Anthem

Anthem Coverage for Addiction Treatment in Albany, NY

Don’t let insurance questions get in the way of recovery. At Fusion Recovery in Albany, NY, our admissions team will verify your Anthem Blue Cross and Blue Shield benefits, explain what’s covered in plain language, and help you start treatment, often the same day.

Start Your Recovery
866.936.2290

START HEALING TODAY

Personalized Outpatient Treatment for Albany Residents

At Fusion Recovery, we understand the weight that addiction places on your life and the lives of those you love. That’s why we offer personalized outpatient addiction treatment built around your specific situation, your goals, your schedule, and your recovery needs.
As an outpatient rehab serving the Albany, NY region, we provide flexible scheduling so you can stay engaged with work, family, and other commitments while getting the help you deserve. Our team blends evidence-based therapies with medication-assisted treatment, clinical counseling, and holistic support to help you build a recovery that lasts.
If you or someone you love is struggling, contact us today. Our admissions team will verify your Anthem benefits, walk you through your treatment options, and help you take the next step at no cost and with no pressure.
Start Your Recovery
866.936.2290

ABOUT ANTHEM IN NEW YORK

Empire BCBS Is Now Anthem Blue Cross and Blue Shield

If you’re an Anthem member in New York, or if your card still says Empire, here’s what you need to know. Effective January 1, 2024, Empire BlueCross BlueShield rebranded as Anthem Blue Cross and Blue Shield, and Empire BlueCross became Anthem Blue Cross. Your coverage, network, and member ID stayed the same. Only the name changed.
Anthem Blue Cross and Blue Shield is an independent licensee of the Blue Cross Blue Shield Association and a subsidiary of Elevance Health, formerly known as Anthem Inc. Anthem has served New Yorkers for nearly 90 years and offers a wide range of HMO, PPO, EPO, individual, family, group, Medicare Advantage, and Medicaid plans across New York State, including Albany and the Capital Region.
Under the Mental Health Parity and Addiction Equity Act and the Affordable Care Act, Anthem plans must cover mental health and substance use treatment at the same level as physical health services. New York State Insurance Law adds further protections, including up to 28 days of inpatient substance use treatment at NY OASAS-licensed facilities for members with a primary substance use disorder diagnosis.

OVERVIEW OF ANTHEM BENEFITS

What Anthem Covers at Fusion Recovery

Coverage details vary by plan and product line, but most Anthem plans cover a comprehensive range of addiction treatment services at Fusion Recovery.

Treatment services that are typically covered

Coverage Details

Out-of-pocket costs, including copays, coinsurance, and your deductible, depend on your specific Anthem plan, whether you’re in an HMO, PPO, EPO, individual, group, Medicare Advantage, or Medicaid managed care product. Our admissions team will verify your benefits and explain exactly what to expect before you start treatment.

Preauthorization and behavioral health management

Some Anthem plans require prior authorization for medical detox, inpatient treatment, partial hospitalization, or intensive outpatient programs. Behavioral health authorizations for many Anthem plans are managed by Carelon Behavioral Health (an Elevance Health subsidiary). For substance use disorder care in New York, Anthem uses LOCADTR 3.0, the Level of Care for Alcohol and Drug Treatment Referral tool developed by NYS OASAS and Columbia University, to determine the appropriate level of care. Fusion Recovery’s admissions team handles authorizations and continued-stay reviews on your behalf so treatment isn’t delayed.

Call Now to Verify Your Coverage

866.936.2290

HOW IT WORKS

How to Verify Your Anthem Benefits

Verification is fast, free, and fully confidential. Here’s how it works:

01.

Share your details

Call us at 1.866.936.2290 or fill out our contact form with your Anthem member ID and group number. If your card still reads Empire BlueCross BlueShield, we can verify those benefits too, your coverage is the same.

02.

We verify your benefits

Our team contacts Anthem (or Carelon Behavioral Health, where applicable) to confirm in-network status, deductibles, copays, prior authorization requirements, and what level of care is covered under your plan.

03.

We explain your options

We walk you through your benefits in plain language, outline any out-of-pocket costs, and recommend the level of care that fits your needs.

04.

You take the next step

When you’re ready, we schedule your clinical assessment and help you begin treatment, often the same day.

