Will Anthem Blue Cross of California Provide Coverage for Alcohol Rehab?
Alcohol use disorder (AUD) is a mental health condition characterized by person’s inability to control or end alcohol consumption even though it’s having a negative effect on their personal and professional lives.1 AUD creates lasting changes in the brain which make individuals susceptible to relapse and possible alcohol related overdose, and unable to control strong urges to drink.1
Nationwide Anthem Blue Cross of California rehab coverage has been boosted since the adoption of Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and the Affordable Care Act of 2010 (ACA).2 MHPAEA is a federal law that mandates parity between coverage for mental health and medical/surgical benefits.3 The ACA defines substance abuse as one of essential health benefits that must be covered by all healthcare plans offered on the market.3
So, if you have Anthem Blue Cross of California insurance you can expect coverage for at least a portion of your alcohol rehab, but the exact extent of coverage will mostly depend on the specific healthcare plan that you have. With almost 9 million members and a network of over 65,000 providers, Anthem Blue Cross is the largest carrier in California giving you ample options to choose from.4
What Can I Expect from Anthem Blue Cross of California Insurance Coverage for Alcohol Rehab?
Keep in mind that your Anthem Blue Cross of California healthcare coverage might depend on the state in which you are seeking help since states reserve their right to regulate insurance coverage.3 But, setting of spending limits isn’t allowed and insurers can’t deny you coverage or charge extra if you have a pre-existing condition.3
With Anthem Blue Cross of California you’ll have coverage for screening and brief interventions, so if you or someone you hold dear is engaged in some form of alcohol misuse you should consider making use of your health insurance to schedule a medical screening with a doctor.
Screenings are a valuable tool that doctors use to diagnose medical conditions even before the symptoms appear greatly improving patient’s chances of successful recovery.5 In addition to screening and interventions, you’ll be covered in case you need a:6
- Behavioral therapy in the form of psychotherapy or counseling.
- Some type of mental health inpatient addiction treatment.
- Rehabilitation treatment for existing substance use disorder (SUD).
This means that Anthem Blue Cross of California healthcare plan gives you the option of choosing an addiction treatment procedure that is best suited to your individual situation, such as:5
- Detoxification programs to rid the body of harmful substances.
- Specialized treatment approaches for numerous co-occurring disorders (COD).
- Proven outpatient programs of varying intensity.
What Anthem Blue Cross of California Won’t Cover for Alcohol Treatment
Most Anthem Blue Cross of California healthcare plans provide coverage for procedures, services and treatment approaches that are considered part of proven, tested and necessary medical practice. This means that you’ll be covered for mental health treatments which your doctor deems a necessary part of your addiction treatment.7
Your specific healthcare plan might include them, but you should not expect coverage for:7
- Services which are not considered a medical necessity (including food deliveries, recreational programs, massage therapy, and meditation).
- Procedures that are experimental and not sufficiently medically tested (including acupuncture, holistic care, and alternative medicine).
- Treatment approaches that were deemed outdated and were replaced with newer or better alternatives.
Still, there are certain benefits that are not mandatory and which certain states may provide coverage for, including:8
- Prescription drugs.
- Physical and occupational therapy.
- Speech and hearing disorder services.
- Certain diagnostic, preventive and rehabilitative services.
- Personal care.
- Case management.
How Much Does Anthem Blue Cross of California Alcohol Rehab Cost?
Straightforward answer would be: it depends. There are no two identical cases since addiction is a very personal issue and will largely depend on an individual’s specific mental health situation. For this reason there are many different Anthem Blue Cross of California healthcare plans that are tailored to meet the specific needs of different people.9
Most important factors that will contribute to the overall costs of Anthem Blue Cross of California alcohol use disorder (AUD) rehabilitation are:5
- Types of services or treatment approaches that can vary to a great extent because everybody reacts differently to alcohol and treatment that works for one person might not be so effective for another.
- Intensity of services, since patients that suffer from more severe forms of alcoholism might need more intense forms of treatment than those who are experiencing comparatively mild symptoms.
- Duration of treatment could be a major contributing factor in determining the overall price of alcohol rehab since it can vary greatly from case to case. From basic 7 day and 28 day programs to those that last for months or years.
