Who we areAnthem, Inc. is one of the largest health benefits companies in the United States. With local service and the value of the Blue Cross brand, we have been committed to ensuring our members have access to affordable health benefits for over 80 years. Anthem BCBS insurance plans offer substance abuse and mental health coverage benefits. The level of coverage is dependent on your specific insurance plan.8 Anthem blue cross alcohol treatment and drug rehab coverage varies by state, policy, member, and provider.
Many services are approved if they are medically necessary; therefore, alcohol, benzodiazepines, and opioid detox are often covered. Sharp Health Plan continues to be recognized in California and nationally for their high-quality care and service. They are the highest member-rated health plan in California, and they also hold the highest member ratings for health care, personal doctor and specialist among reporting California health plans. As part of Sharp HealthCare's integrated delivery system, Sharp Health Plan directly connects members to an expansive network of nationally recognized doctors, elite-rated medical groups and hospitals. In 2004, WellPoint Health Networks Inc and Anthem, Inc. merged and became the nation's leading health benefits company.
In December 2014 WellPoint Inc. changed its corporate name to Anthem, Inc. Anthem has about 40 million members and is ranked 33rd on the Fortune 500. Our hospitals are contracted service providers with private health insurance plans, several Medicare Advantage plans and a number of insurance companies who cover mental health services. When you've confirmed your health care coverage plan is open access, this means you can choose to see the doctors and visit the health systems you prefer within your network, including specialists. For most patients with Anthem insurance plans, CoxHealth providers are now considered in-network.
Because of its large network of providers, giving you many choices for where you get medical services. Anthem has a variety of health insurance plans available including options for individuals, families, Medicare, Medicaid and group insurance. Finally, you might see a dollar amount, such as $10 or $25. This is usually the amount of your co-payment, or "co-pay." A co-pay is a set amount you pay for a certain type of care or medicine.
Some health insurance plans do not have co-pays, but many do. If you see several dollar amounts, they might be for different types of care, such as office visits, specialty care, urgent care, and emergency room care. If you see 2 different amounts, you might have different co-pays for doctors in your insurance company's network and outside the network. To check if your Anthem Blue Cross and Blue Shield health insurance plan covers therapy services, head over to your Summary and Benefits document.
You'll likely find this document through your online Anthem Blue Cross and Blue Shield account. Within this document, you'll find the different rates of coverage — including copayment or coinsurance amounts — for each type of service available. Look for "outpatient mental health services" to see your coverage for therapy. Yes, Anthem Blue Cross and Blue Shield does cover therapy services. However, the amount of the therapy cost they cover depends on your unique health insurance plan.
Because Anthem Blue Cross and Blue Shield is such a large health insurance company, they offer many different types of plans across their various geographies. This means that coverage for outpatient mental health services also varies widely. We want you to know that right now, as much as ever, your health and wellness concerns remain our top priority.
We know you're doing all you can to ensure you and your family are safe during this time. And we want you to know we're doing everything we can so you can access the care you need. We know that many patients are apprehensive about coming to the doctor's office or the hospital due to COVID-19 concerns. However, for some, the risk of delaying or neglecting ongoing medical care can be just as serious as COVID.
You don't have to delay care for your annual check-up, chronic care management or other health care concerns. Whatever you need, we're here for you with services like 24/7 urgent care, Virtual Visits and Save My Spot for urgent care and walk-in clinics. Our physicians are accepting new patients and many have same day or next day appointments available. Each UC SHIP campus has its own out-of-pocket limits , depending on where you access care. Visit the My Coverage page to review your campus's benefits.
Medical and pharmacy copayments, as well as coinsurance and the deductible, apply toward the out-of-pocket maximum. You will pay a lower out-of-pocket maximum if you receive care from the SHC and network providers. You will pay a higher out-of-pocket maximum if you visit out-of-network providers. Yes, a benefit year deductible applies for most medical services accessed outside the student health center . Visit theMy Coverage pageto check your plan's annual deductible. This deductible does not apply to services with fees at an SHC, to emergency or urgent care clinic visits for students, or to pharmacy claims.
