Anthem Blue Cross Coverage for Drug Rehab and Behavioral Health

By The Fix staff 05/02/19

Anthem Blue Cross alcohol rehab centers, drug addiction rehab facilities, and behavioral health treatment centers are important providers of mental health care coverage. 

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anthem blue cross drug rehab coverage

Substance use disorders, alcohol abuse, drug addiction, and behavioral health issues are all important mental health conditions that can cause significant dysfunction in your life. They often occur together too, which can make symptoms worse. There is hope, though, as these are all conditions that are treatable and manageable. Anthem Blue Cross alcohol rehab centers, drug addiction rehab facilities, and behavioral health treatment centers are important providers of mental health care. 

Table of Contents

  1. Defining Substance Abuse, Alcohol Addiction, and Behavioral Health
  2. Does Anthem Blue Cross Cover Substance Abuse Treatment and Alcohol Addiction?
  3. Does Anthem Blue Cross Cover Mental Health Treatment?
  4. Understanding Anthem Blue Cross Substance Abuse Coverage
  5. Understanding Anthem Blue Cross Mental Health Coverage
  6. Anthem Blue Cross In-Network Providers or Out-of-Network Providers?
  7. Types of Substance and Alcohol Abuse Treatment Covered by Anthem Blue Cross 
  8. Types of Mental Health Care Covered
  9. Coverage for Aftercare Services
  10. Types of Services Anthem Blue Cross May Not Cover
  11. Choosing the Best Mental and Behavioral Health Services
  12. Using Anthem Blue Cross Insurance for Behavioral Health Care

Defining Substance Abuse, Alcohol Addiction, and Behavioral Health

Substance abuse is any misuse of a drug or alcohol. If you misuse drugs, you are not necessarily addicted, but you are at significant risk for it. Alcohol or drug addiction refers to a serious illness characterized by being unable to control your use of the substance. Some of the Anthem Blue Cross substance abuse criteria include: 

  • Intense cravings

  • Regularly using more than you intended

  • Being unable to stop using or to use less

  • Spending a lot of time on using

  • Spending less time on other activities because of substance use

  • Failing to meet your responsibilities because of substance use

  • Using a substance in spite of problems it causes with friends and family

  • Continuing to use a substance even though it causes or worsens health problems

  • Using in dangerous situations, like while driving

  • Needing more and more to get high

  • Having withdrawal when you try to stop using


Substance abuse, addiction, and alcoholism are all considered to fall under the category of behavioral health. These are conditions related to how you react to the world and how you behave and the choices you make, such as alcohol use or drug use. You may need Anthem Blue Cross Substance abuse care if you find you can no longer control your use of alcohol or drugs.

But behavioral health also includes mental illnesses, like depression, anxiety disorders, and personality disorders. These are conditions that have no known causes but plenty of risk factors, like genetics and substance abuse. Anthem Blue Cross mental health coverage is important because it will cover these mental illnesses that require treatment. 

Does Anthem Blue Cross Cover Substance Abuse Treatment and Alcohol Addiction?

Most insurance companies do cover treatment for addiction and substance use disorders, although the degree of coverage depends on each individual plan. Anthem Blue Cross providers may offer detox services, medical treatment for certain types of drug addiction, treatment in rehab facilities, and outpatient therapy. Anthem Blue Cross Blue Shield subsidiaries offer coverage in a number of locations.

It is important that you understand your own Anthem Blue Cross substance abuse policy so that you know what to expect. There may be certain criteria you must meet, for instance, in order to be covered. You may also be facing some co-pays or a deductible, so know what these are before you enroll in treatment. 

Does Anthem Blue Cross Cover Mental Health Treatment?

Yes, as with substance use disorders, most insurers do also cover treatment for all types of behavioral health, including mental illnesses. With Anthem Blue Cross mental health providers, you will have access to a great network of professionals. This includes therapists, counselors, physicians, psychologists, and psychiatrists. You also have access to Anthem Blue Cross approved mental health facilities for residential treatment if necessary. 

Understanding Anthem Blue Cross Substance Abuse Coverage

What your coverage includes for alcohol addiction or substance abuse depends on the plan you have. Make sure you read over the materials you have for your policy so that you can make better decisions about treatment. Consider factors like deductibles, whether you have to stick with in-network providers, if treatment in an inpatient center will be covered, the costs and coverage for prescription drugs, and more. 

