Mental Health and Substance Addiction Treatment Health Insurance Coverage From Anthem BCCS of Wisconsin

If you’re one of the 859,000 WI residents living with a mental health disorder, your Anthem Blue Cross Blue Shield of Wisconsin rehab coverage can make treatment services more affordable.  Anthem BCBS provides coverage for inpatient care and outpatient treatment programs for insured members who are experiencing psychological distress.

Treatment programs typically included in Anthem Blue Cross Blue Shield of WI coverage can treat behavioral health conditions like mental health, substance abuse, and dual diagnosis conditions. These conditions often benefit from personalized care that incorporates evidence-based treatments such as Cognitive-Behavioral Therapy (CBT) and Motivational Interviewing (MI) to ensure effective and personalized care. Continue reading to learn about common uses of Anthem Blue Cross and Blue Shield of Wisconsin’s alcohol and drug rehab coverage.

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What Is Health Insurance From Anthem Blue Cross Blue Shield of Wisconsin?

Anthem Blue Cross Blue Shield of Wisconsin is a member of the Blue Cross Blue Shield Association, providing a range of healthcare coverage options to Wisconsin residents. Insurance plans are available with a range of price options, tailored to the needs of individuals, families, and employers.

Anthem BCBS of WI provides coverage options, including vision, dental, and prescription drug coverage. Supplemental plans are available from LifeSecure and provide additional insurance options for accidental, critical illnesses, and hospital stays. To better serve insured members, policyholders can utilize the Sydney Health App to locate local treatment providers, access a 24/7 nurse line, and explore virtual care options.

There are three plan tiers available with Anthem Blue Cross and Blue Shield of Wisconsin. Bronze plans are recognized for offering low monthly premiums and higher deductibles. This is ideal for those who want to keep their monthly costs down and have a few doctor’s appointments. The silver plan has a higher monthly premium and a lower deductible compared to bronze plans. This can be particularly helpful for individuals and families with average health needs. Gold plans have higher monthly payments and lower deductibles, which is ideal for individuals with ongoing medical or psychological needs.

Mental health disorders affect 1 in 5 adults in the United States. This includes over 850,000 adults living in Wisconsin. An estimated 244,000 people are living with serious mental illnesses, which can negatively impact their everyday functioning and quality of life. Depression affects 70,000 youth within the state, which can affect their academic performance and development.

Substance use disorders are another behavioral health concern in Wisconsin. It is estimated that 25,000 residents receive treatment each year at a drug rehab, and 23,000 engage in outpatient treatment programs. A concern among WI residents is the cost of treatment and access to qualified professionals. 37% of adults who did not receive the mental health treatment they needed in 2021 indicated that the main barrier they experienced was treatment costs. This is especially true for the 5% of uninsured residents. Additionally, over 2.1 million WI residents live in a community that does not have enough mental health professionals to provide the necessary care for its residents. Because of this, WI residents are 4x more likely to use out-of-network providers, which can increase treatment costs.

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Is Coverage for Substance Addiction Treatment Included in Anthem Blue Cross Blue Shield of Wisconsin Health Plans?

Yes, Anthem Blue Cross Blue Shield of Wisconsin drug and alcohol rehab coverage can include coverage for inpatient care and various forms of outpatient treatment programs. Coverage can vary depending on your location, insurance provider, and the type of plan you have. Some plans require prior authorization or a referral from your primary care physician to initiate the claims process.

Rehabilitation programs often offer Medication-Assisted Treatment (MAT) for those experiencing withdrawal symptoms and specific forms of addiction. Dual diagnosis care is another specialized treatment that is typically recommended if you’re experiencing a co-occurring mental health disorder. The main goal of addiction treatment programs is to help you understand the factors that contributed to your addiction and to develop the skills needed to navigate your sobriety successfully.

Mental Health and Substance Addiction in Wisconsin: Which Treatment Programs Are Covered?

Rehab centers that take Anthem Blue Cross Blue Shield of Wisconsin can offer a range of behavioral health programs. Treatment options focus on addressing varying severities of symptoms. Although this is not a comprehensive list, it highlights some of the more common rehabilitation programs.

