Anthem Blue Cross for Therapy | Mental Health Insurance Coverage — Zencare

Anthem Blue Cross for Therapy

Anthem Blue Cross is one of the largest health insurance companies in California and provides medical and behavioral health benefits to millions of residents. They offer many mental health services including access to a large provider network of high-quality therapists. Not to be confused with Blue Cross Blue Shield, Anthem Blue Cross stands as its own health insurance company in California.

Does Anthem Blue Cross cover therapy?

Yes, Anthem Blue Cross provides coverage for therapy sessions. This means that you can use your Anthem Blue Cross health insurance to decrease your out-of-pocket costs for mental health services.

Anthem Blue Cross only provides these benefits to in-network therapists, that is, therapists who are Anthem Blue Cross providers. If you choose to see an out-of-network therapist, you may be responsible for a portion of or the entire session fee.

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.

Example Anthem Blue Cross Summary of Benefits, with outpatient mental health section highlighted

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 my Anthem Blue Cross plan?

Therapy costs with Anthem Blue Cross vary based on the specific plan; however, a copayment of around $50 - $65 or a 20 - 50% coinsurance per session with your in-network therapist is typical.

Anthem Blue Cross does not offer reimbursement for sessions with out-of-network therapists, so you will be responsible for all costs if you see a therapist not in-network with Anthem Blue Cross.

If you’re concerned about paying for therapy, ask your therapist about sliding scale options. If your therapist offers sliding scale payments, you may be eligible to pay a lowered fee per session.

What types of mental health conditions does Anthem Blue Cross cover?

Anthem Blue Cross covers many mental health conditions, including all mental health conditions treated under a specific diagnosis. When you start seeing your therapist, they will provide you with a diagnosis under which you’ll receive reimbursement.

Some common mental health conditions covered by Anthem Blue Cross include:

What types of therapy does Anthem Blue Cross cover?

Anthem Blue Cross reimburses for all therapy services provided by a credentialed mental health professional. This could include psychologists, psychiatrists, social workers, licensed professional counselors, nurse practitioners, and more.

Therapists need to provide evidence-based, clinically rigorous treatments that are appropriate for the client’s diagnosis. This includes the following therapeutic modalities:

What types of therapy does Anthem Blue Cross NOT cover?

Anthem Blue Cross will not cover any therapies that are not evidence-based or based. Treatment also needs to be based upon a specific mental health diagnosis. For these reasons, Anthem Blue Cross will not cover career counseling, life coaching, holistic therapies, or reiki healing.

Does Anthem Blue Cross cover online therapy?

Yes, Anthem Blue Cross covers online therapy. Whether you choose to see your therapist in-person or through an online platform, your Anthem Blue Cross benefits remain the same — you’ll pay the same copayments or coinsurance no matter the location.

Anthem Blue Cross offers LiveHealth Online Psychology, an online mental health platform, to its members in addition to reimbursement options. This online platform gives members access to therapists through a video portal.

Does Anthem Blue Cross cover couples therapy?

Anthem Blue Cross does not cover couples counseling. Because Anthem Blue Cross requires that each client have a mental health diagnosis to guide treatment, couples counseling is typically not eligible for reimbursement.

However, couples counseling is still possible — and affordable! — for many couples through other options.

Do I need to see my primary doctor before starting therapy?

Anthem Blue Cross offers both HMO and PPO plans. If you have an HMO health insurance plan, you will need a referral from your primary care physician before you begin your search for a great therapist. If you have a PPO plan, you can start working with a therapist as soon as you’re ready!