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BCBS of Virginia Insurance Coverage for Drug and Alcohol Treatment

Anthem Blue Cross and Blue Shield of Virginia, also called Anthem Health Plans of Virginia, is part of the Anthem, Inc. network. This company is one of the largest insurers in the entire nation. This company is headquartered in Indianapolis, Indiana and is a part of the Blue Cross and Blue Shield Association. In addition to Virginia, this company also manages subsidiaries in many other states.

Anthem Health Plans of Virginia serves the majority of the state of Virginia, with the exception of the Town of Vienna, the City of Fairfax and all areas east of State Route 123.

Will My Anthem Blue Cross and Blue Shield of Virginia Plan Be Accepted?

Not all providers will accept Anthem Blue Cross and Blue Shield of Virginia. Nonetheless, this insurance company offers an expansive network of covered providers, offering its customers a range of options when it comes to choosing a doctor, hospital or another provider. The exact providers included in each policy will vary based on the specifics of the policy chosen. For this reason, it is important to verify that your insurance will be accepted before you enroll in a program.

Different Types of Plans Available from Anthem Blue Cross and Blue Shield of Virginia

As a customer of Anthem Blue Cross and Blue Shield of Virginia, you may have access to different types of plans. The specific plan you purchase will depend on your location, whether you are enrolling in an employer-sponsored plan, your budget and your own preferences. Plans available include:

Preferred Provider Organization (PPO)

PPO plans from Anthem are designed to give you plenty of choices when choosing a provider by offering a large network. If you have this type of plan, you won’t need a referral to see a specialist. However, if you choose providers outside of your network, you may face higher expenses. When choosing an addiction treatment program, it is best to find an in-network provider if possible.

 

Select Preferred Provider Organization (PPO)

Select PPO plans are similar to a standard PPO, but they come with a smaller network in exchange for lower monthly premiums and deductibles. As with Anthem’s standard PPO plan, you won’t need a referral to see a specialist for addiction treatment or any other service.

Health Maintenance Organization (HMO)

Anthem’s HMO plans are similar to a PPO in that members have access to an expansive network of providers. However, unlike a PPO, members are required to select a primary care physician from their network. This physician will be responsible for coordinating all care and providing referrals when specialist visits are needed. HMO plans come with less flexibility than PPOs, but out-of-pocket costs are typically lower.

Select Maintenance Organization (HMO)

Similar to a standard HMO, Select HMO plans require members to select a primary care physician to oversee all of their care and provide referrals when necessary. However, Select HMO plans come with a more restrictive network, leading to lower monthly premiums and out-of-pocket expenses.

Point of Service Plan (POS)

Anthem’s POS plans are managed care plans that combine aspects of an HMO and PPO plan. Similar to an HMO structure, POS plans require members to select an in-network primary care physician. However, like a PPO, POS plans allow patients to venture outside of the network for services if they desire. It is important to note that out-of-network costs can be high when a PCP has not made a referral. POS plans offer more choices than an HMO but lower premiums than a PPO.

Consumer-Driven Health Plans (CDHP)

CDHP plans from Anthem are high-deductible plans that offer lower premiums in return. In most cases, these plans include a Health Savings Account, which allows members to save up for healthcare expenses with tax-exempt funds. For the purposes of addiction treatment, this means that out-of-pocket costs may be higher than with other plans.

Does Anthem Blue Cross and Blue Shield of Virginia Cover Addiction Treatment?

Anthem Blue Cross and Blue Shield of Virginia will cover qualifying rehab services, including outpatient care, inpatient care and intermediate services. However, the exact coverage you will receive under your Anthem plan will depend on the specifics of the policy and your choices, including:

  • Whether you choose an in-network program.
  • Your deductible.
  • Your co-insurance requirements.
  • The length of treatment.
  • The cost of your program.

Because so many different factors can affect the cost of your coverage, it is important to do plenty of research on your policy and its provisions before you enroll in a program. You can learn more about the specifics of your coverage by reading your policy documents or contacting Anthem directly.

Will Preauthorization or Precertification Be Required?

Depending on the specifics of your plan, you may need to obtain preauthorization or precertification from Anthem Blue Cross and Blue Shield of Virginia before you are able to attend an addiction treatment program. This typically means that you will need to show the insurance company evidence that the treatment is medically necessary and get the company’s approval in order to use your benefits.

In some cases, Anthem may ask for more information before issuing a preauthorization or precertification. Although this part of the process can be nerve-racking, it does not mean your treatment will be denied. In most cases, providing this additional information will lead to an approval.

How Much Will My Rehab Cost?

