BlueCross of California For Alcohol And Drug Rehab Programs in CA

Table of Contents

Does Anthem Blue Cross of California Insurance Cover Drug Treatment Programs?

Evidence-based addiction treatment can be a life-saving solution for individuals who are struggling with substance addiction disorders.1 Unfortunately, drug and alcohol rehab can often be costly.2 This is especially true if the patient requires long-term, intense, inpatient treatment at a specialized facility, as in cases where individuals are battling long and complicated substance use disorders that may or may not include past relapses.1,2

Insurance coverage can make all the difference when it comes to helping these individuals access the treatment they need. It’s significantly easier for insured individuals to find treatment facilities that are in-network with their insurer, especially if they have limited private pay options that allow them to cover a portion of the cost of treatment.3

Established in 1936, Anthem is one of the biggest health insurance providers in the United States. Anthem Blue Cross of California provides medical insurance coverage for many Californians and partners with numerous private treatment facilities, including various outpatient and inpatient alcohol and drug rehab centers in California.4

An individual who has Anthem Blue Cross of California Insurance substance abuse treatment coverage can lower or even eliminate the upfront cost of addiction treatment at an in-network facility. To learn more about what is included in your coverage, call the number on the back of your insurance card or consult directly with your in-network rehab center of choice.4

What Is Anthem BC of California Insurance?

Anthem Blue Cross and Blue Shield is a daughter company of Anthem, Inc., which was formed in 2004 when Anthem, Inc. and WellPoint Health Networks Inc. merged to become one of the leading health insurance providers in the country.5 With over 70 million members through its affiliated companies, one in eight Americans is insured by Anthem Blue Cross and Blue Shield.4

What Does Anthem Blue Cross of California Rehab Coverage Include for Addiction Treatment?

Your coverage for Blue Cross drug treatment programs in California will likely include these benefits:6

These are just some of the many treatment options available at alcohol and drug rehab centers throughout CA that are covered by major insurers such as Anthem Blue Cross of California.2 Depending on the facility you opt for, your insurance carrier may also cover more specialized programs such as substance use rehab for veterans, intense 3-7 day treatment opioid rehab programs, belief-based addiction treatments for spiritually-inclined individuals, extended stays at sober living homes, and more.

What Is Not Included in Anthem Blue Cross of California Healthcare Plans?

Blue Cross coverage does not include a variety of non-essential services, such as:6

  • Private treatment
  • Non-medical conveniences
  • Recreation programs
  • Holistic care
  • Alternate therapies
  • Food delivery

Does Anthem Blue Cross of California Offer Treatment for Mental Health & Co-Occurring Disorders?

According to the 2017 National Survey of Substance Abuse Treatment Services (N-SSATS), nearly half (46.5%) of patients in California’s addiction treatment facilities were diagnosed with co-occuring substance abuse and mental health disorders.7 In about 50% of these cases, the patients are also battling severe mental illness.8

Whether the substance use disorder was caused by underlying mental health problems or vice-versa, neither condition can be treated separately from the other. Research has shown that addressing both disorders at the same time offers the highest chance of long-term recovery.9

Fortunately, insurance carriers are required to provide coverage for mental health care & treatment under the Affordable Care Act (ACA), which includes both standalone substance use rehab and co-occurring disorder treatment. The precise benefits and coverages can vary depending on the individual’s insurance plan.10

Does Anthem Blue Cross of California Cover Therapy for Substance Use Treatment?

In most cases, yes. However, what exactly is included in the coverage can vary depending on the unique needs of the treatment-seeking individual, and which insurance plan and level of coverage they have. Most insurance holders can expect Anthem Blue Cross of California to at least partially cover the following treatments:6

  • Care manager access
  • Residential treatment and detox
  • Partial hospitalization
  • Outpatient treatment
  • Intensive outpatient treatment
  • Acute inpatient hospitalization

Depending on the rehab center you choose, these treatment options may offer specialized programs, such as gender-specific addiction treatments for men, rehab programs that have been optimized for women, programs for couples that are undergoing addiction treatment, and so on.

How Long Does Anthem Blue Cross of California Provide Coverage for Inpatient Rehab?

