BCBS of Virginia (Anthem) Rehab Near Me
If you or someone you love is struggling with addiction, it can be extremely difficult to know where to turn. In many cases, the path involves seeking rehabilitation for successful recovery. Unfortunately, this care often comes at a cost, which can be overwhelming if you’re shouldering such costs out-of-pocket. If you have insurance through Anthem Blue Cross Blue Shield of Virginia, you may be able to use your health plan to offset some or all the costs associated with drug or alcohol rehab.
Does Anthem BCBS of Virginia Insurance Cover Inpatient Alcohol and Drug Rehab Centers?
Almost all health insurance plans, including Anthem Blue Cross Blue Shield of Virginia (BCBS of VA) plans, must provide some level of coverage for inpatient alcohol and drug rehab centers thanks to the Affordable Care Act (ACA).1 This federal health care reform law also mandates coverage in some capacity for other mental and behavioral health care.1 What this means for you as a policyholder is that you may be able to use your policy to obtain covered inpatient alcohol and drug rehab services in Virginia.
However, despite coverage being mandated, your exact coverage details may vary. As such, it’s important to verify your levels of coverage by calling the number on the back of your Anthem BCBS of VA insurance card and speaking to a representative. Another way to verify your benefits and coverage is to call the rehab center you’d like to attend and ask if they can help you check your coverage. If you’re attending an American Addiction Centers (AAC) facility for care, all staff members are trained to help you verify your benefits and coverage. If you’re more comfortable checking yourself, you can also use the chat function on AAC websites or the benefits form that’s located at the bottom of this page.
How to Find Anthem BCBS of Virginia Covered Inpatient Drug Treatment Centers in VA?
If you’re facing addiction, it’s easy to feel like you’re alone in your struggle, but you’re not. According to the most recent data, 24,630 other Virginians entered treatment for substance use disorders.2 While there isn’t data available on how many of these individuals used their Anthem BCBS of VA plan to finance their rehab stay, it’s safe to assume that at least some of them did. Using your insurance plan may be the most cost-effective option for you to receive your rehab care.
It may understandably be overwhelming trying to find a quality rehab center, and especially one that takes your insurance plan. You can use Project Know’s treatment facility locator to easily find a top-notch AAC facility that takes your Anthem BCBS of VA health plan in and around Virginia. After you’ve found a location on this site, it’s recommended that you call either your insurance company or the facility itself to confirm whether they’ll accept your insurance.
What Is Anthem BCBS of Virginia?
Anthem Blue Cross Blue Shield of Virginia is a combination of two well-known U.S. health care companies—Anthem, Inc. and Blue Cross Blue Shield. In this case, Blue Cross Blue Shield is the facilitator of the network and health plan, while Anthem is the parent company of managed health care plans.3 Given its massive reach, it’s estimated that nearly 1 in 8 Americans across the country are covered by a plan sponsored by Anthem or an Anthem-affiliated plan.4
Thanks to its national network of providers, many top-notch providers may work with Anthem BCBS of VA plans. It’s always important to verify coverage and benefits with either an insurance representative or with facility staff before you seek care (unless it’s an emergency) to avoid any surprise or high out-of-pocket costs.
How Much Does Anthem BCBS of Virginia Cover (Addiction Treatment)?
How much your Anthem BCBS of Virginia health plan will cover for addiction treatment will vary upon a multitude of factors. Some of the most influential factors include your plan design, cost-sharing requirements (e.g., copay or deductible), and the facility you select.
Despite these differences, it’s important to follow the treatment course your provider recommends. While everyone’s situation will be different, you may be recommended any of the following treatments:
- Inpatient/residential rehab: This type of care involves round-the-clock care for a few days or weeks (inpatient rehab) or months (residential rehab). Here, you’ll receive care until you’re ready to be discharged.5
- Outpatient rehab/therapy: This type of care is often the most hands-off approach to care, with a patient going to an appointment at a facility to receive care, but returning home after the appointment.5
- Intensive outpatient programs (IOP): This type of care generally includes more structure than a standard outpatient rehab program, with the patient being required to attend outpatient appointments a few days a week.6
- Partial hospitalization programs (PHPs): This type of care often involves visiting a hospital or similar facility for portions of the day, multiple days a week. However, unlike inpatient care, you’d be allowed to return home after your care is received.7 (“What is it)
It’s important to remember that no two people are on the same path to recovery, which means that no two treatment paths will be the same. Similarly, rehab programs are not guaranteed to be covered under your plan. Please review your benefits and coverage carefully to avoid any surprise bills.
Does Blue Cross Blue Shield of Virginia Provide Coverage for Mental Health Facilities?
The ACA, the federal health care reform law, requires that mental and behavioral health services be covered as essential health benefits by almost all insurance plans, including BCBS of Virginia Anthem plans.1 As an essential health benefit, your Anthem BCBS of Virginia plan will likely provide insurance coverage for inpatient mental and behavioral health care services, substance use disorder treatment, and treatment for behavioral health services.1
Beyond ensuring that your plan will typically provide coverage in some capacity for stand-alone and co-occurring disorders (any combination of a substance use disorder and mental health disorder) can receive the care they need.8 It’s estimated that 9.2 million American adults have a co-occurring disorder, and it’s generally recommended that both disorders be treated simultaneously rather than separately.8,9
Does Anthem Blue Cross Blue Shield of Virginia Cover Addiction Treatment Therapies?