Partial Hospitalization Programming (PHP) is a treatment program that can focus on mental health, substance use disorders, and dual diagnosis concerns. These programs offer a full day of recovery-oriented care, eliminating the need for overnight stays. Treatment can include therapy, counseling, and group support.

Anthem Blue Cross Blue Shield of Wisconsin’s rehab options commonly include coverage for PHPs. Insurance companies commonly require prior authorization or referrals from your primary care physician.

Intensive Outpatient Programs (IOPs) are a type of treatment program that typically involves 3 to 5 days per week, with several hours of therapy. This can include group and individual sessions. Dual diagnosis treatment, psychiatric care, and MAT services are commonly available for comprehensive care.

Anthem Blue Cross Blue Shield of Wisconsin covers rehab services in outpatient facilities, including IOPs, when medically necessary. IOPs may require pre-authorization, like PHPs and inpatient care, because they are a specialized program. You may be responsible for out-of-pocket expenses, such as copayments and deductibles, at the time of service.

Residential and inpatient care are intensive programs ideal for those experiencing moderate to severe symptoms that are challenging to navigate independently. Common treatment services include group support, therapy, and family programming. These programs can range from a few weeks to a month or two, depending on your recovery needs.

Anthem Blue Cross Blue Shield of Wisconsin covers inpatient rehab when it is medically necessary. Coverage options commonly include coverage for residential and inpatient care. Limitations and exclusions may apply to some residential programs, as they are considered private treatment centers.

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Drug Addiction, Alcohol Addiction, and Mental Health Treatment in Wisconsin

Anthem Blue Cross Blue Shield of Wisconsin Health Insurance: Are Drug Addiction, Alcohol Addiction, and Mental Health Treatment Covered?

Anthem Blue Cross Blue Shield of Wisconsin rehab coverage commonly includes programs specializing in mental health disorders, alcoholism, and drug dependency. Coverage for these programs can vary significantly based on your insurance policy. Out-of-pocket expenses are ordinary and may include deductibles, premiums, and copayments. Coverage exclusions may apply for out-of-network providers.

Insurance companies typically offer a range of products and services, allowing insured members to choose a plan that aligns with their mental health needs and budget.

This process begins with an actuary who evaluates health trends along with their associated risks and liabilities. The underwriting process can then tailor the details of these plans to individual factors. This is why there are variations among individuals who the same company insures. You can learn more about the scope of your Anthem BCBS of Wisconsin policy when you verify your coverage with CheckMyInsurance.co today.

Anthem Blue Cross Blue Shield of Wisconsin addiction rehab coverage can include dual diagnosis treatment. This is an essential coverage option for insured members who have co-occurring mental health disorders like anxiety, depression, and trauma-related disorders. Your coverage may require prior authorization and documentation of your diagnosis and treatment recommendations.

Dual diagnosis care is often available in inpatient and outpatient care settings, promoting access to whole-person care in the various stages of sobriety. Treatment can include therapy, counseling, and support groups. CBT, motivational interviewing, and holistic approaches can be utilized to foster relapse prevention skills and promote positive coping strategies.

Yes, Anthem Blue Cross Blue Shield of Wisconsin drug rehab coverage can include Medication-Assisted Treatment (MAT) services. MAT promotes access to needed care for the use of addiction medicines when needed. You may be required to use prescription drug coverage for medications like buprenorphine, methadone, and naltrexone. These policies may have their own designated out-of-pocket costs that you’re responsible for.

MAT services are commonly used in detoxification programs to decrease the intensity of withdrawal symptoms. The FDA has approved medications for opioid and alcohol use disorders, which may be used on a long-term basis to help manage cravings. Your prescribing physician can help you navigate policy requirements for generic medications if necessary.

How Much Does Treatment for Substance Addiction and Mental Health Cost With Anthem Blue Cross Blue Shield of Wisconsin Health Insurance?