For some UC SHIP campuses, the benefit year deductible does not apply to UC Family services. If you do not see your coverage amounts and co-pays on your health insurance card, call your insurance company . Ask what your coverage amounts and co-pays are, and find out if you have different amounts and co-pays for different doctors and other health care providers. This plan combines traditional medical coverage with a Health Savings Account . Under this plan, all covered services (except preventive services/prescriptions) are subject to the annual deductible. The deductible is a dollar amount of out-of-pocket costs you must pay each year before the plan will begin paying its share of your healthcare expenses.
The nice thing about this plan is that you can pay for that deductible using the tax-free funds in your HSA. Once the deductible has been met, most in-network services are covered with a 20% coinsurance. Even Medicare health plans with a national presence can vary locally in their cost, quality, and customer satisfaction. We included the National Association of Insurance Commissioners' complaint index and AM Best's financial stability ratings. We also considered information from the companies on their programs and strategies.
Whether Anthem Blue Cross and Blue Shield covers couples counseling depends on the plan. Generally, health insurance plans do not cover couples therapy. This is partially because there cannot be a diagnosis to base the reimbursement upon. However, some Anthem Blue Cross and Blue Shield plans may provide coverage at the same or differing rates as individual therapy. To see if yours does, visit your Summary and Benefits document. Anthem is a well-established provider of healthcare coverage that offers benefits not only in specific states, but access to a nationwide network of BCBS providers.
They offer various plans and levels of coverage through employers, Medicaid, Medicare, and for current or retired federal employees. Checking your benefits can be done easily by contacting the company by telephone or through the member login website. While Anthem does offer coverage for addiction treatment, it's best to confirm what your benefits will cover so that you can focus on your recovery. Anthem is a leading health benefits company dedicated to improving lives and communities, and making healthcare simpler.
Through its affiliated companies, Anthem serves more than 79 million people, including 41 million within its family of health plans. We aim to be the most innovative, valuable and inclusive partner. For more information, please visit or follow @AnthemInc on Twitter.
UC SHIP provides 100% coverage of allowed charges for emergency room services after a copayment, and 100% coverage of urgent care center allowed charges after a specified copayment. If Anthem determines that the reason for the visit was not an emergency, the coverage of the charges will be reduced. The annual deductible does not apply to emergency room or urgent care center visits. If you are admitted to the hospital, UC SHIP will cover a percentage of inpatient charges, and the emergency room copayment will be waived. Visit theMy Coverage page to view the benefit levels, copayments and coinsurance for your campus. All follow-up care must be authorized in advance by the SHC.
When you elect the Anthem PPO HDHP, you are also eligible to elect a Health Savings Account , a special tax-advantaged bank account to help cover your out-of-pocket healthcare costs. Coverage for mental health services varies by each health plan. Some plans have a "carve out" for mental health benefits, which means these services are covered by a separate organization which you need to contact directly.
For example, Health Net HMO members usually access MHN, a Health Net subsidiary. Check your insurance ID card, and contact your insurance carrier to determine if your mental health benefits are carved out to another organization. Anthem's PPO plans, called Anthem MediBlue PPO, offer more flexibility in accessing providers than the HMO plans.
Though PPO members still choose a PCP, you don't need to go through your PCP to get a referral to a different doctor or specialist. Members can see doctors outside the Anthem network on the PPO plan, though you may pay more. For 2021, Anthem offers 1,214 local PPO plans with prescription drug coverage and 233 without. Anthem offers a wide range of plan options and covers a fairly wide geography with extra benefits and competitive customer service options. These plans earn average quality ratings from CMS, with a few standouts.
Anthem plans aren't rated by NCQA, one of the main health insurance accrediting bodies, so it is hard to compare them to other national competitors. However, Anthem Blue Cross and Blue Shield is dedicated to whole-person health, which includes mental health care. For this reason, they provide coverage across the majority of their health insurance plans. HMO - A Health Maintenance Organization plan provides health care from specific doctors and hospitals under contract with the plan. You pay co-payments for some services, but you have no deductible, no claim forms, and a geographically restricted service area. WHA offers affordable, quality health care to its neighbors in Marin, Napa, Sacramento, Solano, Sonoma, Yolo and parts of Colusa, El Dorado, Humboldt, and Placer counties.
