Anthem Coverage for Addiction & Mental Health Treatment
Federal parity law requires Anthem and most other plans to cover substance use and mental health treatment on par with medical care. Verify your specific benefits — free, confidential, in about 15 minutes.
About Anthem Behavioral Health Coverage
Anthem is a subsidiary of Elevance Health (formerly Anthem Inc.) and is one of the largest Blue Cross Blue Shield licensees, serving members across 14 states. Anthem plans cover the full continuum of substance-use and mental-health care under federal parity law, including medical detox, residential treatment, PHP, IOP, and outpatient therapy.
What Anthem Typically Covers
Under the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA), Anthem must cover substance use and mental health services at parity with medical/surgical benefits. Specific covered levels of care include:
Medical Detox
24/7 medical supervision during withdrawal. Typically 3-10 days, usually fully covered when medically necessary.
Inpatient Hospitalization
Acute psychiatric or medical stabilization in a hospital setting. Pre-authorization required.
Residential Treatment
24-hour clinical care at a non-hospital facility. Coverage varies; often requires step-down from inpatient or PHP.
Partial Hospitalization (PHP)
5-6 hours/day, 5 days/week. Step-down from residential. Generally well-covered.
Intensive Outpatient (IOP)
3 hours/day, 3-5 days/week. Highly covered across plans.
Standard Outpatient
1-2 sessions per week with a therapist or psychiatrist.
Medication-Assisted Treatment
FDA-approved medications for opioid and alcohol use disorder.
Telehealth Therapy
Virtual psychiatry and counseling, typically covered at in-person rates.
Anthem Plan Types and Network
Anthem offers HMO, PPO, EPO, and high-deductible health plans (HDHP) with HSA compatibility. Plan availability and behavioral-health network depth vary by state. Most Anthem commercial plans now use Anthem’s internal behavioral-health network rather than a third-party carve-out, which streamlines authorization.
Pre-Authorization for Anthem
Anthem requires pre-authorization for inpatient psychiatric admissions, residential treatment, PHP, and most IOP admissions. Authorization is based on the facility’s submission of clinical documentation meeting ASAM (substance use) or LOCUS (mental health) medical-necessity criteria. Concurrent reviews continue throughout the stay.
Frequently Asked Questions
Does Anthem cover detox?
Yes. Anthem covers medically supervised detox when medically necessary. Coverage typically includes the full inpatient or residential detox stay (3-10 days) plus medication and physician services.
Is rehab covered if I have an Anthem HSA-eligible HDHP?
Yes. After your high deductible is met, Anthem covers behavioral-health services the same as any other medical service. Before deductible, you pay the negotiated in-network rate yourself, which still counts toward your deductible and out-of-pocket max.
Does Anthem cover dual-diagnosis treatment?
Yes. Anthem covers integrated treatment for co-occurring mental health and substance use disorders. Many Anthem-contracted facilities offer specialized dual-diagnosis programs.
Will Anthem cover telehealth therapy for addiction?
Yes. Most Anthem plans now cover telehealth psychiatry and substance-use counseling at the same cost-sharing as in-person visits.
Treatment locations we cover
Programs in these locations work with this plan. Each page sets out levels of care, what insurance usually pays, and what to ask before admission.
See all treatment locations.
Find Out What Your Anthem Plan Covers
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