Finding a Treatment Center with Anthem Insurance

Addiction is a wide-reaching, indiscriminate disease that can affect anyone regardless of their age, wealth, race, beliefs, or location. Unfortunately, of the more than 20 million American adults who fit the criteria of having a substance use disorder, only about 12 percent actually receive recovery treatment.

There are many reasons for this, including denial, shame, lack of access to treatment resources, and one of the biggest perceived barriers to addiction recovery treatment, cost.

None of these things should ever keep someone from being able to get the help they both need and deserve to free themselves from addiction and begin their recovery journey. But many people are overwhelmed at the prospect of navigating their rehab insurance coverage or are not aware of how exactly cost correlates to addiction treatment.

But that does not mean that recovery has to be out of reach! Finding an affordable treatment center is more than possible, especially with insurance companies like Anthem Insurance providing coverage for a range of different addiction treatment services and the majority of treatment centers accepting most private insurance options, including Anthem.

The first step is finding out the exact details of your rehab insurance coverage, as well as the addiction recovery program that will best suit your needs. Once you have a clearer idea of the treatment services you require to successfully recover, what facilities can provide it, and how much of it your Anthem insurance policy will cover, you will be able to work on getting started on the path to a life free from addiction.

WHAT IS INVOLVED IN ADDICTION REHABILITATION?

Addiction rehabilitation is meant to treat every aspect of a person’s addiction, both the mental and the physical. The first thing typically addressed in an addiction recovery program is detoxification, which is the process of removing the drugs, alcohol, and various other toxins from your system.

Medical detox is a key part of recovering from a substance use disorder. Because chronic drug or alcohol use creates fundamental changes in the body and the brain, when you stop using, you will experience painful and possibly even life-threatening withdrawal symptoms.

Medical detox ensures you go through withdrawal in a safe, controlled environment where you are carefully monitored by an experienced detox team that will help to keep you stable and ease the uncomfortable symptoms of withdrawal.

When you begin your addiction treatment program, you will typically start at the highest level of care and then slowly progress down the ladder to less intensive modes of treatment, which, depending on the specific needs of the person in treatment, include:

•  Medical detox
•  Inpatient care
•  Partial hospitalization
•  Intensive outpatient care
•  Outpatient care
•  Post-treatment maintenance programs (support groups, alumni programs, etc.)

Depending on the severity of someone’s addiction, they may not require certain rungs on the treatment ladder and will move through it in their own way.

Within these different levels of care, there are many addiction treatments and therapy services that are meant to provide support, guidance, and education to those working to both understand and effectively manage their addictions. Some of these services include:

•  Individual counseling
•  Group counseling
•  Family therapy
•  Case and care management
•  Medication management
•  Holistic therapy
•  Stress management
•  Cognitive Behavioral therapy
•  Motivational interviewing
•  12-step programs
•  Addiction education classes
•  Relapse prevention planning
•  Aftercare recovery support

It is important to keep in mind, however, that not all of these treatments will necessarily be offered at every treatment center, and even if they are provided, may not be covered by your Anthem insurance plan.

BREAKING DOWN THE COST OF REHAB

People’s recovery treatment needs are always going to vary based on the fact that each individual’s relationship with their addiction is going to be unique. What serves as an effective treatment for one person may even be actively harmful when applied to another person’s recovery.

These needs are going to shape the kind of recovery treatment program and center you will be looking for as well as determine the general cost of your treatment through Anthem Insurance, including:

• If you choose a private treatment center, a government-funded clinic or a hospital
• Whether it is an inpatient or outpatient treatment program
• If you need medication-assisted treatment or medical maintenance therapy
• If you have a co-occurring issue or require dual diagnosis treatment
• What level of amenities are provided, ranging from basic to luxury
• The length of treatment, such as needing a long-term residential program
• If you need or are provided with post-rehab recovery services

If someone does not have a severe substance use disorder and has a stable enough home environment, then their treatment costs are going to be much less than someone who needs long-term residential treatment to successfully recover.

Apart from the level of care, time spent in treatment is also a major factor, as different insurance policies will provide coverage for only certain lengths of time. However, the National Institute on Drug Abuse (NIDA) recommends, based on comprehensive research, at least 90 days should be spent in an addiction treatment program for it to have any lasting positive results.

Even if it requires some out-of-pocket pay, what is most important is that you get the treatment that you need to recover effectively and increase your chances of maintaining your sobriety in the long-term. Trying to save money by skimping on proper treatment will only result in a relapse and more time spent in a rehab program anyway.

WHAT IS COVERED BY REHAB INSURANCE?

Most private insurers are going to provide at least some level of addiction treatment insurance coverage. To find out the exactly how much your specific plan through Anthem Insurance will cover, it is recommended that you call your Anthem service rep or an addiction specialist who will take the time to thoroughly explain your rehab insurance coverage.

When Anthem Insurance or really any insurance company examines a potential addiction treatment center, they consider a number of different factors, including:

• Is it in their network? In-network providers are more likely to qualify for full coverage.
• What kind of treatment is offered? Insurance companies are more likely to cover evidence-based practices that have gone through rigorous scientific testing as opposed to other alternative or holistic therapies that have not been as thoroughly evaluated.
• Anthem Insurance will also carefully examine a treatment center’s track record of success, including how long they have been operating, if they have been penalized for any violations, and if they have a history of results-oriented treatment. This works in your favor as well, helping to avoid any fraudulent or illegitimate treatment center.

“Your rehab insurance coverage through Anthem Insurance will vary based on what policy you have and what state you live in.

On the other hand, if your withdrawal symptoms are not deemed life-threatening or otherwise requiring intensive medical monitoring, your rehab insurance coverage may not apply.

In that case, if you want a medical detox, you will have to pay out of pocket or work with both your insurance and treatment center to find a way to get the most coverage for the treatment you need.

OUR ADMISSIONS SPECIALISTS ARE HERE TO HELP

Figuring out your options and exactly what your Anthem insurance policy does and does not cover in terms of substance abuse detox and treatment can be confusing, especially if you are also new to finding addiction treatment.

But that should never keep you from seeking out the help and treatment you need, either for yourself of a loved one, and more importantly, you don’t have to do it alone. Delphi Behavioral Health Group is here to do whatever it takes to make financing your treatment with Anthem insurance as easy as possible.

Sources

Mayo Clinic. (October 2017). Drug Addiction (Substance Use Disorder). Retrieved from https://www.mayoclinic.org/diseases-conditions/drug-addiction/diagnosis-treatment/drc-20365113

SAMHSA. (n.d.). Trends in Substance Use Disorders Among Adults Aged 18 or Older. Retrieved from https://www.samhsa.gov/data/sites/default/files/report_2790/ShortReport-2790.html

Johns Hopkins Medicine. Substance Abuse / Chemical Dependency. Retrieved from www.hopkinsmedicine.org/health/conditions-and-diseases/substance-abuse-chemical-dependency

ASAM. ASAM Criteria. What is The ASAM Critera? Retrieved from https://www.asam.org/asam-criteria/about

National Institute on Drug Abuse. (2018, January). How long does drug addiction treatment usually last? Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment

Verywell Mind. (2018, June 29). Top 5 Triggers of Addiction Relapse and How to Avoid Them. Hartney, E. Retrieved from https://www.verywellmind.com/why-did-i-relapse-21900