WHAT WE TREAT

Conditions We Treat at Fusion Recovery

Our Albany, NY treatment programs serve adults struggling with a wide range of substance use and co-occurring mental health conditions, including:

Ready to Take the First Step?

Recovery begins when you reach out. Our admissions team is available to verify your Anthem coverage, answer your questions, and help you start treatment in Albany, NY. Call anytime, we’re here when you’re ready.
Start Healing Today
866.936.2290

Frequently Asked Questions

01. Is Fusion Recovery in-network with Anthem?
Fusion Recovery may be in-network with Anthem Blue Cross and Blue Shield plans serving Albany, NY, and the surrounding Capital Region. Network status varies by your specific plan and product line, so we recommend calling our admissions team at 1.866.936.2290 to verify your in-network benefits before starting treatment.
Anthem plans typically cover the full continuum of substance use treatment, including medical detox, inpatient rehabilitation, partial hospitalization (PHP), intensive outpatient programs (IOP), standard outpatient care, medication-assisted treatment, dual diagnosis care, and aftercare. Specific coverage depends on your plan and product line.
Under New York State Insurance Law, Anthem plans must approve up to 28 days of inpatient substance use treatment at a NY State Office of Addiction Services and Supports (OASAS)-licensed facility for members with a primary substance use disorder diagnosis. Coverage for the past 28 days is reviewed using LOCADTR 3.0, an NY-specific level-of-care tool, based on your progress and ongoing clinical need.
Out-of-pocket costs depend on your specific Anthem plan, your deductible, and any copays or coinsurance under your policy. Our admissions team will verify your benefits and give you a clear picture of expected costs before treatment begins.
Federal law (HIPAA and 42 CFR Part 2) provides strong confidentiality protections for substance use treatment records. Your employer is not notified, and Anthem cannot share your treatment details with anyone without your written authorization. Our admissions team is happy to walk you through how your privacy is protected at every step.
Yes. Effective January 1, 2024, Empire BlueCross BlueShield rebranded as Anthem Blue Cross and Blue Shield in New York. If your card still reads Empire, your coverage, network, and benefits stayed the same, only the name changed. Our admissions team can verify benefits under either name.
Yes. Anthem plans typically cover FDA-approved medication-assisted treatment medications, including Sublocade and Suboxone for opioid use disorder, as well as naltrexone and Vivitrol for opioid and alcohol use disorders. Some medications may require prior authorization, which our admissions team handles for you.
For many Anthem plans, behavioral health and substance use authorizations are managed by Carelon Behavioral Health, a sister company under the Elevance Health umbrella. Our admissions team is experienced working with both Anthem and Carelon and will handle the authorization process on your behalf.
Most Anthem plans don’t require a referral for substance use or mental health treatment, but some HMO and POS plans do. Our admissions team will check the requirements for your specific plan during the verification process.
Don’t give up. Anthem plans typically have multiple levels of internal appeals, and our admissions and clinical teams help guide you through that process. Federal and state parity laws require insurers to cover behavioral health at the same level as medical care. If a denial isn’t resolved through internal appeals, you can also file a complaint with the New York State Department of Financial Services at 1-800-400-8882.
01. Is Fusion Recovery in-network with Anthem?
Fusion Recovery may be in-network with Anthem Blue Cross and Blue Shield plans serving Albany, NY, and the surrounding Capital Region. Network status varies by your specific plan and product line, so we recommend calling our admissions team at 1.866.936.2290 to verify your in-network benefits before starting treatment.
Yes. Effective January 1, 2024, Empire BlueCross BlueShield rebranded as Anthem Blue Cross and Blue Shield in New York. If your card still reads Empire, your coverage, network, and benefits stayed the same, only the name changed. Our admissions team can verify benefits under either name.
Anthem plans typically cover the full continuum of substance use treatment, including medical detox, inpatient rehabilitation, partial hospitalization (PHP), intensive outpatient programs (IOP), standard outpatient care, medication-assisted treatment, dual diagnosis care, and aftercare. Specific coverage depends on your plan and product line.
Yes. Anthem plans typically cover FDA-approved medication-assisted treatment medications, including Sublocade and Suboxone for opioid use disorder, as well as naltrexone and Vivitrol for opioid and alcohol use disorders. Some medications may require prior authorization, which our admissions team handles for you.
Under New York State Insurance Law, Anthem plans must approve up to 28 days of inpatient substance use treatment at a NY State Office of Addiction Services and Supports (OASAS)-licensed facility for members with a primary substance use disorder diagnosis. Coverage for the past 28 days is reviewed using LOCADTR 3.0, an NY-specific level-of-care tool, based on your progress and ongoing clinical need.
For many Anthem plans, behavioral health and substance use authorizations are managed by Carelon Behavioral Health, a sister company under the Elevance Health umbrella. Our admissions team is experienced working with both Anthem and Carelon and will handle the authorization process on your behalf.
Out-of-pocket costs depend on your specific Anthem plan, your deductible, and any copays or coinsurance under your policy. Our admissions team will verify your benefits and give you a clear picture of expected costs before treatment begins.
Most Anthem plans don’t require a referral for substance use or mental health treatment, but some HMO and POS plans do. Our admissions team will check the requirements for your specific plan during the verification process.
Federal law (HIPAA and 42 CFR Part 2) provides strong confidentiality protections for substance use treatment records. Your employer is not notified, and Anthem cannot share your treatment details with anyone without your written authorization. Our admissions team is happy to walk you through how your privacy is protected at every step.
Don’t give up. Anthem plans typically have multiple levels of internal appeals, and our admissions and clinical teams help guide you through that process. Federal and state parity laws require insurers to cover behavioral health at the same level as medical care. If a denial isn’t resolved through internal appeals, you can also file a complaint with the New York State Department of Financial Services at 1-800-400-8882.
Disclaimer: The information provided on this website regarding insurance coverage is only a summary. It does not include all limitations, exclusions, or qualifiers that may apply to your actual coverage. Please refer to your health plan's Evidence of Coverage or Summary Plan Description for full details. Treatment services must be medically necessary to be covered. Any treatment decisions must be discussed with your health provider. We cannot guarantee any coverage or reimbursement. Please contact your health plan directly for the most accurate information regarding your benefits.

