Does Anthem cover rehab in Maine?

Yes. Anthem covers substance use disorder treatment as a behavioral health benefit on its commercial, employer, marketplace and Medicare Advantage plans. What varies is your cost share and whether prior authorization is required for higher levels of care like PHP.

Will Anthem pay for IOP?

IOP is the most routinely covered level of outpatient addiction care under Anthem plans. Most plans require an authorization based on a clinical assessment, which we complete and submit during admission.

How much will I pay out of pocket with Anthem?

It depends on your deductible, coinsurance and out-of-pocket maximum. Early in the plan year with an unmet deductible you may pay several hundred dollars before coverage kicks in; later in the year, many clients pay only a per-visit copay. We give you a written estimate before you start.

Is Portland Treatment in-network with Anthem?

Yes. We are contracted in-network with Anthem Blue Cross and Blue Shield of Maine, which means your care is billed at Anthem's negotiated rate and your coinsurance is calculated on that lower amount instead of full charges.

Does Anthem cover Suboxone or other MAT medications?

Yes, though the preferred formulation and any prior authorization requirement differ by plan. We verify your pharmacy benefit at the same time as your behavioral health benefit.

Will my employer find out I used my Anthem benefits for treatment?

No. Your employer receives aggregate claims data, not diagnoses or provider names. Substance use records also carry extra federal protection under 42 CFR Part 2.

Insurance · Anthem Blue Cross Blue Shield

Using Anthem insurance for rehab in Maine

In-network provider

Portland Treatment is in-network with Anthem Blue Cross and Blue Shield of Maine.

Anthem Blue Cross and Blue Shield covers more Mainers than any other commercial plan, and we are in-network with them, so you pay Anthem's contracted rate rather than out-of-network prices. Here's what Anthem typically pays for at Portland Treatment in Biddeford, and how to find out your actual cost in a single phone call.

855-449-7674

Network status: In-network with Anthem
Levels covered: PHP · IOP · OP · MAT
Verification time: Usually the same day

Accredited & Licensed

LegitScript Certified
Joint Commission Accredited
Maine DHHS Licensed
Psychology Today Verified

What's covered

What Anthem typically covers at Portland Treatment

Under federal parity law, Anthem must cover substance use treatment comparably to medical care. In practice, that means these levels of care are billable behavioral health services on nearly every Anthem plan sold in Maine.

Partial Hospitalization (PHP)

Our most structured outpatient level, full days of clinical programming. Anthem plans typically cover PHP with prior authorization, which our admissions team requests for you.

More about partial hospitalization (php)

Intensive Outpatient (IOP)

Three to five sessions a week, mornings or evenings, so you can keep working. IOP is the most commonly authorized level of care under Anthem behavioral health benefits.

More about intensive outpatient (iop)

Outpatient Program (OP)

Weekly individual and group therapy for step-down and long-term maintenance. Usually the lowest-cost level under a Anthem plan.

More about outpatient program (op)

Medication-Assisted Treatment (MAT)

Buprenorphine, naltrexone and related medications, billed through your medical and pharmacy benefits. Coverage and preferred formulary vary by Anthem plan.

More about medication-assisted treatment (mat)

Dual diagnosis care

Depression, anxiety, PTSD and bipolar disorder treated alongside substance use, one treatment plan, one set of clinicians, billed under your behavioral health benefit.

More about dual diagnosis care

Detox placement

We don't run a detox unit. We coordinate placement with licensed Maine detox providers and confirm they take your Anthem plan before you go.

More about detox placement

Plan details

Know which Anthem plan you actually have

"Anthem" is not one plan, it's dozens. The plan type on your card changes how referrals, networks and authorizations work.

Employer PPO plans

The most flexible. No referral needed, and out-of-network care is often still partially covered. Most Southern Maine employer plans fall here.

HMO and Anthem HealthChoice

Care must generally stay in-network, and some plans want a PCP referral on file before behavioral health services start.

ACA marketplace (CoverME.gov)

Individual plans bought through Maine's exchange. Substance use treatment is an essential health benefit, but deductibles are frequently high.

Medicare Advantage

Covers outpatient behavioral health with plan-specific copays. We'll confirm the specifics of your particular Advantage plan before you start.

