Find Rehabs That Accept Elevance Health Insurance

Elevance Health was named Anthem, Inc. until 2022. They offer a variety of health plans, including Anthem Blue Cross and Blue Shield plans, in 14 states. They also have Wellpoint Medicare and Medicaid plans and additional affiliates. I am impressed with how Elevance works with its local communities to improve access to care and health equality.

Does Elevance Health Cover Addiction Treatment?

In 2010, a law called the Affordable Care Act (ACA) passed. This law requires all long term health insurance plans to cover a specific list of essential health benefits. Both mental healthcare and addiction treatment are part of the list, so you can rely on your Elevance Health plan to help cover at least some of the cost of drug rehab.

How much is covered? The details vary from plan to plan, so it’s important to talk to the insurance company for specifics. One thing is certain though — the law requires mental health and addiction to be treated the same as any other health condition but some conditions and exceptions do apply. They can’t charge extra or have higher out of pocket costs for those programs compared to other care.

It’s important to understand your specific plan so you know what centers are considered in network. Also, you should ask if there are any out of network benefits, in case your preferred treatment location isn’t part of your plan.

One thing that’s really exciting is that Elevance supports holistic treatment options, which means that those types of treatment are more likely to get coverage from your plan. In 2020, the company announced that they had more than doubled the number of members receiving whole person therapies for opioid use disorder.

Also, Elevance plans provide access to the Bright Heart Health telehealth MAT program to make it easier to pair counseling with medication use. Getting both is essential if you want to lay the foundation for long term recovery.

What Are Elevance Plans?

Elevance uses several companies to offer health insurance. The most well known are the Anthem Blue Cross Blue Shield plans. Those are offered in 14 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.

Anthem plans might be offered as a Health Maintenance Organization (HMO), which costs less per month but requires you to use in network providers. Or, the plan could be a Preferred Provider Organization (PPO) which gives you more medical options but also costs more per month. Other times the plan will be an Exclusive Provider Organization (EPO), which is in between the two, offering some flexibility and moderate cost.

If you have Medicare Advantage or Medicaid, you might have an Elevance Health affiliated plan through Wellpoint. Wellpoint used to be called Amerigroup. There are other Elevance affiliates as well, but they generally sell short term or catastrophic care only plans, which are not under the ACA and may not offer coverage for addiction treatment.

Does Elevance Health Cover Methadone & Suboxone (MAT)?

Most Elevance plans cover medication assisted treatment (MAT). MAT can be used during medical detox to manage withdrawal symptoms and it can also be used as a longer term treatment for those struggling with opioid or alcohol misuse.

MAT has been shown to help those struggling with substance use stay stable during treatment which lowers the chances of relapse and overdose.

Coverage for MAT must be verified for each individual health care plan. Talk to your doctor about medical necessity and get any preapproval or preauthorization you need before you start treatment.

What Inpatient Addiction Treatment Does Elevance Health Cover?

When it comes to inpatient care treatment plans commonly include 5 to 10 days of medical detox and 60 to 90 days of residential or inpatient treatment. Before you commit to a program you will want to verify coverage with your insurance company. For example you may need a referral or preauthorization before you start.

A medical detox program allows you to be medically monitored to help you get through the detox process. Medication and medical treatment can help with withdrawal symptoms which keeps the process safe and as comfortable as possible.

After detox patients start the recovery process by attending an inpatient or residential inpatient program. These rehabs allow you to focus on your recovery without any distractions from daily life. You will receive individual and group therapy along with holistic approaches which may include yoga and art therapy and meditation. There will also be recreation and other activities.

To maximize your chances of long term recovery, you will want to follow your inpatient or residential rehab with outpatient treatment that helps you reinforce and practice your new habits in your daily life.

What Outpatient Rehab Does Elevance Cover?

There are several types of outpatient treatment. As with all rehab programs you will want to verify your insurance and make sure you get any referrals or preauthorizations before you begin treatment.

A Partial Hospitalization Program (PHP) is a full day program that provides more than 20 hours per week of treatment. It’s similar to inpatient care except that you go home or to a sober living facility outside of treatment.

Intensive Outpatient Treatment (IOP) is generally 3 days a week for about 9 hours of group or individual therapy along with other approaches. There may also be peer support and other activites.

Finally general outpatient programs may only require 1 to 3 hours per week. This can be individual therapy or group meetings. You may also be connected to a peer support group like a 12 step program and to other community resources.

How to Verify Coverage with Elevance Health?

Elevance offers a variety of insurance plans and they are primarily through Blue Cross and Blue Shield. To verify your coverage and ensure you have met all requirements for coverage there are a few different ways to get your plan details.

First you can contact your insurance company directly. You can look up the insurance customer service number on the back of the insurance card. Call them and ask how much coverage you have for rehab and what out of pocket costs you might have such as deductibles and copayments.

Another idea is to go online and log in to your account on the Elevance website. You’ll be able to view your coverage information and look for in network providers that offer the care you need.

Finally many treatment centers can help you verify your insurance. The center will know what insurance plans they accept and what kind of out of pocket costs you can expect. They should also let you know if your doctor needs to provide a referral or if you need to get a preauthorization.

Elevance Health Insurance Coverage for Addiction Treatment