Does Anthem Blue Cross of California Cover for Opioid Rehab?

Edited by: Editorial Staff
Last updated on June 7, 2022

Opioids, also known as narcotics, are usually prescribed by doctors to reduce pain after surgery or some type of bodily injury, but also to fight chronic pain caused by certain illnesses and conditions such as cancer.1 There are two types of opioids. Synthetic opioids like oxycodone, tramadol, or fentanyl which are made in a laboratory, and natural occurring opioids like codeine, morphine, and the street drug heroine.1

Opioids are very addictive and can alter people’s brain chemistry making it harder for them to realize their health situation and resist the urge to take drugs even if they know it’s not good for them.1 Big problem with opioids is the potential to overdose with almost 50,000 American lives lost in 2019 due to misuse of opioids other than methadone.2

Luckily, congress passed the Affordable Care Act in 2010 which builds on the previous Health Parity and Addiction Equity Act from 2008 in making substance abuse treatment more available to people who suffer from opioid misuse and addiction. If you have Anthem Blue Cross of California healthcare plan you will be covered for opioid treatment in one of American Addiction Centers (AAC) nationwide rehab facilities.3 

What’s Included in Anthem Blue Cross of California Opioid Rehab Coverage?

Since individuals who suffer from opioid addiction want to quit using but can’t on their own, many different types of treatment have been developed to fight this problem. Substance abuse treatment is a mental health issues and as such falls under one of 10 essential health benefits that must be covered by all health plans on the Marketplace.4

Opioid addiction is a serious and potentially deadly condition which must be treated targeting not just people’s addiction but their overall wellbeing, enabling them to become productive and self-sufficient members of the community who are capable of remaining sober.5

With Anthem Blue Cross of California insurance coverage you will have the option of choosing one of treatment approaches that best serves your medical situation and personal needs. Depending on the insurance policy you have you should expect at least some coverage for:6

What Anthem Blue Cross of California does not cover for Opioid Rehab?

Opioid misuse, just like any other mental health issue is a highly personalized issue that is unique in each case and requires treatment that is tailor to fit the individual patient.5 All Marketplace plans must provide parity between coverage for mental health problems like opioid misuse and medical and surgical issues.4

But, there are certain benefits and services that might not be covered nationwide since each state has laws that mandate healthcare coverage.4 There are also elective or non-mandatory procedures that don’t fall under the category of medical necessity and that won’t be covered as such. It depends on the specific Anthem Blue Cross of California healthcare plan, but you should not expect to be covered for:7

  • Holistic care, also known as holistic healing.
  • Recreational programs like yoga, swimming, or outdoor exercise like cycling.
  • Alternative therapies such as acupuncture or homeopathy.
  • Non-medical amenities like private rooms or golf courses in luxury and executive rehab options.
  • Food delivery.

How Much Does Anthem Blue Cross of California Opioid Rehab Cost?

The overall costs of Anthem Blue Cross of California opioid rehab is hard to determine in advance because treatment of opioid misuse is a process which differs in each individual case depending on the severity of opioid addiction, the sort of opioids used, and the type and intensity of treatment.8

In practice, this means that certain people will need some counseling or support group sessions while others might need detox and more intense inpatient treatment programs.5 Furthermore, some patients might spend 2 or 3 months in treatment, whereas others might need more. There is also the varying number of weekly appointments and their duration that can also be adjusted to suit the needs of different patients.9

Another factor that will influence the cost of drug rehab is the type of treatment facility and the amenities it has to offer. In case of executive or luxury Blue Cross Inpatient drug rehab centers in California amenities and services offered can be state-of-the-art and much more expensive than in regular treatment facilities. There are additional factors that go into consideration so it’s better to determine your specific medical situation before thinking about the costs of treatment.9

What are the Costs of Anthem Blue Cross of California Inpatient Drug Rehab?

For people who are long-term or heavy drinkers inpatient rehab offers constant medical attention in a specially designed structured environment. Since patients are spending the night in a rehab center it tends to cost more than other forms of treatment. For this reason inpatient rehab is usually an intense form of therapy that aims to get the maximum out of treatment while the patient is staying in a treatment facility.9

In general, costs of Anthem Blue Cross of California addiction treatment are mostly influenced by two factors. The first is the type of facility in which the rehab is taking place, and the second is the duration of treatment:9

What are the Costs of Anthem Blue Cross of California Outpatient Opioid Rehab?

Outpatient rehab is probably the most flexible and adaptable form of alcohol rehab. It’s a good treatment approach for individuals that still possess enough discipline or willpower to maintain regular attendance. Patients receive treatment during the day and then return to their everyday lives. For this reason it’s important to have a supportive and trigger free home situation and decent transportation options.5

Treatment programs can be adjusted in terms of duration and will usually last for a couple of months, or up to a year.5 Outpatient programs can vary in intensity. More demanding programs during which patients have daily sessions of up to 10 hours are called intensive outpatient programs (IOP).9 Less intensive outpatient programs have 1 to 3 weekly sessions that can last just a couple of hours.9

What are the Costs of Anthem Blue Cross of California Opioid Partial Hospitalization Programs (PHP)?

Partial-hospitalization programs, also called day treatment, could be described as halfway between inpatient and intensive outpatient programs. PHP is an intensive treatment program for people who are unable to commit to staying in a rehab dedicated treatment facility full time due to their job obligations or financial situation.10

PHP programs are more intensive than intensive outpatient programs with sessions lasting up to 10 hours, meaning patients spend their entire day in a hospital setting before going home to sleep. If you have a healthy and stable home environment, or just can’t afford sleeping in a hospital, PHP could be a good treatment option.9

What are the Costs of Medication-Assisted Treatment (MAT) Covered by Anthem Blue Cross of California?