Anthem Blue Cross Blue Shield of Wisconsin’s rehab coverage can provide coverage for some, if not most, of the costs associated with substance abuse and mental health treatment. Coverage rates can vary, although it typically costs less than paying out of pocket for treatment. You may incur monthly premiums, copayments, and deductibles when undergoing treatment.

You can learn more about your available coverage options when you verify your insurance with CheckMyInsurance.co. This complimentary resource provides reliable and simplified details of your policy so you can find your ideal treatment provider.

How Much Does Treatment for Substance Addiction and Mental Health Cost Without Health Insurance?

Behavioral health treatment costs can vary based on the details of your care. Typically, inpatient care is more expensive than outpatient care. For example, residential care costs an average of $56,625, while outpatient care can cost as much as $1,708 in Wisconsin.

Your treatment costs can be lower or higher than the average noted above. If you receive dual diagnosis treatment, psychiatric care, or MAT services, you may experience higher costs. Similarly, private treatment centers, such as residential rehabilitation programs, typically have higher costs than public or community treatment programs. For a personalized treatment cost, contact nearby healthcare facilities and request a customized quote.

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Where Is the Best Place to Check My Anthem BCBS of Wisconsin Health Plan Information?

To learn about your Anthem Blue Cross Blue Shield of Wisconsin rehab coverage, you can use the verification tool available at CheckMyInsurance.co. This free resource can provide you with quick and accurate details from your policy that can impact your choice of a treatment provider.

You can also review your policy documents by logging into your Anthem BCBS portal. Try to focus on details about behavioral health, mental health, and substance abuse treatment. It is also recommended that, before engaging in treatment, your treatment provider confirms their network status and the other details of your policy. This can help you feel confident in your decision-making and decrease some of the stress associated with mental health treatment.

Are Former Military Personnel Included in Anthem BCBS of Wisconsin Health Insurance Plans?

Yes, Veterans who have a marketplace insurance policy often have Anthem Blue Cross Blue Shield of Wisconsin rehab coverage. This can include those with family, group, and employer-sponsored plans. Rehab coverage from Anthem BCBS in Wisconsin is also commonly a component of Medicaid and Medicare when medically necessary.

It is important to note that health insurance differs from health benefits provided through the VA system. Qualifying Veterans can access a range of medical and psychological treatments from a VA healthcare facility or a treatment provider within the Community Care Network (CCN). 

Does Anthem Blue Cross Blue Shield of Wisconsin Pay for Mental Health and Substance Use Disorder Treatments Received Out-of-State?

In some cases, you can receive coverage for out-of-state rehabilitation programs. Eligible insured members have access to the BlueCard program, which allows them to access in-network pricing for treatment providers within the BCBS network. This can broaden your access to behavioral health providers, enabling you to find your ideal treatment provider.

Access to this benefit is dependent on your policy and whether you’re eligible for the BlueCard program. Verify your Anthem Blue Cross Blue Shield of Wisconsin rehab coverage today to learn more.

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Ten Wisconsin Treatment Centers for Mental Health That Typically Accept Anthem Blue Cross Blue Shield of Wisconsin

When you’re considering nearby mental health treatment providers, begin by narrowing down your search to in-network treatment providers. You can then compare available treatment services, therapies, and holistic options to find the program that best suits you. Continue reading for a short list of premier mental health treatment facilities across the country.

  1. Aurora Psychiatric Hospital – Dewey Center: 1220 Dewey Avenue, Wauwatosa, WI 53213
  2. Mendota Mental Health Institute: 301 Troy Drive, Madison, WI 53704
  3. Rogers Behavioral Health – Oconomowoc Campus: 34700 Valley Road, Oconomowoc, WI 53066
  4. Willow Creek Behavioral Health: 1351 Ontario Road, Green Bay, WI 54311
  5. Winnebago Mental Health Institute: 4100 Treffert Drive, Oshkosh, WI 54901
  6. Rogers Behavioral Health – Silver Lake Outpatient Center: 1205 Corporate Center Drive, Oconomowoc, WI 53066
  7. Rogers Behavioral Health – Wausau Outpatient: 500 North 3rd Street, Suite 600, Wausau, WI 54403
  8. Aurora Psychiatric Hospital (Inpatient Services): 1220 Dewey Avenue, Wauwatosa, WI 53213
  9. SSM Health Behavioral Health – Fond du Lac Day Treatment: 40 Camelot Drive, Fond du Lac, WI 54935
  10. SSM Health Specialty Services – Sun Prairie PHP/IOP: 10 Tower Drive, Sun Prairie, WI 53590

