What Is Anthem Insurance and How Does It Work?

Some clients may be concerned about the cost of addiction treatment. Today, most health insurance plans provide some coverage or full coverage for inpatient and outpatient treatment. Muse Treatment’s staff can help you navigate your insurance and payment concerns. As a leading drug and alcohol treatment center, we provide affordable care. Your Anthem insurance coverage for drug and alcohol rehab treatment may provide the coverage amount you need to enroll in treatment right now. If you have Anthem or a different insurance provider, contact us to learn more.

Anthem Insurance is the largest for-profit medical insurance company under the umbrella of the Blue Cross Blue Shield Association. Anthem is one of Blue Cross’s 36 health insurance providers serving 14 states, including California. Roughly 40 million people have Anthem medical insurance. Anthem provides insurance to customers via their employers or directly from the marketplace. In addition to basic health insurance, Anthem also offers coverage plans for dental, vision, prescription drugs, and supplemental insurance. More than 90% of doctors and hospitals accept Blue Cross Blue Shield, of which Anthem is a member. 

What Are Anthem’s Types of Plans?

Anthem offers various types of coverage plans that include:

  • HMO: A health maintenance organization plan features in-network coverage for members; members must obtain a referral from their primary care physician in order to obtain specialist care. 
  • EPO: An exclusive provider organization that features in-network coverage for care; however, members can obtain specialist care without a referral.
  • PPO: A preferred provider organization that covers in-network and out-of-network medical care.

Customers can choose from individual or family health insurance plans. Anthem also offers coverage for seniors on Medicare with various types of options.

Drug and Alcohol Rehab Facilities That May Accept Anthem

Since Anthem serves members in California, many of the state’s rehabs accept its plans. Muse Treatment accents Anthem Insurance. Your level of coverage will depend on the type of plan you have. You may or may not need a referral. When you contact us, we can help you determine the type of coverage you have based on your policy. Many clients have questions about how long their insurance plan will cover their treatment and how much coverage they can depend on. Call Muse Treatment Center at 800-426-1818 to discuss your plan. Our insurance specialists are familiar with Anthem’s plans regarding drug and alcohol rehab treatment. We can provide you with the answers you need to proceed with treatment. 

Does Anthem Insurance Cover Alcohol & Drug Rehab Treatment?

Like most other major health insurance providers, Anthem generally provides coverage for substance abuse treatment. However, how much coverage depends on the individual’s insurance plan and the rehab. As an accredited addiction rehab center, Muse Treatment qualifies for many in and out-of-network plans, but the coverage amounts will necessarily vary in accordance with each person’s plan. When you call Muse, our insurance specialists will help you determine your amount of coverage and why types of treatment plans it will cover. 

How to Check Your Anthem Insurance Coverage

You can check your Anthem Insurance plan to determine your coverage in a couple of ways. First, you can contact Anthem. Their customer service representatives can explain what level of coverage your Anthem plan entitles you to. On the other hand, some people may not want to contact their insurer. In this case, you can contact the rehab you plan to attend. You can contact Muse and our insurance specialists can also help you determine what type of treatment your insurance covers. You are typically afforded full or partial coverage if you have Anthem for coverage. 

What Does Anthem Insurance Cover

Anthem covers various health and mental health conditions, including drug and alcohol addiction and dual diagnosis. Coverage typically includes any type of drug addiction, including illicit or prescription drug addiction. Anthem also provides coverage for preventative, virtual, and pharmacy care. Some people may qualify for special assistance programs too. For information about special coverage, you should contact Anthem. 

Does Anthem Insurance Cover Mental Health & Substance Abuse Treatment?

Anthem typically offers mental health and substance abuse treatment for drug or alcohol addiction. The Affordable Care Act (ACA) mandated that any insurer wishing to participate and sell its products in the insurance marketplace must provide mental health and substance abuse treatment coverage. Like most other major health insurance carriers, Anthem does offer this coverage. Coverage amounts and where coverage applies (not all rehabs may qualify) depend on the insurance plan and the rehab. Muse Treatment does accept Anthem Insurance. If you contact us, we can let you know the specifics of your health insurance as they apply to alcohol and drug abuse treatment.

Does Anthem Insurance Cover Inpatient Drug and Alcohol Rehab?

Again, Anthem does typically provide full or partial coverage for inpatient or outpatient treatment. Depending on the plan, the insurer may require clients to secure a referral for treatment. When you contact Muse, we can advise you about your coverage options. In addition to traditional inpatient and outpatient treatment, virtual treatment may also be covered by your Anthem plan. Clients may be required to pay a deductible or a portion of payment not covered by Anthem Insurance. In some cases, this may affect whether a person chooses residential or outpatient treatment; however, it’s important to note that most providers offer full or partial coverage for inpatient and outpatient drug and alcohol treatment plans.