- Amenities can also vary between inpatient drug rehab centers in California and could contribute significantly to overall cost, for instance, in case of high-end luxury alcohol addiction treatment programs that are much more expensive than cheaper alternatives.
How Much Would Inpatient Anthem Blue Cross of California Alcohol Rehab Cost?
Inpatient alcohol rehab is an addiction treatment approach that takes place inside a specialized substance abuse treatment facility and is usually reserved for long term or severe alcohol users who can’t keep on living their lives due to addiction issues.5
Patients spend their days in a structured environment under constant medical supervision and professional care which greatly aids their rehabilitation. Since patients stay in the hospital during treatment, costs of inpatient rehab are influenced by the duration of treatment and it usually represents a more expensive type of treatment.5
How Much Would Outpatient Anthem Blue Cross of California Alcohol Rehab Cost?
Outpatient rehab is the most popular type of addiction treatment for AUD with more than 50% of all rehab admissions in the year 2016. The reason for this is because outpatient rehab is very adaptable and can be modified to meet different needs of different individuals.10
It can consist of drug education or group counseling, but it can also be a good solution for more severe addicts who simply can’t enroll in inpatient rehab because of their work obligations.In its more intensive form it’s called Intensive outpatient treatment (IOT). Outpatient rehab can also serve as a stepping stone or a follow-up program for patients which completed inpatient rehab.11
How Much Would Partial Hospitalization Program (PHP) for Alcohol Cost?
Partial hospitalization programs could be seen as a combination of inpatient and outpatient rehab approaches. They use inpatient treatment techniques and are more intense than outpatient rehab but individuals don’t have to spend the night in the hospital.11 This saves money and helps people who need inpatient level of intensity but just can’t afford that form of treatment.
Patients get from 30 to 50 hours of daily sessions per week in a hospital environment.11 For people who attend 10 hour sessions every day it means they practically spend their entire day in inpatient rehab before sleeping in their homes.11 For this reason it is a good option for those who have a stable home situation and friends that don’t drink and could support them though treatment.
How Much Would Medication-Assisted Treatment (MAT) of Alcohol Cost?
Medication-assisted treatment is a very promising rehab approach that incorporates medication for treatment of alcohol use disorder. In MAT, medication is used in combination with counseling and behavioral therapies as a comprehensive treatment approach in order to achieve the best results.12
MAT has been proven effective in improving patient chances of survival and increasing the possibility of individuals staying in treatment. Like every other type of rehab, overall cost will depend on the duration, but also on the type of medication that is used in treatment.13
There are 3 medications for treatment of alcohol related addiction issues that have been extensively tested and approved by FDA:12
- Acamprosate, that is used to maintain the abstinence from alcohol in patients who were abstinent when the treatment began.
- Disulfiram, which aids in the management of selected patients who want to remain in a state of enforced sobriety so that supportive and psychotherapeutic treatment may be applied to their advantage.
- Naltrexone, which comes in tablet and injection form and is used for treatment of patients who were able to remain sober while receiving outpatient rehabilitation treatment.
MAT suffers from prejudice because people wrongly think they will substitute one addictive substance with another, but medications used in MAT block the euphoric effects associated with alcohol consumption thereby dissuading any further use.13
How Do Costs of Alcohol Rehab and Costs of Alcohol Addiction Compare?
There were more than 550,000 admissions for AUD in the US in 2016 alone, or 32.5% of all substance abuse admissions. For the state of California the number was little under 32,000 individuals, with more than half of them belonging to the age group of 25-40 year olds.10 The good news is that the highest completion rate of all substance related rehabs was for alcohol with 56% of positive outcome discharges.10
Estimated costs of excessive alcohol use for the state of California were a whopping 35 billion dollars, or almost a thousand dollars per person or 2.5 dollars per drink consumed. In addition to these costs which the public pays are the individual costs that people suffering from AUD have to pay.14
The biggest costs are the numerous health problems which burden people who drink excessively. Even sporadic binge drinking can have a long-term negative effect on key organs like brain, heart, liver and pancreas.15 Clear patterns have also been established between regular or long-term drinking and various forms of cancer. 15
How Long Will Anthem Blue Cross of California Cover My Alcohol Rehab?