Medication-assisted treatment is a modern “whole patient” rehab approach that uses medication to fight opioid addiction and proven behavioral therapies in order to achieve full recovery which includes improvement in both physical and mental health.11 MAT is also good at managing painful withdrawal symptoms.11

Costs of MAT are determined by the duration of treatment but also depend on the type of substance used in therapy. FDA has so far medically tested and approved 3 medications that are effective in reducing the need for detox in severe cases of opioid addiction.11

Medications that have proven very effective for use in opioid MAT are:11

  • Buprenorphine
  • Methadone
  • Naltrexone

There is a misunderstanding concerning MAT because people wrongly think they will substitute opioid addiction with medication used in MAT. But the truth is that MAT medications don’t produce euphoric effects that addicts associate with opioid consumption. They were proven safe to use for a long period of time, practically as long as therapy requires it.12

How do Costs of Opioid Rehab compare with the Costs of Opioid Addiction?

There were approximately 165,000 cases of opioid addiction in 2017 in California, with 2,199 resulting in a fatal outcome.13 California was the state which in 2020 had the most substance abuse treatment facilities in the US with 1,734, which is important since treatment has to be readily available.14

Cost of fatal opioid overdose for the year 2017 was more than 25 billion dollars while the cost of opioid use disorder was 36.5 billion just for the state of California.This means that California lost almost 62 billion dollars in combined costs in just one year. Only 273.9 million, or less than half percent of that amount went into opioid substance abuse treatment.13

It should also be added that opioid addiction takes a heavy toll on an individual’s physical and mental wellbeing causing people to lose money in the form of lost future income and possible advancement opportunities. Added to this are the costs of substance abuse itself since addicts always have to maintain their expensive habit. All this unequivocally shows that drug rehab is a cheaper option for both individuals and society at large.14

What Length of Opioid Rehab will be Covered by Anthem Blue Cross of California?

Length of treatment will depend on your specific needs and medical situation. There are people who are long-term users, but there are also those who just use greater quantities of opioid even though their addiction is relatively short-lived. Some people will respond to treatment better than others. And some might try different types of rehab before they find the one that suits their medical situation.5

For this reason every treatment is different and needs to be monitored and adjusted accordingly. There is an understanding that beast results for opioid rehabilitation are achieved when people stay in treatment for a prolonged period of time because longer treatments yield better results.5

Every person needs a personalized and tailored approach and for this reason there are different types of rehab and many Anthem Blue Cross of California healthcare plans to choose from. If you aren’t sure about the specifics of your plan you can call the number on the back of your Anthem Blue Cross of California insurance card to learn more.5

Should I Choose Anthem Blue Cross of California Inpatient or Outpatient Opioid Rehab?

If you are not a severe or long-term opioid user, outpatient rehab might be the solution for you. But if opioid addiction is having a detrimental effect on your daily life making you unable to function properly or avoid the urge to consume opioids it might be best to try inpatient Anthem Blue Cross of California addiction treatment.5

Inpatient rehab is considered the ultimate addiction treatment because patients receive the greatest quality of care under the watchful eye of medical professionals. Rehab centers offer a beneficial treatment ecosystem with support groups of peers who understand and encourage one another because they are suffering from similar issues.5

Inpatient treatment offers a focused and structured environment with tight and predictable daily schedule that fosters accountability and aids recovery.6 Patient’s progress is monitored daily and they are encouraged to examine their destructive behavioral patterns and adopt new and healthier habits.5

How to Start with Opioid Rehab using Anthem Blue Cross of California Insurance Coverage?

The first step of treatment is using your Anthem Blue Cross of California to contact a doctor and schedule a consultation. Doctor is the one authorized to look into your medical condition, do a mental health assessment, and make recommendations for a suitable treatment that matches your individual needs.15

After completing the doctor’s appointment, you can start looking at your options with AAC’s nationwide network of specialized high-class rehab centers. While talking with the experienced admissions team you don’t have to worry about answering some personal and sensitive questions because all calls are absolutely confidential and you won’t be reported to authorities for discussing your drug use.15

Don’t be afraid to ask questions yourself because feeling confident about the rehab center you chose is an important part of the treatment process. Knowledgeable and attentive administrators will then enquire into your ability to use insurance and advise you about possible payment options that are available with your Anthem Blue Cross of California coverage.15

Which Opioid Rehabs Will Accept Anthem Blue Cross of California Rehab Coverage?

To find out, just call Anthem Blue Cross of California helpline dedicated to opioid users which will provide you with answers to all the questions you need answered in order to make an informed decision. People who answer the call have in many instances been through the same issues and fully understand your situation and empathize with what you are facing.16

If you or someone you care for needs help with opioid addiction don’t wait any longer to use your Anthem Blue Cross of California healthcare insurance and get started in one of American Addiction Centers leading rehab clinics.

AAC operates the largest network of substance abuse rehabilitation facilities that are located around the country, giving people the option to choose the center that is most convenient and appropriate for their specific situation.

One of AAC top-notch facilities, Laguna Treatment Hospital, is located in California’s famous Orange County and offers a full continuum of care in a pleasant and luxurious setting. Laguna Treatment Hospital is an accredited high-end rehab center that offers all the best amenities, services and treatment approaches, including:

  • Treatment of one or more co-occurring disorders.
  • Safe medical detoxification programs.
  • Short and long-term inpatient rehab.
  • Partial hospitalization and day treatment programs.
  • Regular and intensive outpatient rehab.
  • Telehealth.
  • Coronavirus testing facilities.

 

 

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