Elevance Health, formerly known as Anthem, Inc., is a health insurance provider that offers coverage for a range of conditions, including pharmaceuticals, dental care and behavioral health. The company claims its insurance plans have more than 47.5 million members in the United States. Navigating insurance coverage and understanding deductibles, networks and providers can be challenging. In this guide, we’ll look at typical options for using Elevance Health for mental health care and explain how providers can check your coverage before you start treatment.
Does Elevance Health Cover Mental Health Care?
Elevance Health covers mental health, but the extent of coverage depends on the individual patient’s plan. Elevance is a member of the Blue Cross Blue Shield Association and has a large network of providers.
In many cases, Elevance therapy coverage goes beyond the essential services and may include residential treatment or intensive outpatient treatment. In some cases, aftercare in the form of support groups or ongoing group therapy may be available. However, the company offers several different plans through Blue Cross and Blue Shield, along with a Medicare Advantage Plan, and the exact details of Elevance behavioral care provisions will vary depending on the plan.
Some examples of treatment that may be available under Elevance mental health coverage include:
- Dual-diagnosis treatment
- Outpatient care
- Counseling
- Behavioral therapy
- Group therapy
- Inpatient services for mental and behavioral health
- Substance abuse care
There may be limits on the duration of treatment or the number of sessions a person can have covered in a given time period. However, the Mental Health Parity and Addiction Equity Act requires Marketplace insurance providers to treat mental and behavioral health coverage as equal to medical or surgical coverage.
This means an insurer can’t charge a higher co-pay for a visit to a therapist than it would for a typical medical/surgical office visit. With more than 21 million Americans enrolled in plans via the Marketplace, these protections are essential for ensuring widespread access to mental health care.
Elevance Health and other insurance providers are permitted to place limits on behavioral care based on “medical necessity,” but the annual limits that used to be an issue for people seeking mental health care are generally a thing of the past.
Using Elevance Health to Find Mental Health Care
While Elevance is a for-profit health insurance provider, the company does run several initiatives to make mental health care resources more accessible. Elevance works with the organization Stronger Together to implement programs to improve health equity and raise awareness about substance abuse and depression.
The company also operates Beacon Health Options in several states, connecting 988 Helpline callers to specialists and clinicians who can help with mental health challenges. This initiative helps people who are going through a mental health crisis access the support they need quickly.
If you have an Elevance Health insurance policy and are considering seeking mental health care, the first thing you’ll want to do is check what’s covered. Marketplace plans treat mental health and substance abuse services as an essential health benefit, so they can’t put limits on annual spending for this kind of care. However, you’ll need to find a provider that’s part of the Elevance network.
How Mental Health Care Providers Can Check Your Coverage Before You Commit to Treatment
If you’re considering seeking mental health treatment but not sure if the provider you’d like to work with is part of the Elevance network or what your deductible would be, you have two options: You can call the provider and ask them to confirm that they’re in-network and whether you’ve met your deductible, or you can log on to your insurance portal and check that way. If you’re not sure how to do that or nervous about talking to your insurer yourself, you can ask your health care provider to do it for you.
When you contact a therapist or a rehab facility for the first time, they’ll call you back to talk to you about the services they offer and arrange a consultation. At this point, you haven’t committed to receiving care from them.
Mental health care providers understand that many people are concerned about the cost of care and find insurance difficult to navigate. They have dedicated teams to assist with billing issues, including checking insurance networks, deductibles and co-pays. You can ask the finance team to check your deductible for you in confidence and then make a decision about whether to commit to care.
If you’re unable to meet the deductible or your plan doesn’t cover the type of care you’re looking for, you may be able to get financial support or find a provider that offers care on a sliding scale.
We’re Here to Help People in Crisis
If you or a loved one is struggling with a mental health crisis, don’t give up hope. The Mental Health Hotline offers free, confidential assistance 24 hours a day, 7 days a week. Whether you just need someone to talk to or you want to be directed to a care provider in your area, we can help you.
Contact the Mental Health Hotline now or browse our list of resources to get free, confidential mental health support whenever you need it.
