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Using Anthem for therapy

Anthem is one of the brands under the Elevance Health umbrella (the former Anthem Inc.) and is the licensee of Blue Cross Blue Shield plans in 14 states, including California, New York, Connecticut, Indiana, and Ohio. The mental-health coverage on most Anthem plans is administered through Anthem's behavioral-health division, which in some regions partners with Carelon Behavioral Health (formerly Beacon Health Options). If your card mentions Carelon or Beacon for behavioral-health benefits, your therapy benefits run through that network.

Federal parity rules require Anthem to cover outpatient mental-health at terms comparable to medical care. In practice, most Anthem commercial plans cover individual therapy with an in-network provider for a copay (typically $25-$50) or coinsurance after deductible. Session limits are uncommon on commercial plans. Telehealth is reimbursed at the same rate as in-person on virtually all Anthem plans.

Anthem operates a mix of HMO, PPO, EPO, and HDHP products. HMO plans may require a primary-care referral for outpatient mental-health in some markets; PPO and EPO plans generally don't. The Anthem app and member portal are reasonably navigable and will tell you your behavioral-health benefits without a phone call.

What to verify before your first session: that outpatient mental-health is covered on your specific plan, your copay or coinsurance amount, and whether your deductible has been met for the year. If you'd rather not handle the verification yourself, our intake coordinator can verify with the therapist's billing team.

For out-of-network coverage on Anthem plans: most commercial plans provide partial out-of-network reimbursement, typically 50 to 70 percent after an out-of-network deductible. You'd pay the therapist up front and submit a superbill (an itemized receipt the therapist provides) for reimbursement.

A regional note: Anthem's various BCBS licensee operations are administered separately. A therapist in-network with Anthem Blue Cross of California isn't automatically in-network with Empire BCBS in New York, even though both are part of the Elevance Health family.

To find an Anthem-accepting therapist, submit the matching form or browse the profiles below.

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