Estimating your out-of-pocket expenses for addiction treatment services can be a challenge. Fortunately, you can use our addiction coverage tool to get a better idea of how much you will owe toward your treatment.

Anthem Health Plans of Virginia serves the majority of the state of Virginia, with the exception of the Town of Vienna, the City of Fairfax and all areas east of State Route 123.

Will My Anthem Blue Cross and Blue Shield of Virginia Plan Be Accepted?

Not all providers will accept Anthem Blue Cross and Blue Shield of Virginia. Nonetheless, this insurance company offers an expansive network of covered providers, offering its customers a range of options when it comes to choosing a doctor, hospital or another provider. The exact providers included in each policy will vary based on the specifics of the policy chosen. For this reason, it is important to verify that your insurance will be accepted before you enroll in a program.

Different Types of Plans Available from Anthem Blue Cross and Blue Shield of Virginia

As a customer of Anthem Blue Cross and Blue Shield of Virginia, you may have access to different types of plans. The specific plan you purchase will depend on your location, whether you are enrolling in an employer-sponsored plan, your budget and your own preferences. Plans available include:

Preferred Provider Organization (PPO)

PPO plans from Anthem are designed to give you plenty of choices when choosing a provider by offering a large network. If you have this type of plan, you won’t need a referral to see a specialist. However, if you choose providers outside of your network, you may face higher expenses. When choosing an addiction treatment program, it is best to find an in-network provider if possible.

 

Select Preferred Provider Organization (PPO)

Select PPO plans are similar to a standard PPO, but they come with a smaller network in exchange for lower monthly premiums and deductibles. As with Anthem’s standard PPO plan, you won’t need a referral to see a specialist for addiction treatment or any other service.

Health Maintenance Organization (HMO)

Anthem’s HMO plans are similar to a PPO in that members have access to an expansive network of providers. However, unlike a PPO, members are required to select a primary care physician from their network. This physician will be responsible for coordinating all care and providing referrals when specialist visits are needed. HMO plans come with less flexibility than PPOs, but out-of-pocket costs are typically lower.

Select Maintenance Organization (HMO)

Similar to a standard HMO, Select HMO plans require members to select a primary care physician to oversee all of their care and provide referrals when necessary. However, Select HMO plans come with a more restrictive network, leading to lower monthly premiums and out-of-pocket expenses.

Point of Service Plan (POS)

Anthem’s POS plans are managed care plans that combine aspects of an HMO and PPO plan. Similar to an HMO structure, POS plans require members to select an in-network primary care physician. However, like a PPO, POS plans allow patients to venture outside of the network for services if they desire. It is important to note that out-of-network costs can be high when a PCP has not made a referral. POS plans offer more choices than an HMO but lower premiums than a PPO.

Consumer-Driven Health Plans (CDHP)

CDHP plans from Anthem are high-deductible plans that offer lower premiums in return. In most cases, these plans include a Health Savings Account, which allows members to save up for healthcare expenses with tax-exempt funds. For the purposes of addiction treatment, this means that out-of-pocket costs may be higher than with other plans.

Does Anthem Blue Cross and Blue Shield of Virginia Cover Addiction Treatment?

Anthem Blue Cross and Blue Shield of Virginia will cover qualifying rehab services, including outpatient care, inpatient care and intermediate services. However, the exact coverage you will receive under your Anthem plan will depend on the specifics of the policy and your choices, including:

  • Whether you choose an in-network program.
  • Your deductible.
  • Your co-insurance requirements.
  • The length of treatment.
  • The cost of your program.

Because so many different factors can affect the cost of your coverage, it is important to do plenty of research on your policy and its provisions before you enroll in a program. You can learn more about the specifics of your coverage by reading your policy documents or contacting Anthem directly.

Will Preauthorization or Precertification Be Required?

Depending on the specifics of your plan, you may need to obtain preauthorization or precertification from Anthem Blue Cross and Blue Shield of Virginia before you are able to attend an addiction treatment program. This typically means that you will need to show the insurance company evidence that the treatment is medically necessary and get the company’s approval in order to use your benefits.

In some cases, Anthem may ask for more information before issuing a preauthorization or precertification. Although this part of the process can be nerve-racking, it does not mean your treatment will be denied. In most cases, providing this additional information will lead to an approval.

How Much Will My Rehab Cost?

Estimating your out-of-pocket expenses for addiction treatment services can be a challenge. Fortunately, you can use our addiction coverage tool to get a better idea of how much you will owe toward your treatment.

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If you come across any information that you might believe is inaccurate, please contact us right away. 

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