Wellpoint Insurance Coverage For Drug & Alcohol Rehab

Wellpoint is a health insurance company with a long history in the industry. The company started about 30 years ago and grew by buying other insurance providers over the years. One of their biggest purchases was Amerigroup, which they acquired in the 2000s. In 2014, Wellpoint changed its corporate name to Anthem, which many people recognize today.

Recently, Anthem decided to bring back the Wellpoint name for some of its insurance plans. Starting in 2024, Amerigroup members in certain states will see their insurance rebranded as Wellpoint. If you have coverage through Amerigroup or are looking into Wellpoint plans, you might be wondering what this means for drug and alcohol treatment coverage. The good news is that Wellpoint insurance includes benefits for addiction treatment.

Wellpoint doesn’t operate in every state, so it’s important to know if it’s available where you live. The company offers both Medicaid and Medicare plans in Iowa, New Jersey, Tennessee, Texas, and Washington. If you live in Georgia, Maryland, or Washington, D.C., Wellpoint only provides Medicaid coverage. For people in New Mexico and Arizona, Wellpoint offers Medicare plans but not Medicaid.

Does Wellpoint Cover Rehab?

Yes, Wellpoint offers extensive coverage through Medicaid and Medicare insurance for substance abuse rehab programs.

This includes short-term or long-term care, inpatient or outpatient treatment, and behavioral therapy or medication-assisted treatment (MAT).

Substance Abuse Treatment Services Covered By Wellpoint Insurance

In the table below, you can find treatment programs and services and whether or not they are covered by Wellpoint.

Wellpoint Insurance Coverage By Treatment Type

Wellpoint’s coverage for substance abuse treatment follows the guidelines set by the American Society of Addiction Medicine (ASAM).

If you are interested in learning more about what Wellpoint covers under each treatment type, browse through the tabs below.

Wellpoint Insurance Plan Types

Wellpoint offers Medicaid and Medicare plans in the states listed above. Depending on the state, it may offer one type of Medicaid plan, but several types of Medicare plans.

Medicare insurance plans offered by Wellpoint include:

• Medicare Advantage
• Medicare HMO
• Medicare PPO
• Medicare Part D
• Medicare Supplement

How To Use Wellpoint Coverage For Substance Abuse Treatment

Getting treatment with Wellpoint coverage is straightforward. First, you need to find a rehab center in your area that accepts Wellpoint’s Medicare or Medicaid plans. Not every treatment facility works with these programs, so it’s important to ask before you start.

Once you find a center that takes your insurance, just give them your Wellpoint insurance card and information. The treatment center will contact Wellpoint to verify your benefits and find out what services are covered. They can usually tell you right away if your plan will pay for detox, inpatient treatment, outpatient programs, or therapy sessions. This helps you understand any costs you might need to pay out of pocket before you begin treatment.

Wellpoint Co-Pays And Deductibles For Addiction Treatment

Wellpoint Medicaid plans may have co-pays associated with a service, but they will be nominal and based on your income, ranging from $0 to $15 for outpatient treatment and $0 to $100 for inpatient treatment.

Medicare plans may also have no deductibles or co-pays, depending on what type of plan you have.

What Addictions Does Wellpoint Cover?

Wellpoint insurance provides coverage for many different types of substance use disorders. Whether you’re battling legal substances like alcohol and prescription medications or illegal drugs, Wellpoint plans typically include treatment benefits for a range of addictions.

These may include:

• alcohol use disorder
• opioid addiction (including heroin, fentanyl, and prescription painkillers)
• methamphetamine addiction
• cocaine and crack cocaine addiction
• benzodiazepine addiction (like Xanax or Valium)
• prescription stimulant addiction (like Adderall or Ritalin)
• other street drugs and substances

No matter what substance a person is abusing, Wellpoint coverage can help you access the treatment you need. The key is finding a rehab center that accepts your plan and offers the right level of care for you.

What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?

If your health insurance plan doesn’t cover the treatment services you need, don’t give up. You still have other payment options for addiction treatment.

Other payment options include:

• block grants or awarded grants through the Substance Abuse and Mental Health Services Administration (SAMHSA)
• government-funded insurance programs like the ones Wellpoint offers, including Medicaid and Medicare or TRICARE (a military insurance program that Wellpoint does not offer)
• scholarships from nonprofit organizations or treatment centers
• payment plans or a sliding fee scale offered by some rehab centers

State-funded addiction treatment facilities also offer free or low-cost addiction treatment and may be worth looking into.

Finding A Rehab Center That Accepts Wellpoint

Wellpoint has a network of treatment providers it works with and should be able to direct you to an addiction treatment center that is in your area or close to it.

You can access this information through your provider directory, Wellpoint’s website, or Wellpoint’s call center.

If you are already interested in a treatment center, you can call its helpline to ask if your insurance is accepted or search its website for an insurance verification form.

Written by the Addiction Resource Editorial Staff