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Anthem In-Network Providers: What You Need to Know

anthem in-network providers

Understanding Anthem Coverage for Rehab: In-Network vs Out-of-Network Benefits

Anthem Insurance coverage can be used for medical care, dental care, vision care, pharmacy expenses, and mental health care. If you are considering a detox and rehabilitation program, you may be pleased to know that Anthem will cover certain evidence-based treatments, when they are provided by licensed and certified providers. This includes inpatient and outpatient programs, partial hospitalization programs, intensive outpatient treatment plans, aftercare, medications, and psychological treatments like behavioral therapy.

Not all treatment centers have been created equal, but when you choose a rehab center that is in-network with Anthem, you can rest assured that your choice has been added to their approved providers because they offer high-quality care that has been measured to be effective.  In this article, we will further explore the difference between using Anthem in-network providers and out-of-network rehabs, so you can better understand your options.

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The Advantages of Choosing Anthem In-Network Providers for Rehab

While substance use disorder treatment is considered essential health care in the United States, the level of coverage your insurance company provides depends on your insurance plan. Anthem ensures mental health and addiction treatment at various levels are insured, covering the costs of some or all of your program.

When using your Anthem coverage for rehab, choosing an in-network preferred provider will provide advantages like:

  • The treatment center can request approval for coverage before treatment begins
  • Your provider can submit your claim for you using direct billing, so there is less paperwork for you to do
  • Cost will be more predictable, and can be much lower than in out-of-network centers, reducing your out-of-pocket medical expenses
  • You can be certain your treatment will be at least partially covered
  • Many different incurred costs can be put toward your deductible when you use in-network facilities
  • You can be certain that the care provider meets the insurance company’s high standards

Utilizing Anthem’s Online Directory for Rehab and Addiction Treatment Centers

anthem coverage for rehab

Anthem has a simple online directory designed to help determine if your preferred doctor or care provider is in-network. Using Anthem’s online directory for rehab simplifies the search for a care provider, and you won’t have to phone dozens of places to find the best match for your needs. Simply find the “find care” tool on the Anthem website, select your state, to begin a general search, or log in for a more personalized search in your area.

Cost Savings with Anthem’s In-Network Providers for Addiction Recovery

The cost savings with Anthem’s in-network providers can be substantial. The costs are regulated, so when you choose a doctor, specialist, hospital, pharmacy, lab, urgent care center, or addiction treatment facility that is in-network, they must charge a specific amount. Participating providers will also file your claims for you, and they can request preapproval for coverage for specific treatments, making the process easier and helping you financially plan for your care.

Ensuring Quality Assurance with Anthem’s Network of Rehab Centers

Anthem takes care to ensure that every provider they recommend is a safe, effective, and efficient treatment facility. Anthem alcohol treatment providers and drug treatment providers meet high standards of care, at lower rates than other treatment providers would. Quality assurance with Anthem’s network is done by professionals who have a deep understanding of substance use disorder treatment and care.

Maximizing Your Anthem Insurance Benefits for Rehab Services

When we talk about maximizing insurance benefits, this means using as much insurance as possible to pay for treatments, medications, procedures, and aftercare, so that there is a lower out-of-pocket cost for treatment.

When you choose Resurgence Behavioral Health for your substance use disorder treatment, our team will work with you to create a customized care plan that best suits your unique needs, including fitting your insurance plan coverage, as much as possible and creating the most streamlined process for addiction recovery possible.

Insurance will not determine your length of stay or your treatment modalities, but we know that maximizing Anthem insurance for rehab coverage can take some of the stress off your plate during this challenging time of your life.

Tips for Finding the Right Anthem In-Network Provider for Your Needs

As an individual, it is up to you to make sure the treatments you receive are provided by an in-network facility. The following are some helpful tips you can use to find in-network providers that will suit your individual needs:

  • Check on the helpful Anthem list of in-network providers first, to see if there are any in your area (or that you are willing to travel to) that will suit your needs. Anthem’s website makes it simple to browse treatment centers, doctors, dentists, mental health care providers, and more with just a few clicks
  • Call Anthem directly to ask for local participating providers, or to ask if a specific doctor or facility is in-network
  • Anthem also recommends trying the Sydney Health mobile app to customize your search to look for providers with certain specialties, vision care, behavioral health professionals, and dental offices in your area
  • Ask your care provider. When speaking to the treatment center, don’t ask if they take your insurance. Instead, ask if they are “in-network” with your insurance, and in the case of an emergency, you can clarify that your care is only in-network care without extras that aren’t covered by insurance

Anthem has worked hard to screen providers to create a strong, helpful network that can assist you in all aspects of your health, from simple preventative care appointments to long-term stays in inpatient rehab. Be confident in your healthcare choices with Anthem.

Make Resurgence Your Choice for Anthem In-Network Providers

Resurgence Behavioral Health is an in-network provider with Anthem, offering comprehensive, personalized treatment plans for anybody with a substance use disorder, including those with dual diagnosis, and those with co-occurring health conditions. Our team tailors each client’s treatment plan to best suit not only their medical needs, but also their psychological well-being, their comfort level, and their budget.

Some of the treatments that will likely be partially or completely covered by Anthem include cognitive behavioral therapy (CBT), dialectic behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR) therapy, housing during inpatient rehab, mindfulness practices, and more. Dual diagnosis care, medications, and doctor care needed for a safe detox process, outpatient treatment plans, and relapse prevention programs may also be covered.

Insurance coverage plays a big part in whether or not some people can enter treatment quickly to get the help they need, so we do all we can to ensure that we maximize insurance benefits to the fullest, and only provide top-level treatments that are evidence-based and efficient, in a holistic treatment plan designed to best set our clients up for a successful future, free from drugs and alcohol.

To learn more about how Resurgence Behavioral Health can help you achieve sobriety, overcome addiction, and prevent relapse through strong outpatient and aftercare treatment, please call us at (951) 708-7961. We will not pressure you into making a decision, and you can ask as many questions as you like about the process, in-network vs out-of-network benefits, your insurance coverage, and more. We will help you figure this out, you are not alone! 

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David Rofofsky
David Rofofsky
After growing up in New York, David chose to get help with substance abuse in California because of the state's reputation for top-tier treatment. There, he found the treatment he needed to achieve more than nine years of recovery. He's been in the drug and alcohol addiction rehab industry for eight years and now serves as the Director of Admissions for Resurgence Behavioral Health. David remains passionate about the field because he understands how hard it is to pick up the phone and ask for help. However, once the call is made, someone's life can be saved.


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