Anthem is part of the Blue Cross/Blue Shield family of insurers. Blue Cross has long been one of the most recognizable and reliable names in healthcare insurance; anthem members receive the peace of mind that comes from working with an established, trusted brand. Founded in 2004, Anthem is one of the largest providers in the United States. In 2004, three smaller companies merged to form Anthem, and a comprehensive and consumer focused brand was born.
Anthem’s continued focus on forward thinking expansion includes a heavy emphasis on preventative medicine and wellness care. They have been early adopters of technology for all of their 16 years in business, and New Hampshire Anthem users enjoy a wide range of virtual services, telemed and other innovations.
Anthem Blue Cross and Blue Shield is also home to the Anthem Foundation, which serves communities in the 16 states that Anthem offers coverage in, including New Hampshire. In 2019 alone, over 50 million dollars was donated to local and community projects and resources.
Who Accepts Anthem Blue Cross Blue Shield Insurance?
As part of the expansive Blue Cross-Blue Shield network, Anthem is widely accepted in New Hampshire. While locations vary, the large customer base and high membership numbers mean that most physicians, facilities and hospitals accept Anthem insurance.
As a leading United States health insurance brand, Anthem Blue Cross Blue Shield insures 41 million members across 16 states. In addition to that staggering number, Anthem is home to dental, Medicaid, Medicare and disability plan members as well. Thousands of hospitals and facilities, and over a million providers accept Anthem Blue Cross Blue Shield, according to the brand’s 2019 annual report.
Anthem Blue Cross Blue Shield Health Care Plans
Anthem offers a full lineup of plans designed to serve the needs of a diverse member group that includes children, adults and seniors in all stages of health and wellness.
Anthem PPO Plans
Preferred Provider Organization (PPO) plans offered to New Hampshire residents have higher premiums, but offer the most flexibility. PPOs offered by Anthem offer a wide range of options, fewer copays and a more convenient and flexible array of options for both families and individuals.
Anthem HMO Plans
Health Maintenance Organization (HMO) plans with Anthem offer lower premiums than PPO plans, but are more restrictive. Like most HMO plans, Anthem Blue Cross Blue Shield plans require you to work with in network providers — and may charge more if your doctor is out of network. As with most HMO plans, Anthem HMO users need to get pre-authorized or referrals for some services and visits. For most families, an HMO offers a good balance of cost and convenience, making this a popular option.
Anthem Catastrophic Coverage
Catastrophic Coverage is Anthem’s lowest cost offering – but is also a no frills plan. Healthy individuals may find that this streamlined, affordable plan meets ACA requirements and allows for medical care in urgent and unexpected situations.
Can Anthem Pay for Substance Abuse Treatment?
Yes, Anthem does pay for substance use disorder treatment in many cases! As with any coverage, though, your particular circumstances will impact the way that coverage is administered and what it will cost. Expect the following to impact your total substance abuse costs, and coverage
- The specific Anthem insurance plan you have chosen.
- The type of program you have chosen and the rehab plan that is best for you.
- The cost of the program you need and the services that you will require.
- Your annual and family deductible (if applicable) and if you have met it in the calendar year.
- If you have an HSA in place and can use the funds for your treatment.
- If the facility and treatment you are considering is in network (a consideration for HMO and other plans; may not apply to Anthem PPO members).
Since every patient is different and requires individualized care for addiction treatment, both out of pocket cost and the amount covered will vary considerably between individuals. To get a good sense of what to expect in your specific situation, you’ll need to explore your options and review your specific situation.
Does Anthem Require Preauthorization for Addiction Treatment?
Anthem requires precertification or preauthorization for some forms of addiction treatment.
For many members, this is an additional phone call or form from your doctor, stating that addiction treatment and intervention is needed. In some cases, you may need to provide additional information (or your healthcare team will need to do so on your behalf).
While every individual and healthcare plan is different, Anthem will require precertification for the following services in most cases:
- Treatment at a residential facility
- Inpatient treatment
- Intensive outpatient programs
- Medical and related testing
- Electroconvulsive therapy (ECT)
- Detox services
- Psychological or Neurological testing
Inpatient care takes place in a treatment facility, with overnight stays, short or long term stays, and room and board is covered.
Outpatient care also takes place in a facility, but the patient can come to the facility for treatment and still live at home. Some partial hospitalization is also considered outpatient care.
Get the Answers You need About Treatment Coverage and Cost
Making the decision to learn more about your treatment options is a huge step towards more healthy living, and learning exactly what to expect can give you peace of mind about the process. We know you have a lot of questions and concerns, and our addiction treatment insurance coverage tool was designed with you in mind. Learn more about your specific options and take the next step towards a better future today.