Anthem Blue Cross for Therapy
Anthem Blue Cross and Blue Shield for Therapy
Anthem Blue Cross and Blue Shield is one of the largest health insurance companies in the country, with plans offered across multiple states. As a subsidiary of Blue Cross Blue Shield, Anthem has an incredibly expansive provider network for physical health as well as specialty behavioral health options — which includes many excellent therapists.
Is Mental Health Treatment covered by Anthem Blue Cross?
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.
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.
How do I check if my Anthem Blue Cross plan covers therapy?
To check if your Anthem Blue Cross 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 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.
Here is an example of what your Anthem Blue Cross and Blue Shield Summary of Benefits may look like, and where to find the Outpatient Mental Health line item:
If your Summary and Benefits document does not share this information with you, give the phone number on the back of your insurance card a call. The Anthem Blue Cross customer service department will share with you the coverage available to you through your plan.
How much does therapy cost with the Anthem Blue Cross plan?
Because Anthem Blue Cross offers so many health insurance plans, out-of-pocket costs vary depending on the person’s plan, geography, and the therapist they see.
Anthem Blue Cross only provides coverage for in-network therapists. This means that there is a set network of therapy providers to choose from — anyone else outside of this network will not be eligible for reimbursement. For this reason, it is typically most cost-effective to see an in-network therapist if you have Anthem Blue Cross and Blue Shield.
Many Anthem Blue Cross behavioral health services plans require the client to pay a copayment that may be between $15-30 each session. Other plans require that the client pays a coinsurance percentage, which may range from 20-80%. To find out your actual out-of-pocket expense for therapy, search your Summary and Benefits document for your plan’s rates.
Anthem Blue Cross can also help you figure out if you qualify for financial assistance or subsidies from the Affordable Care Act (ACA).
What types of mental health conditions does Anthem Blue Cross cover?
Anthem Blue Cross covers many mental health conditions. To reimburse therapists or clients, Anthem Blue Cross requires that the client receive a diagnosis from their mental health care providers. This diagnosis guides treatment and insurance coverage.
Examples of eligible mental health conditions include:
- Anxiety and stress
- Alcohol abuse
- Infertility concerns
- Grief and loss
- Eating disorders
- Learning disabilities
There are many more diagnosable — and reimbursable — mental health conditions, all of which are covered by Anthem Blue Cross.
What types of mental health treatment does Anthem Blue Cross cover?
Anthem Blue Cross covers many different types of therapy. As long as the therapist provides an evidence-based, clinically rigorous therapy modality that is appropriate for the given diagnosis, Anthem Blue Cross will provide coverage.
These evidence-based therapy modalities include:
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Eye Movement Desensitization and Reprocessing (EMDR)
- Mindfulness practices
- Child-parent psychotherapy
- Acceptance and Commitment Therapy (ACT)
Check your plan coverage to see if partial hospitalization programs will be reimbursed.
What types of therapy are NOT covered by Anthem Blue Cross?
Anthem Blue Cross does not cover life coaching, career counseling, or holistic treatment modalities like aromatherapy, massage therapy, or non-medically required acupuncture. It also does not cover energy work such as reiki healing. While these treatments may offer relief from some symptoms of mental illness, they are not covered by insurance.
Anthem Blue Cross requires therapists to be professionally credentialed and offer evidence-based treatment appropriate for the diagnosis of mental disorders.
Does Anthem Blue Cross cover online therapy?
Yes, Anthem Blue Cross offers coverage for online therapy. This opens the doors for many clients who can’t physically attend mental or behavioral health therapy sessions each week. Anthem Blue Cross even created its own online teletherapy resource center, LiveHealth Online, back in 2016, which is available in all 50 states.
LiveHealth Online provides an adequate technological solution for remote therapy treatment. There are several mental health resources and information about community programs available on the Anthem mental health website and easy access to online psychological and psychiatric care. Robust customer service assistance can ensure blind users visiting or using the site or audio-impaired clients can still receive online treatment.
Your coverage for therapy costs will remain the same, whether you visit your therapy in-person or online.
Does Anthem Blue Cross and Blue Shield cover couples therapy?
Whether Anthem Blue Cross 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 plans may provide coverage at the same or differing rates as individual therapy. To see if yours does, visit your Summary and Benefits document.
However, many couples still benefit from seeing a therapist together. If your Anthem Blue Cross health insurance plan does not include a couples counseling benefit, there may be ways to decrease the cost of couples counseling, such as sliding scale.
Do I need to see my primary doctor before starting therapy?
If your Anthem Blue Cross health insurance plan is an HMO plan, you will need to get a referral from your primary care physician before you start seeing a therapist. This means that you’ll likely need to first schedule a visit with your primary care physician to get this referral.
However, some people have Anthem Blue Cross PPO plans instead. If you have a PPO plan, you do not need a referral from your primary care physician before seeing a therapist. This means you can begin your search and mental health help journey when you’re ready!