Ten Wisconsin Treatment Centers for Addiction That Typically Accept Anthem Blue Cross Blue Shield of Wisconsin

It can be challenging to find addiction treatment programs that offer the services you are interested in. Thankfully, as a member of the BCBS Association, Anthem BCBS of Wisconsin has an extensive list of in-network treatment providers to choose from. Read below for the 10 leading rehabilitation programs in the U.S.

  1. Wood Violet Recovery: 938 S Front Street, Dodgeville, WI 53533
  2. Wellbrook Recovery: 355 S Moorland Road, Brookfield, WI 53005
  3. Rogers Behavioral Health – Oconomowoc Campus: 34700 Valley Road, Oconomowoc, WI 53066
  4. Burkwood Treatment Center: 1102 Plum City Road, Hudson, WI 54016
  5. Wausau Comprehensive Treatment Center (CTC): 1000 Sherman Street, Wausau, WI 54403
  6. Manitowoc Comprehensive Treatment Center (MAT): 1601 S 17th Street, Manitowoc, WI 54220
  7. WisHope Recovery – Waukesha: 223 Wisconsin Avenue, Unit A, Waukesha, WI 53186
  8. SSM Health Behavioral Health – Fond du Lac Day Treatment: 40 Camelot Drive, Fond du Lac, WI 54935
  9. SSM Health Specialty Services – Sun Prairie PHP/IOP: 10 Tower Drive, Sun Prairie, WI 53590
  10. Rogers Behavioral Health – Silver Lake Outpatient Center: 1205 Corporate Center Drive, Oconomowoc, WI 53066
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Where Should I Go to Verify That A Treatment Center Accepts Anthem BCBS of Wisconsin Health Insurance?

You can complete the insurance verification form with CheckMyInsurance.co to learn about in-network provider options. This is a free and reliable resource that can simplify the details of your policy, allowing you to make an informed decision about your treatment options.

Another option is to log in to your Anthem BCBS member portal. Here you can access and review essential policy documents. You can also ask your treatment provider to confirm their network status before beginning treatment to ensure that you’re eligible for coverage with their treatment program.

What’s the Best Way to Get Drug/Alcohol and Mental Health Treatment Covered by Anthem Blue Cross Blue Shield of Wisconsin?

The best way to receive drug, alcohol, and mental health coverage from Anthem Blue Cross Blue Shield of Wisconsin is to verify your insurance coverage. Learning about your behavioral health benefits can help you understand requirements and exclusions associated with your insurance policy.

Once you have verified the details of your policy, ensure that you take the steps outlined in your policy. This can involve obtaining necessary authorizations or referrals. Verifying your policy also allows you to understand your out-of-pocket treatment expenses, enabling you to plan accordingly. In most cases, choosing an in-network provider allows you to receive the most coverage from your policy. 

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  • In 2023, adults between the ages of 45 and 54 had the highest rates of suicide in Wisconsin.
  • Wisconsin was ranked 21st regarding the mental health concerns of residents. This rating encompasses the prevalence of mental health conditions, access to healthcare coverage, and the availability of rehabilitation programs.
  • 52% of high school students reported having anxiety symptoms, and 35% indicated that they feel sadness or hopelessness daily.
  • The rate of treatment engagement for men and women in 2021 was almost identical, according to the Substance Abuse and Mental Health Service Administration (SAMHSA).
  • While over 859,000 adults are living with a mental health disorder, an estimated 244,000 are experiencing severe mental illnesses.