How Anthem Covers Substance Use Treatment
Federal Law Protects Your Coverage Rights
Parity Act 2008
Federal Parity Law
According to the Centers for Medicare & Medicaid Services, federal parity law generally stops plans that cover substance use treatment from setting stricter limits on it than on medical and surgical care. Parity applies to substance use treatment but does not guarantee any specific benefit, so your plan documents still decide what you owe.
ASAM Criteria
Medical Necessity
Plans decide what they cover by medical necessity. For substance use treatment, many use the ASAM criteria, which weigh severity, treatment history, medical needs, and the level of care that fits. Mountain View Health assesses you clinically, and your plan makes the coverage decision.