Does Anthem Insurance Cover Intensive Outpatient Alcohol & Drug Rehab?

Anthem does generally provide full or partial coverage for an intensive outpatient treatment plan either in lieu of inpatient treatment or in addition to it depending on the individual’s healthcare needs and the specific coverage allotments associated with their specific insurance plan. Many clients prefer intensive outpatient treatment because it allows them to continue to work or attend school. Contact Muse so we can help you determine how much coverage your plan provides for outpatient addiction treatment programs.

Does Anthem Insurance Cover Partial Hospitalization?

Anthem states that it does provide health insurance coverage for residential treatment, partial hospitalization, and intensive outpatient treatment programs. So, if you enroll in partial hospitalization treatment, your treatment will be covered in full or with partial coverage depending on the particulars of your insurance plan. Partial hospitalization is an outpatient program, but it involves extensive support typically only exceeded by an inpatient treatment plan.

How Long Will Anthem Insurance Cover Alcohol and Drug Rehab?

Most addiction treatment programs run for 30, 60, or 90 days. However, the length of time a person needs treatment depends on their specific needs. Some people may need ongoing dual diagnosis treatment that exceeds 90-day programs. What Anthem will cover depends on the individual’s diagnosis, their needs, and their specific insurance plan. Anthem’s plans generally provide coverage ranging between 60-80%, but this depends on the plan in question.

Anthem Insurance May Offer Treatment Coverage for the Following Addictions

Anthem Insurance covers addiction treatment for alcohol and drugs. You can expect coverage for addictions that include:


Heroin is a powerful addictive drug. It’s an illegal opioid that is associated with high overdose and relapse rates. If you have a heroin addiction, you can get treatment at Muse. We accept Anthem Insurance and if you have this insurance, your plan should typically provide a level of coverage between 60-80%. 


Anthem covers other forms of addiction to illicit drugs, including cocaine and methamphetamine. We feature addiction treatment that targets each aspect of the addiction. Your coverage will depend on the Anthem plan you’re enrolled in. 


Addictions to prescription drugs can be every bit as powerful as an addiction to an illicit drug. Your insurance coverage entitles you to substance abuse treatment for Xanax addiction as well as other types of prescription drugs. 


Like Xanax, Ativan is a benzodiazepine drug. As such, it is highly addictive. Long-term use of Ativan increases the risk of addiction development. If you have an Ativan addiction, Muse Treatment can help, and your Anthem plan should provide some level of coverage.


Ambien is prescribed to treat insomnia, but like other sedatives, it can be addictive. Addictions to Ambien have increased in recent years. If you’re addicted to Ambien or other prescription drugs, Muse Treatment can help. Your Anthem Insurance will generally provide coverage for inpatient and outpatient treatment. 



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What Are the Options If Anthem Insurance Does Not Cover the Cost of Drug and Alcohol Rehab?

Each client is unique and will typically have different treatment needs. At Muse Treatment, we customize treatment for every individual. Your individual insurance plan may or may not provide the level of coverage that you need to pay for your addiction treatment. Some people may find it difficult to pay for their portion of treatment that insurance doesn’t cover. We invite you to discuss your circumstances with us. Our insurance specialists and staff can help you develop a plan for getting the needed treatment. You may qualify for alternative plans or other options we can share with you based on your situation. Let us help you find a way to get the treatment you need to put addiction behind you. 

Verify Your Insurance With Us

Muse Treatment features a team of experienced insurance specialists who help clients navigate their insurance plans and coverage. We understand how complex questions of coverage may seem. We make it as easy as possible to verify your insurance so you begin treatment as quickly as possible. As soon as we verify your insurance, you can begin treatment. Many clients start with medical detox, which is included in coverage plans, but you may or may not require this first step. Our clinicians will evaluate your needs and help you determine what treatment plan suits your needs and preferences. If you have other questions about our enrollment process, be sure to contact us at 800-426-1818 for assistance.

Next Steps with Insurance Coverage for Alcohol and Drug Rehab Treatment with Muse Treatment

If you are addicted to alcohol, a prescription drug, or an illicit drug, don’t put off treatment. If you have Anthem Insurance, call Muse so that we can verify your coverage and help you understand the ins and outs of your coverage and how they apply to your treatment needs. Muse features a full continuum of care, so we can provide the level of support you need to get well. Additionally, your Anthem coverage should pay for some or most of your treatment costs. Call Muse Treatment Center at 800-426-1818 to learn more about our addiction treatment programs and our evidence-based and holistic therapies. With treatment, you can achieve lasting recovery from drug and alcohol addiction. 

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