With a mix of benefits that deliver patient-centered care, health and wellness programs and award-winning customer service, UnitedHealthcare is a smart choice for your family's health care coverage needs. The MetLife DHMO plans provide access to a large network of dental providers throughout California. Preventive dental care is an important part of overall health and MetLife is committed to ensuring that its members receive a high level of dental care. As part of this commitment, all Quality Management Activities are designed to meet or exceed NCQA standards. These standards are applied to plan design, through the credentialing of network providers, member services standards and on-going peer review and facility audits. If you use an in-network provider, you don't need to file a claim — your doctor will file one with Anthem.
Anthem will then pay your doctor amounts it covers under the Health Account Plan and send you an Explanation of Benefits . However, not all small, independent pharmacies have the correct computer system to validate your transaction, in which case you'll need to pay for the prescription using another form of payment. Health coverage through Anthem offers access to an extensive network of providers for all your medical, prescription drug and mental health care needs. The health care network specified by your Anthem insurance policy will determine whether you have access to in-network providers in other states. When submitting an out-of-state claim, you must contact Anthem's customer service department because the process may be different. If you need a service not offered at the SHC, your clinician will refer you to an off-campus health care provider.
The SHC will provide you with a referral to see the off-campus provider. This is not a guarantee of payment, and your deductible, copay and coinsurance will apply. Your SHC clinician may suggest a specific provider, or you can choose a provider. However, we strongly recommend that UC SHIP members see providers who belong to the Anthem Blue Cross Prudent Buyer PPO network, including UC Family providers. Doing so ensures UC SHIP members will pay the lowest out-of-pocket costs.
You might see another list with 2 different percent amounts. Anthem insurance will typically pay for individual therapy costs for substance use disorders and other mental health conditions. American Addiction Centers is in-network with many insurance companies, including Anthem at some of our facilities. Depending on the type of coverage you have and which state you live in, your addiction treatment could be covered. Our Signature plan offers access to a full network of contracted providers with more than 62,590 physicians and health care professionals, and 273 hospitals.
The Advantage, Alliance and Harmony plans offer the same level of benefit coverage as our Signature plan but has a narrower network of contracted providers. You can find listings for physicians and hospitals in our provider directories. UnitedHealthcare Signature1 - The Signature plan includes our full network of contracted providers. With this HMO plan, members simply choose a primary care physician from our full network of contracted providers to coordinate all their medical care. They can then visit their PCP for routine checkups, and when they need to see a specialist, their PCP provides a referral. Members are charged only a copayment for each doctor's visit.
With Sutter Health Plus, members gain access to an integrated network of high-quality healthcare providers, including many of Sutter Health's hospitals, doctors and healthcare services. If you use an out-of-network provider, you may need to pay your doctor up front and then file a claim with Anthem. Anthem will then pay your doctor amounts it covers under the HAP and send you an EOB. The rate you pay for insurance will vary based on your personal details, where you live and the level of coverage you select.
In 2022, individual health insurance plans are likely to be priced slightly higher, and the rate of increase varies by state. Anthem's size has advantages such as being widely recognized and having the financial weight to provide members with good tech tools and helpful medical resources. There are also downsides including poor customer service and a lack of personalization. The "coverage amount" tells you how much of your treatment costs the insurance company will pay. This information might be on the front of your insurance card.
It is usually listed by percent, such as 10 percent, 25 percent, or 50 percent. For example, if you see 4 different percent amounts, they could be for office visits, specialty care, urgent care, and emergency room care. Anthem offers more Medicare plans than many competitors, from comprehensive Medicare Advantage plans to supplemental dental and vision coverage. Anthem plans don't stand out for quality in CMS Star Ratings, and they aren't rated by NCQA—one of the main accrediting bodies for health plans.
Anthem's Medicare Advantage HMO is called Anthem MediBlue HMO. Members need to choose a primary care provider who provides most of their care and serves as a gatekeeper to specialists. These plans typically have lower monthly premiums than PPOs. In 2021, Anthem offers 1,829 HMO plans with prescription drug coverage and 84 plans without.
PPO - A Preferred Provider Organization is similar to a traditional "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance . You must usually meet an annual deductible before some benefits apply. You're responsible for a certain co-insurance amount and the plan pays the balance up to the allowable amount. Visit your health plan's website to learn how benefits, claims, and payment of claims are covered, as well as the service limitations and exclusions that may apply.
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