There’s no question that addiction treatment can be difficult to afford. Companies like Anthem can help you get the care you deserve at an affordable cost. Not only that, but it can also be intimidating or confusing. At Crest View Recovery Center, we believe it’s important to help patients make sense of what their plans cover.
What Does Your Policy Cover?
Anthem may cover rehab services if you’re looking for substance abuse treatment. Seeking assistance can be very difficult when care is so expensive. This makes the road to recovery even more difficult. At Crest View, we want to help patients get to where they can settle into stability by whatever means necessary.
Depending on the plan you have with Anthem, coverage details may differ. However, some of their plans include the following:
- Bronze: Covers 60% of healthcare costs; member covers 40%
- Silver: Covers 70% of healthcare costs; member covers 30%
- Gold: Covers 80% of healthcare costs; member covers 20%
- Catastrophic Coverage: Catastrophic coverage plans are available on and off the exchange to applicants under age 30, or to applicants 30 years or older with a hardship exemption. All applicants must meet basic eligibility requirements for these plans.
Some of their network options include the following:
- Preferred Provider Organization: Clients see any provider they want without a referral; no primary care gatekeepers are required
- Tiered PPO: Includes tiered hospitals for inpatient admission. Hospitals are split into two categories: Tier 1 and Tier 2. Clients pay a lower cost-share for hospitals in Tier 1
- Health Maintenance Organization (HMO): Clients do not have to choose a primary care physician. Also, referrals from PCP are not required to see other doctors. There are no benefits for out-of-network facilities except in cases of emergency, urgent care, or if a service has been preapproved. Should members venture outside the network, they will likely have to pay 100% out-of-pocket.
You may prefer a particular payment plan. Anthem’s payment plans include the following:
- Automatic bank withdrawal (bank draft)
- Check or money order
- ePayBill online through WebPay portal
- WebPay automatic payments with Visa or Mastercard
- Pay over the phone with credit or bank account
- Personal banking online bill-pay service
- A client may qualify for a tax credit subsidy or cost-share reduction on Silver plans purchased on the marketplace
- Clients should check for more information and find out if they will qualify for a tax credit or subsidy
- Subsidies are not available with plans sold off the exchange
Anthem believes that what individuals do has an impact on those around them. They’re dedicated to providing better care to members, greater value to customers, and helping improve the health of communities.
This insurance company does its best to keep coverage and benefits consistent with all current clinical and behavioral health guidelines. Anthem also regularly measures the quality of service you receive so that you are getting the most out of what you’re paying for.
Anthem for Drug and Alcohol Treatment
Services for drug and alcohol treatment include the following:
- Outpatient care
- Rehabilitative and habilitative services and devices
- Mental health treatment
- Substance abuse treatment
- Emergency services including urgent care
- Preventative and wellness services
Anthem covers all of the essential health benefits required from the affordable care act, covering a wide variety of services from substance abuse to mental health treatment.
Also, Anthem works hard to make sure that every single one of their clients has access to quality treatment. In this aspect, our goals here at Crest View align similarly to Anthem’s. Our ultimate goal is that your recovery needs are met in order that you might pursue a more healthy lifestyle and be equipped with the tools necessary to maintain stability.
HMO and PPO
To understand how HMO and PPO work, one must first understand the foundational aspect of each of these organizations.
Health maintenance organizations (HMO) are paid monthly or annually to provide health insurance to clients. HMO does not cover out-of-network care unless there’s been a medical emergency.
Preferred provider organizations (PPO) provide different services to subscribed clients at a reduced rate. In other words, somebody with a PPO pays less if they choose a provider that is already apart of their plan’s network. Anything done outside of that would be an additional cost.
The purpose of both of these organizations is to help cut the medical costs their clients are paying by providing a network of doctors and care within their organization. The big difference is really who clients can see outside of each plan.
Anthem’s Detox Coverage
The treatment programs Anthem covers include detox programs. Some clients may require these programs in order to recover effectively and safely. There is no “one size fits all” program for recovering from substance abuse. It is imperative that people find the ones that work to fit their unique needs.
Anthem will more than likely treat your addiction with a detox method if that is what works for you, but it is imperative that you check your plan to see what is covered, or speak with a representative.
Anthem Outpatient Coverage
There are many different methods for treating substance abuse, and outpatient treatment is one of the most commonly used treatments. In outpatient programs, patients live at home or in a sober living center, but attend therapy and receive treatment outside their homes.
Typically outpatient treatment occurs following inpatient treatment. Outpatient treatment may also be good for those who live a more demanding lifestyle. It is worth noting, however, that it is best to talk with a professional at Anthem first to find out whether or not your plan covers outpatient treatment.
Mental Health Treatment Coverage
Mental and behavioral health disorders in substance abuse include the following:
- Eating Disorders
- Obsessive-Compulsive Disorder (OCD)
- Attention Deficit Hyperactivity Disorder (ADHD)
- Post-Traumatic Stress Disorder (PTSD)
Mental health and behavioral disorders can be directly linked to substance abuse. As a dual-diagnosis, this is largely due to the effect that substances have on the pleasure receptors or other parts of the brain. Those who suffer from this could also have become addicted as a result of a behavioral or mental health disorder. Often times substances are used as coping mechanisms.
Dual diagnosis is crucial to recognize because treating one problem without treating the other can be counter-intuitive. It’s as if somebody is treating the symptoms without weeding out the cause. This is why these programs are so important when it comes to substance abuse and mental health.
Mental health has a huge impact on the recovery process. Often times, it can have a negative effect on a patient’s progress. Moving forward is so important, but recognizing other issues that need treatment is necessary in order to do so. Poor mental health has a negative impact on sleep, mood, and even motivation. This alone makes it increasingly difficult for a patient to get to where they want to be.
It is imperative that if you or a loved one are suffering from both a mental health disorder and substance abuse you seek help right away. If left untreated, a mental health disorder could put a roadblock in the way of your recovery process. Talk to a representative at Anthem as soon as possible to find out whether or not you are covered; your plan may include treatment.
Crest View Can Help
Recovering from substance abuse is a difficult task; you don’t have to do it alone. If you’ve considered receiving treatment, it would never hurt to investigate your options. Our aim is to help you receive the best care affordable that you might pursue a life of health and stability. We are here to be a resource and solid foundation for your pathway to recovery.
We want to guide our patients to their complete potential in the recovery process. At Crest View, this means providing them with programs and resources that we know their insurance can cover so that they’re not taken by surprise. The last thing anyone wants to worry about in their recovery journey is what they can’t afford to get better.
Our desire is ultimately that we empower our patients and equip them with the right tools in order that they may build upon their foundation we’ve helped them build when they walk out the door. Treatment should never be too difficult to receive, so we will do whatever we can to make sure you are aware of everything your insurance covers.
If you or a loved one suffer from substance abuse and want to take a step towards recovery, and if you’d like to know exactly what your plan covers, don’t hesitate to reach out at (866) 327-2505.