Because treatment for substance use disorders (addiction treatment therapies) is considered an essential health benefit under the ACA, your Anthem BCBS of Virginia plan must cover such treatment in some capacity.1 The exact level of coverage will depend upon the plan you’ve selected (including cost-sharing requirements), the provider you see, and your location. This is why it’s so important to always check your benefits with the insurance company or the facility at which you’re receiving care to see whether your plan is accepted.
How Long Does Anthem BCBS of Virginia Insurance Cover Alcohol and Drug Rehab Programs?
How long your Anthem BCBS of Virginia health plan will cover your Virginia addiction rehab will vary. Due to differences in plan design, networks, and locations, your coverage may or may not be accepted, or may vary in length. Your plan may also be subject to varying cost-sharing requirements like copays, deductibles, and out-of-pocket limits, which may affect how much you’ll spend on rehab care.
Despite cost being a factor in receiving treatment, it’s important to remember that getting the care you need to overcome your addiction should be prioritized. Your provider will have the most informed view of your situation, and you should adhere to their advice—not the advice of your insurance company. With that being said, you should keep in mind that most experts recommend at least three months of treatment to reduce negative outcomes associated with recovery, as well as make it as effective as possible.10
The best way to ensure your coverage is to call the number on the back of your Anthem BCBS of Virginia health insurance card or call an AAC facility and speak with a staff member to verify your benefits and coverage. Someone should be available to walk you through your insurance benefits and the rehab process.
What if My Anthem BCBS of Virginia Policy Does Not Cover an Inpatient Drug Rehab Program?
If your Anthem BCBS of Virginia health plan doesn’t fully or partially cover your inpatient drug rehab program or other substance use disorder treatment methods, it’s easy to decline treatment. However, please know that pushing off the care you need today will only create problems for you in the future. You could potentially have your addiction worsen, which would result in higher health care costs for treatment down the road, or face other unfortunate consequences.
If you are in a situation where your insurance plan doesn’t fully or partially cover treatment, you may not be out of options. Be sure to talk to the facility staff and ask whether there are financing or scholarship opportunities that may be available to you to help offset the cost of going to rehab.
Anthem BCBS of Virginia In-Network vs. Out-of-Network Inpatient Drug Rehab Centers
Choosing an in- vs out-of-network provider may be the decision that greatly affects your health insurance coverage for inpatient drug rehab centers. Here’s the difference: An in-network provider is one that’s contracted with your Anthem BCBS of VA health plan to provide services, while an out-of-network provider isn’t.11,12 In most cases, getting care from an in-network provider is more affordable because it’s covered at a higher percentage than care from an out-of-network provider.11
You can call the number on the back of your insurance card or ask the facility at which you intend to attend inpatient drug rehab to help you check whether a facility is an in- or out-of-network provider. Don’t hesitate to do this, as it could save you a lot of money.
How to Verify Anthem BCBS of Virginia Insurance Coverage for Drug Rehab Centers?
It can seem daunting if you’re trying to find a quality drug rehab center that takes your insurance plan. Many other people in Virginia are in your situation, so it’s important to know that you’re not alone. One thing that may help ease your mind is limiting your search to only AAC-accredited facilities. AAC rehab centers provide top-notch rehab care, and they also work with a wide variety of insurers, which may help you find care that’s fully or partially covered under your plan network.
You can use Project Know’s treatment facility locator to help you find AAC treatment centers near you that accept your Anthem BCBS of Virginia health plan. Or, you can call an AAC facility near or around you and ask a staff member on the phone to help verify whether their facility is an in-network provider. Another way you can do this is to work with your Anthem BCBS of Virginia representative via phone or member portal to find a facility within your network. Finally, you can enter your insurance information in the insurance form below to instantly verify your benefits and confirm whether a facility is in your network.
- gov. (n.d.). Mental health & substance abuse coverage.
- Substance Abuse and Mental Health Services Administration. (2017). Virginia TEDS admissions aged 12 years and older, by primary substance use and gender, age at admission, race, and ethnicity: Percent, 2017.
- (n.d.). About us.
- (2021). Corporate Fact Sheet.
- National Institute of Drug Abuse. (January 2019). Treatment Approaches for Drug Addiction DrugFacts.
- McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Substance Abuse Intensive Outpatient Programs: Assessing the evidence. Psychiatric Services, 65(6), 718–726.
- gov. (n.d.). Mental health care (partial hospitalization).
- Substance Abuse and Mental Health Services Administration. (2021, November 4). Co-Occurring Disorders and Other Health Conditions.
- National Institute of Mental Health. (March 2021). Substance Use and Co-Occurring Mental Disorders.
- National Institute on Drug Abuse. (January 2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition), Principles of Effective Treatment.
- gov. (n.d.). Network.
- gov. (2016, September 30). Words2Know: Out-of-Network.