We are now offering Telehealth treatment options.
It’s impossible to separate mental and physical health because they’re intertwined. Mental illness increases the risk of physical disorders, and physical conditions raise the risk of mental disorders. Anthem insurance from Blue Cross and Blue Shield knows you can’t treat one without treating the other. To combat both, they include mental health and substance abuse benefits in their medical plans.
Anthem Insurance for Rehab
Approximately 20 percent of adults in the United States live with mental health conditions. Not only are they more likely to have physical illnesses, but they’re also more likely to have substance use disorders. Mental health costs Americans around $200 billion every year.
Congress passed the Affordable Care Act (ACA) in 2010, making health care more affordable and making it easier to get mental health coverage. Anthem’s holistic insurance plans offer an integrated approach that includes mental health and substance use disorders.
Anthem insurance provides these services:
How Anthem Insurance for Rehab Works
As boring as they may be, it’s important to understand how insurance benefits work. You need to choose a plan that’s affordable, but the one with the lowest monthly cost is not necessarily your best option. It all depends on the deductible and copay.
A deductible is the amount you pay out-of-pocket for health care before your insurance plan kicks in. Deductibles vary from a few hundred dollars to several thousand dollars each year, and some plans have no deductibles at all. This is how it works.
If you choose a higher deductible, you’ll have lower monthly payments. If you’re healthy and seldom use your insurance plan, a higher deductible might be the best option. There is one caveat: If you get sick or injured, you’ll pay the amount of the deductible before your insurance pays anything.
If you choose a lower deductible, you’ll have higher monthly payments, but you won’t have to pay as much upfront if you get sick. Families and people with chronic illnesses who have higher medical expenses may benefit from this option.
A copay is a fixed amount you pay upfront for a medical service, and the amount varies for different services. Depending on your insurance plan, you may have a copay before or after you reach your deductible. You may also have a copay if you have coinsurance, such as an agreement with your provider or another insurance plan that pays a portion of the cost.
Before you visit a medical provider, it’s good to confirm your benefits and make sure your provider is in-network. In-network providers have lower copays and contract with the insurance company to limit what they charge.
Anthem Insurance for Rehab and Pharmacy Benefits
Anthem insurance coordinates medical and pharmacy benefits to prevent gaps and make sure patients are getting effective medications at a reasonable price. The company will only pay for brand-name prescription drugs if no generic alternative is available. A brand-name drug may be available if the prescribed specifies a generic is not suitable, but drugs not on Anthem’s approved list may need prior authorization.
Does Insurance Cover Rehab for Individual Therapy?
To find out how many counseling sessions your plan will pay for, call the toll-free number on your EAP card. Anthem provides its members with care managers who explain benefits and help them find providers. Referrals fall into five categories:
Talk therapy can be done in a group or one-on-one with a counselor. Individual therapy gives patients a chance to develop an intimate relationship and share private stories. Group therapy helps patients develop communication skills and experience a sense of community with like-minded souls. Participants also learn by listening to others with similar concerns.
To get the most from your Anthem plan, ask for a referral to a licensed, independent provider who contracts with Anthem to provide behavioral health services. After you’ve chosen from the referral list, call back to confirm your choice.
Does Insurance Cover Rehab Centers?
Finding a rehab center for inpatient and outpatient drug and alcohol rehab can be a daunting task, but care managers know how to navigate the process. For approval, treatment must be medically necessary, and confirming you’re covered early in the process narrows the possibility you’ll be denied the level of care you need. A comprehensive guide to recovery and assistance explains everything from detox to sober living.
Rehab centers and mental health professionals go through a strenuous credentialing process to become Anthem providers. Federal agencies like the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse research treatments and use evidence-based data to determine which ones are effective. Insurance companies look for evidence-based practice and training when they contract with health care providers and facilities, and some require it for coverage.
Mission Harbor Can Help
Mission Harbor Behavioral Health is a mental health treatment program serving Santa Barbara and Southern California. Levels of care include partial hospitalization and intensive outpatient. The center uses an integrated rehab program incorporating cognitive behavioral therapy, dialectical behavioral therapy, and family therapy.
With a specialized adolescent outpatient program and a new telehealth option for those who can’t be there in person, Mission Harbor makes it possible for patients to get help without missing school or work.
If you or a young adult needs help with alcohol or drug rehab, you’ll find experienced, compassionate professionals who know how to tailor a program just for you. Read more about our services or contact us now.
The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.
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Alcohol addiction is extremely difficult to overcome on your own.. Seek specialized help and let professionals guide you in your recovery.