Understanding Anthem Blue Cross Mental Health Coverage

With mental health care, you will also need to understand your specific plan or policy before making treatment decisions. You may be required to get treatment from in-network providers or to pay a certain amount in deductible before insurance payments kick in. Read your Anthem Blue Cross mental health policy carefully before deciding on care, and call if you still have questions about coverage. 

Anthem Blue Cross In-Network Providers or Out-of-Network Providers?

You may have a choice to make in your treatment services between in- and out-of-network providers. Your policy may require that you choose doctors, therapists, and facilities that are in a group of network providers. This is known as an EPO, exclusive provider organization.

Or, your policy may allow you to choose from any provider. This is a PPO, a preferred provider organization. Choosing an out-of-network facility or physician may cost you more money, so be sure you know what your policy says.

Types of Substance and Alcohol Abuse Treatment Covered by Anthem Blue Cross 

When seeking treatment for a substance use disorder or alcohol use disorder, you may have a lot of choices, including between Anthem Blue Cross psychiatrists, therapists, and treatment centers. The first big decision to make is between outpatient and inpatient treatment. 

Inpatient care is intensive, residential treatment. You will live in a facility for a few weeks or months to get treatment on a daily basis. This type of care provides around-the-clock supervision, a safe environment, other residents to work with, and a larger team of caregivers to provide different types of therapy and support services. 

Some benefits of outpatient care include being able to stay at home, being with family more, and being able to keep going to work. On the other hand, you don’t get as much time to focus on your wellness with just a few sessions of therapy per week.

The choice you make will depend on your particular needs, your Anthem Blue Cross substance abuse policy, and your preferences. Many people find they need the intensive care of a rehab facility, while others find success in outpatient therapy.

Types of Mental Health Care Covered

Treatment for mental illnesses can also be inpatient or outpatient, but it is more often provided on an outpatient basis. If your policy does not cover residential care for mental illness, you can still get effective treatment from Anthem Blue Cross therapists and other providers. 

Anthem Blue Cross depression providers, for instance, offer one-on-one therapy sessions on an outpatient basis that can help patients manage their symptoms. This kind of treatment can be very effective as long as you stick with it, get good medical care, and practice healthy lifestyle habits recommended by your therapist. 

Coverage for Aftercare Services

Aftercare is an important part of treatment for substance and alcohol abuse in particular. If you spend time in a residential facility, the transition back to home and work can be difficult. Your Anthem Blue Cross substance abuse care policy may include coverage for ongoing therapy on an outpatient basis. This, along with attendance at support group meetings can help you make a smoother transition and reduce the risk of relapse. 

Types of Services Anthem Blue Cross May Not Cover

You may have the best policy, but there still are some mental health and addiction services that you’ll find are not covered by your insurance. For example, your Anthem Blue Cross approved alcohol abuse facilities list is not likely to include any luxury centers. 

And don’t expect coverage for a private room or some extra services a facility may offer. Things like music therapy, massage, yoga and other exercise classes, or cooking instruction are useful services. However, they may not be covered by your policy.

Choosing the Best Mental and Behavioral Health Services

Your choices may be restricted to some degree by your Anthem Blue Cross substance abuse professionals list or mental health care providers. However, you will still have options, and you shouldn’t have to settle for treatment that doesn’t work for you. Narrow down your list by coverage options, location, and extra costs. 

Once you have a list of facilities or treatment providers that match your needs, visit those facilities and speak with staff. Ask any questions you have about the treatment program, and speak with residents if possible in a rehab facility. Make a choice based on practical considerations, like what your policy will cover, but also what works for your personal needs and preferences. 

Using Anthem Blue Cross Insurance for Behavioral Health Care

Most people will need some type of behavioral health care at some point in their lives. For you it may be alcohol addiction treatment or depression management. To get the most out of your insurance policy, make sure you understand it. Know what is covered and what is not, what extra costs you face, and which providers are in your network. Find out if you need pre-authorization or a referral.

Good mental and behavioral health care is essential for living well, but too few people actually get the treatment they need. With Anthem Blue Cross you should find that you can get treatment and that the costs will not totally come out of your pocket. Working with your insurance company is an important part of getting good care, so don’t hesitate to call if you need help understanding and using your policy.

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