What you'll pay

What determines your out-of-pocket cost

Two people with Anthem cards can pay wildly different amounts for the same IOP. What actually determines your number:

Whether you've met your deductible for the plan year, in January this is the single biggest driver of what you pay.
Your coinsurance or copay per session or per program day once the deductible is satisfied.
Network status, and this one is usually in your favor: Portland Treatment is in-network with every major Maine payer except Cigna, so most clients are billed at the lower contracted in-network rate.
Whether the level of care requires prior authorization and how many days or sessions are authorized at a time.
Your out-of-pocket maximum, once you hit it, covered treatment for the rest of the plan year is paid at 100%.

How verification works

1. You call or submit. We take your Anthem member ID and date of birth, nothing more invasive than that.
2. We call the plan. Our team gets the behavioral health benefit read directly from Anthem Blue Cross and Blue Shield of Maine, in writing.
3. You get a real number. Deductible remaining, coinsurance, authorization requirements and an estimated cost per week, before you commit.
4. We handle the rest. Prior authorizations, concurrent reviews and appeals are our job, not yours.

Call 855-449-7674

Southern Maine

Using Anthem coverage close to home

Our Biddeford campus is a fifteen-minute drive from Saco and Old Orchard Beach, about twenty-five from South Portland, and roughly half an hour from Portland itself. That matters for Anthem coverage because the plan will usually approve outpatient care when a clinically appropriate program is within reasonable driving distance, which is exactly what an IOP three nights a week in York County is.

We handle the paperwork side: benefit verification, prior authorization requests, concurrent reviews when Anthem asks for updated clinical justification, and appeals if a level of care is denied. You should not have to argue with a utilization reviewer while you're trying to get sober.

Biddeford Portland Saco All areas we serve →

Anthem coverage questions

Does Anthem cover rehab in Maine?: Yes. Anthem covers substance use disorder treatment as a behavioral health benefit on its commercial, employer, marketplace and Medicare Advantage plans. What varies is your cost share and whether prior authorization is required for higher levels of care like PHP.
Will Anthem pay for IOP?: IOP is the most routinely covered level of outpatient addiction care under Anthem plans. Most plans require an authorization based on a clinical assessment, which we complete and submit during admission.
How much will I pay out of pocket with Anthem?: It depends on your deductible, coinsurance and out-of-pocket maximum. Early in the plan year with an unmet deductible you may pay several hundred dollars before coverage kicks in; later in the year, many clients pay only a per-visit copay. We give you a written estimate before you start.
Is Portland Treatment in-network with Anthem?: Yes. We are contracted in-network with Anthem Blue Cross and Blue Shield of Maine, which means your care is billed at Anthem's negotiated rate and your coinsurance is calculated on that lower amount instead of full charges.
Does Anthem cover Suboxone or other MAT medications?: Yes, though the preferred formulation and any prior authorization requirement differ by plan. We verify your pharmacy benefit at the same time as your behavioral health benefit.
Will my employer find out I used my Anthem benefits for treatment?: No. Your employer receives aggregate claims data, not diagnoses or provider names. Substance use records also carry extra federal protection under 42 CFR Part 2.

Coverage details described here are general and change by plan year and plan design. Nothing on this page is a guarantee of benefits or payment. The only way to know your coverage is a benefit verification on your specific policy.

Other plans we work with

UMR Cigna MaineCare (Medicaid)Harvard Pilgrim Martin's Point Aetna All insurance & payment options →

Keep exploring

Using Anthem at Portland Treatment

Programs your plan may cover

Partial hospitalization program (PHP) in Biddeford
Our most structured day treatment, five days a week, home each night.
Intensive outpatient program (IOP) in Southern Maine
Nine-plus clinical hours a week with day and evening tracks.
Virtual IOP for anywhere in Maine
The same IOP curriculum by secure telehealth, statewide.
Outpatient program (OP) for ongoing recovery
One to two sessions a week that fit around work and family.

Other plans we accept

MaineCare (Medicaid) addiction treatment coverage
MaineCare members are welcome here.
Cigna coverage for addiction treatment
Verify your Cigna benefits in a few minutes.
UMR coverage for addiction treatment
UMR/UnitedHealthcare plans and outpatient rehab.
Harvard Pilgrim coverage for rehab
A common New England plan for Maine members.

Helpful reading

Does insurance cover rehab?
Coverage, costs and what to ask your plan.
Working during rehab
Evening IOP, FMLA and keeping your job in treatment.
Maine recovery resources directory
Local meetings, crisis lines and state programs.
All Southern Maine areas we serve
Every city and town within driving distance of Biddeford.

Find out what Anthem covers
today