Wellpoint Insurance Coverage For Drug & Alcohol Rehab

Medically Reviewed by Johnelle Smith, M.D. on December 15, 2023

If you need help paying for addiction treatment, consider looking into insurance coverage through a private health insurance company like Wellpoint.

WellPoint Insurance Coverage For Addiction Treatment

Wellpoint has been in the health insurance industry for about 30 years. As a parent company, it acquired several insurance companies throughout the 2000s, including Amerigroup, before changing its name to Anthem in 2014.

Now Anthem is bringing back the Wellpoint name for Amerigroup in select markets, which will take effect in 2024.

Wellpoint offers Medicaid and Medicare coverage in:

  • Iowa
  • New Jersey
  • Tennessee
  • Texas
  • Washington

Wellpoint offers only Medicaid in:

  • Georgia
  • Maryland
  • Washington, D.C.

Finally, Wellpoint offers only Medicare in New Mexico and Arizona.

Does Wellpoint Cover Rehab?

Yes, Wellpoint offers extensive coverage through Medicaid and Medicare 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.

Treatment Type Covered Not Covered
Long-Term Residential Treatment ✔️
Residential Treatment ✔️
Inpatient Treatment ✔️
Inpatient Detox ✔️
Partial Hospitalization Program (PHP) ✔️
Intensive Outpatient Program (IOP) ✔️
Outpatient Program Medication-Assisted Treatment (MAT) ✔️
Dual Diagnosis Treatment ✔️

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

If you are looking for substance abuse treatment in the coverage areas the Wellpoint serves, you can use your Medicare or Medicaid coverage as long as a treatment center works with those programs.

To use it, you simply need to present your insurance information to the rehab center that accepts your Wellpoint plan.

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 covers a range of addictions, including alcohol use disorder and opioid use disorder.

It also covers addictions to “street drugs” such as methamphetamines or cocaine and prescription drugs such as benzodiazepines or stimulant medications.

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.

Find Substance Abuse Treatment Today

If you are looking for substance abuse treatment for yourself or a loved one, call us today. We have more information about the treatment process and how to get started on the recovery journey.

This page does not provide medical advice. See more

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

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Medically Reviewed by
Johnelle Smith, M.D. on December 15, 2023
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