Although the specific needs of individual patients can differ somewhat, extended treatment programs (28-30 day inpatient rehab stays and longer) have been shown to offer the greatest chance of long-term recovery.1

The maximum length of time included in Anthem Blue Cross of California drug and alcohol treatment coverage will vary depending on the patient’s policy and tier of coverage, as well as the scope of their chosen program.1

Treatment-seeking individuals can refer to their plan information on their insurance card to learn more about what exactly is included in their coverage.4

What to Do if My Anthem Blue Cross of California Insurance Does Not Cover Inpatient Rehabilitation Centers?

If this is your situation, you may have to look for other ways to pay for your treatment. If you’re not eligible for state-funded drug rehab programs under Medicaid/Medicare, and you don’t have coverage through an employer, you may still be able to benefit from federal financial aid.11

Also known as a health insurance subsidy, this type of aid was introduced by the Affordable Care Act (ACA).11 Eligibility for federal financial aid is determined based on household size, income, and the cost of health coverage in the patient’s home state.11

A total of 46.6% of rehab facilities in California also offer free substance use disorder treatment programs to patients who are unable to afford the cost of treatment. Furthermore, 61.2% of rehab centers offer a sliding fee scale. Finally, patients also have the option of self-financing their treatment at 85.5% of California’s rehab centers.7

Regardless of the cost, individuals who are struggling with substance use disorder should seek treatment as soon as possible to prevent more serious mental and physical health issues that can be caused by untreated SUD and the lifestyle that frequently accompanies it.12

Choosing Between Anthem Blue Cross of California Outpatient and Inpatient Addiction Treatment Programs

Individuals who have Anthem Blue Cross of California insurance can pick between outpatient and inpatient programs offered by in-network alcohol and drug treatment providers, depending on which treatment type is best suited for their needs.6

That being said, due to the high risk of relapse and overdose, inpatient rehab tends to be the overall safer option that offers a greater likelihood of success. This is particularly true when the following factors are taken into account:1

  • Quality of care
  • Accountability
  • Treatment ecosystem
  • More focused environment
  • Support groups

How Can Patients Use Anthem BC of California Insurance for Substance Addiction Treatment?

Treatment-seeking individuals can get in touch with their insurance carrier and request a list of recommended rehab centers in their preferred area. They can also call a dedicated drug and alcohol rehab hotline to learn more about the available programs and payment options.2

Individuals who have Anthem Blue Cross of California insurance and are looking to enlist in an addiction treatment program can follow these steps:4

  1. Consult with a medical doctor
  2. Find a drug and/or alcohol rehab program that’s suited to their needs
  3. Verify ability to use their insurance coverage
  4. Work with their preferred rehab facility to determine coverage

How Do You Find Anthem BC of California-Covered Drug or Alcohol Treatment?

Individuals who are struggling with opioid addiction tend to have a high chance of experiencing a fatal overdose or suffering severe long-term complications, especially if they’re also dealing with other substance abuse disorders.1

Determining whether you or your loved one qualify for insurance coverage can be a prolonged process. This can be a challenge for treatment-seeking individuals who are looking to be admitted into rehab as soon as possible and who may require same-day admittance in order to safely and successfully go through withdrawal.1

American Addiction Centers (AAC) is partnered with multiple reputable health insurance providers, including Anthem Blue Cross of California. They maintain a 24/7 helpline through which they can promptly determine your or your loved one’s insurance coverage, answer any questions, and provide the necessary guidance in complete privacy.

They can also help you find a local treatment center in California that is well-suited for your needs. AAC’s Laguna Treatment Hospital is a state-of-the-art facility in California that has a top-of-the-line drug and alcohol rehab program that’s designed to assist and support patients at all stages of recovery.

Frequently Asked Questions

What is an Anthem Blue Card? 

A Blue Card denotes membership in a national program that connects healthcare providers from all across the country. Blue Plan members are able to use healthcare benefits and services while living or traveling in any BlueCross BlueShield service area.13

Is Alcohol and Drug Addiction Considered a Pre-Existing Condition? 

Although mental health disorders are usually considered to be pre-existing conditions for insurance purposes, substance use disorders and other types of addiction are no longer seen as such under the Affordable Care Act (ACA).10

Does Drug and Alcohol Rehab Work for Depression? 

A substance use disorder is frequently accompanied by co-occurring mental health disorders, including depression. To address these co-occurring disorders as effectively as possible, addiction treatment centers often offer intense dual diagnosis treatments.14

Does Anthem Blue Cross Cover Behavioral Health Services? 

Anthem Blue Cross of California includes behavioral health services in its mental health services and covers the complete range of coordinated care. This includes substance use disorders and any co-occurring mental health disorders.15