Does Anthem BlueCross California Cover Alcohol and Drug Rehab Centers in California?
Anthem BlueCross California is a health insurance company that provides insurance coverage for the healthcare needs of its members. This includes coverage for drug and alcohol rehab centers. How much of your treatment is covered depends on your plan and the provider/treatment facility you choose.
Many rehab facilities are in-network with Anthem BlueCross California. Rehab treatment facilities offer different levels of care in California for the diverse population in the state. Call the centers you are interested in and share your insurance information. They can check your coverage for you while you’re on the phone. Alternatively, you can call the number on the back of your insurance card for more details about your plan.
What is Anthem BlueCross of California?
Founded in 1936, Anthem started as a small company and has grown to become one of the largest health insurance carriers in the United States. With more than 8.6 million members in California, Anthem Blue Cross covers more Californians than any other insurance provider in the state.1 The trade name of Blue Cross of California is “California Anthem Blue Cross” The company is an independent licensee of the Blue Cross Association.2
Anthem has a very broad network in California, with more than 65,000 care providers within the Anthem BlueCross California network.1 This allows you to find the right treatment facility for your needs in a rehab facility that is close to home.
Anthem BlueCross California offers health insurance plans in different tiers. The packages you can choose from as an Anthem BlueCross California member include:2
- Bronze 60 Plan: Bronze plans offer the lowest monthly premium and highest deductibles. This is an ideal plan for people who do not need a lot of medical care and expect fewer doctor visits each year. Bronze plans cover approximately 60% of your healthcare costs.
- Silver 70 Plan: Silver plans offer modest monthly premiums and lower deductibles than bronze plans. With the silver plan, you are still paying out-of-pocket for hospital visits and outpatient surgeries. Silver plans cover approximately 70% of your healthcare costs.
- Gold 80 Plan: Gold plans have a higher monthly premium but lower deductibles every time you see a specialist or visit the hospital. The gold plan covers approximately 80% of your healthcare costs.
- Platinum 90 Plan: Platinum plans have higher monthly premiums, but provide top-tier coverage. These plans are ideal for people who visit their doctor frequently or have higher medical needs. This plan has no deductible and fewer out-of-pocket expenses. Platinum plans cover approximately 90% of your healthcare costs.
What Does Anthem BlueCross California Insurance Cover in Addiction Treatment?
Anthem Blue Cross California’s Disease Management Centralized Care Unit has a specific care management program tailored for members who have substance use disorder.3 The insurance company will work with you to set health goals, find a treatment center, and create a care plan that fits your needs.
If Anthem BlueCross California is your health insurance provider, your policy may cover the following addiction treatments:4
- Medical detox: Medication-assisted detox uses prescription medications and counseling to help you safely withdraw from substances. Anthem does cover medical detox when it has been deemed medically necessary. This often requires a pre-authorization form for coverage to kick in.
- Inpatient or residential rehab: Live-in rehab facilities allow you to live at the treatment center and get 24/7 support, individual and group counseling, and medication support (if needed) for a set number of days while you get sober and learn ways to continue your journey in recovery.
- Partial hospitalization programs: Sometimes referred to as day treatment, these programs allow you to live at home and spend your days at a designated treatment facility.
- Intensive outpatient programs: Participants attend treatment approximately 3-4 evenings a week. You can live at home and attend to work and family obligations during the day.
- Outpatient rehab/therapy: Outpatient programs allow you to live at home but attend rehab/therapy for a set number of hours a week to complete the program.
Your Anthem BlueCross California health insurance plan will impact the total cost of your drug and alcohol treatment. Depending on your plan and tier level, some parts of treatment may or may not be covered.
Regardless of which plan you have, at least part of your treatment will be covered by Anthem BlueCross California. It’s important to check ahead of time with your insurance company and/or the rehab center to know exactly what to expect so you can avoid any surprises.
Does Anthem BlueCross of California Cover Mental Health and Co-Occurring Disorder Treatment?
Yes, Anthem BlueCross of California covers mental health and co-occurring disorder treatment. Under the Affordable Care Act, all health insurance providers must cover behavioral health treatment (e.g., psychotherapy and counseling), mental health inpatient services, and substance use disorder treatment to some degree.5
Many people with substance use disorders also have mental health conditions. This is known as a co-occurring disorder or dual diagnosis. Disorders may include anxiety, depression, PTSD, mood disorders, and other mental health conditions. More than 8 million adults ages 18 or older have a mental health disorder in tandem with addiction.6
How Long Does Anthem BlueCross of California Cover Inpatient Alcohol and Drug Rehab Programs?
Though every person’s needs are unique, research shows that the longer a person stays in treatment, the better the outcome and chance of long-term sobriety.7 This means a lower likelihood of relapse and a higher probability of staying sober. Research shows that better treatment outcomes are associated with spending three to six months in treatment with continuing care (ongoing counseling).7
The rehab facility you choose will work with Anthem BlueCross California to determine how long you need to stay in rehab and how much coverage you will receive. Factors that affect treatment duration include:
- How long you have been using substances.
- Type of substances being used.
- Co-existing mental health diagnoses.
- Medical history.
- Rehab facility/treatment history (e.g., if you’ve attended treatment in the past and what the outcomes were).
Your plan will determine your addiction treatment coverage. Learn the details of your plan on the Anthem BlueCross California member portal or call the number on the back of your insurance card and speak directly with a customer service agent.
What if My Anthem BlueCross of California Policy Does Not Cover an Inpatient Drug Rehab Program?
If your Anthem BlueCross of California insurance policy does not cover all of your treatment expenses, don’t let that keep you from getting the help you need. Alternative ways to help cover the expenses of treatment include:
- Payment plans. Most treatment facilities will provide financing options that allow you to pay back your out-of-pocket expenses over time.
- Many treatment facilities offer scholarships to people who need rehab but do not have the financial means to pay for it. Some states also offer scholarships and grants to people with substance use disorder who need help paying for treatment.
- Another option is to raise funds by selling goods or asking for donations to auction off, etc.
- Asking family and friends for financial support.
Finances should never be a reason to prevent you from seeking treatment when you are ready. The sooner you get treatment, the sooner you will be on a path to recovery, health, wellness, and happiness.
Anthem BlueCross California In-Network vs. Out-of-Network Inpatient Drug Rehab Centers
A rehab facility that is in-network with Anthem BlueCross California has an agreement with Anthem to offer treatment for Anthem members at a lower rate than other providers.
A facility that is out-of-network means they do not have an agreement with the insurance company, and therefore your insurance may not cover any or most of the costs. You will typically end up paying more out-of-pocket for treatment. Select an in-network facility whenever possible for financial peace of mind. Anthem BlueCross California may provide coverage for out-of-network facilities in some cases. However, given that hundreds of facilities in California accept Anthem insurance, this should not be an issue for most people.
How Can I Check My Anthem BlueCross Coverage for Inpatient Drug Rehab Centers in California?
Before you select a treatment facility, it’s important to check your Anthem BlueCross California benefits to understand which costs will be covered by insurance and what you will be expected to pay out-of-pocket. Call the number on the back of your insurance card or log in to your account on the Anthem BlueCross California website to learn more about the specifics of your plan, including deductibles and copayments.
American Addiction Centers can verify your insurance coverage for you. Call our helpline at to speak to an admissions navigator who can check your benefits with you while you’re on the phone. You can also enter your information on the form below to find out if the facility you are considering is in-network with Anthem BlueCross California.
Laguna Treatment Hospital in California, a top-notch program that will tailor your treatment to your specific needs, is in-network with Anthem BlueCross California.