It will largely depend on the type of Anthem Blue Cross of California plan that you have and your individual needs. Every case of addiction is different and will vary in terms of how long and how frequently the person’s been drinking, how much alcohol they consume, how strong they are mentally, and how determined they are to stay in treatment.5
Different types of alcohol rehab require different duration of treatment and median length of stay can vary greatly between them. Average or median length of stay for those that completed treatment was:10
- Around 4 months in case of standard outpatient treatment.
- A little bit less than 3 months for intensive outpatient treatment programs.
- Just below 100 days for outpatient MAT.
- Approximately 80 days for long-term residential treatment.
- Less than 30 days for hospital residential rehab.
- About 25 days for short-term residential rehabilitation.
- 4 days for standard alcohol detoxification programs.
For this reason there are many different types of Anthem Blue Cross of California insurance policies and multiple tiers of coverage. This effectively means that there are great differences between individual plans so you’ll have to take into consideration the type of plan you have before submitting into addiction treatment.
Whichever rehab you choose, keep in mind that entering into treatment as soon as possible and remaining in rehab long enough could prove crucial for successful recovery.16 If you want to find more information about your specific healthcare plan just call the number that is written on the back of your Anthem Blue Cross of California insurance card.
How to Choose Between Anthem Blue Cross of California Inpatient and Outpatient Alcohol Rehab Programs?
For people that haven’t been drinking for a long time or who just don’t suffer from severe alcoholism, outpatient rehab could be a good option. It could also be a decent option for people who live in a supportive surrounding and have enough willpower to maintain regular attendance.11 Also, if you have previous engagements and are still able to do your job, think clearly and function normally outpatient rehab might be enough.11
But, if you have problems that are making your everyday life hard you should consider entering into an inpatient rehab. Inpatient rehab is the highest level of care because it offers a beneficial ecosystem that is free of triggers and a focused and structured environment that encourages accountability and responsibility.9 Medical professionals will monitor your progress 24/7 and adjust the treatment accordingly.5
During inpatient rehab you will be living with peers who have similar issues and who will act as motivating influence and a support group during treatment.5 If you suffer from severe forms of alcoholism or one or more co-existing mental disorders, inpatient rehab could help you get better before enrolling into an extended outpatient therapy.9
How to Use Anthem Blue Cross of California Insurance for Alcohol Rehab?
Your alcohol rehabilitation will start with a doctor’s appointment. Doctor will have to assess your situation to determine the type and severity of your addiction before he can advise you about your recovery and the type of treatment that would be most suitable.9
When you have all the relevant information about your medical needs you can use your Anthem Blue Cross of California coverage to explore a nationwide network of American Addiction Centers (AAC) substance abuse treatment facilities to see which suits your individual preferences.
Once you’ve chosen a suitable Blue Cross rehab center, they can help you verify your insurance and the extent of your coverage. AAC’s caring admissions team will help you sort out different payment options that are not covered by insurance, like deductibles, co-pays, and various out-of-pocket costs. They might offer some suggestions about beneficial financing options or various government grants so be sure to check this beforehand.
Which Alcohol Rehabs Will Accept Anthem Blue Cross of California Insurance?
You can easily get all the information with one phone call by calling an informative and user-friendly helpline and having a conversation with a professional admissions navigator who will check your insurance coverage and benefits and provide you with all the desired information you need.9
People who answer the phone have in most cases undergone successful addiction treatment themselves and can sympathize with what you are going through. All calls are absolutely confidential and carry no obligation to enter into treatment so you can speak freely about your case.9
AAC operates Orange County’s first chemical dependency rehab facility called Laguna Treatment Hospital. It is easily accessible just off of California State Route 73, located near the world famous Laguna Beach between Los Angeles and San Diego.
Laguna Treatment Hospital is one of the best Blue Cross Inpatient drug rehab centers in California that is ready to respond to all your specific needs and offers a continuum of care and medically tested and proven treatment approaches, such as:
- Co-Occurring Disorder Treatment
- Safe Medical Detox
- Addiction Focused Healthcare
- Inpatient Residential
- Partial hospitalization programs / Day Treatment
- Intensive Outpatient treatments
- Telehealth Addiction Treatment
- Outpatient Therapy
- Coronavirus Testing
Frequently Asked Questions