Anthem is a Blue Cross Blue Shield licensee operating in a number of states, offering commercial and employer-sponsored plans with behavioral health benefits. If you or a loved one is considering luxury rehab and you carry Anthem coverage, the most reliable way to know your exact benefit is a direct verification of your specific plan.
This page explains generally how Anthem coverage tends to work for behavioral health and addiction treatment, and how to start a benefits check for your plan.
How Anthem Coverage Typically Works
Anthem's in-network behavioral health providers vary by state; out-of-network luxury facilities may still offer partial benefit depending on your specific plan. Coverage percentages, deductibles, and prior authorization requirements vary by the specific Anthem plan you hold, whether through an employer, the marketplace, or another source, so a plan-specific check is the only way to know your actual benefit.
What a Benefits Check Will Confirm
A verification call will confirm whether a specific facility is in-network with your Anthem plan, what your deductible and out-of-pocket status currently look like, and whether prior authorization is required before starting residential or inpatient treatment.
Information Needed to Verify Anthem Benefits
- ✓Your Anthem member ID number and group number, if applicable
- ✓The policyholder's name and date of birth, if different from your own
- ✓Whether you have already met your deductible for the current plan year
- ✓Any prior authorization documentation from previous treatment episodes