Take the first step

Providing hope to all. Compassionate outpatient care for our community.
Ready to talk?

Recovery begins when you reach out. Questions?
Call anytime to speak with an Admissions
Specialist, or request a consultation and we’ll follow up.

David Sietz, M.D.

Chief Medical Officer, Fusion Recovery

Email us or Call

Contact Form

"(Required)" indicates required fields

01. –– Your name(Required)
(Required)

Start Healing Today

At Fusion Recovery, we understand the difficulties that addiction can bring into your life. That’s why we offer personalized outpatient addiction treatment tailored to your unique needs. As an outpatient rehab facility, we provide flexible scheduling so you can continue your work, family life, and other commitments while getting the help you deserve.

Fusion Recovery proudly accepts Anthem coverage for addiction treatment services including outpatient rehab, therapy, medication-assisted treatment, and more. Our compassionate team of experts will verify your Anthem benefits, take care of claims, and make insurance processes smooth. More importantly, we’ll craft an individualized treatment plan using evidence-based therapies and holistic methods to facilitate your lifelong recovery.

With Fusion Recovery, you can find judgment-free support and healing in a comfortable environment. Our welcoming facility and amenities create a peaceful space for you to focus on your recovery journey. If you or a loved one is struggling with addiction, contact us today to learn more about Anthem coverage and how we can help you get your life back.

Start Treatment As Soon as Today ​

CALL NOW​

866.936.2290

Overview of Anthem Benefits

Fusion Recovery is in-network with Anthem plans.

Treatment services covered

Anthem covers services like outpatient rehab, individual therapy, group therapy, medication management, and aftercare support. Our team can help verify your coverage and explain your options before starting treatment so you know what to expect.

Coverage details

Coverage details vary by individual Anthem plan. Out-of-pocket costs such as copays, deductibles, and coverage levels depend on your specific benefits. Our team can help verify your coverage and explain your options before starting treatment.

Preauthorization requirements

Prior authorization may be required for medication-assisted treatment and intensive outpatient programs. Fusion Recovery can assist with obtaining authorizations.

CALL NOW

1.866.936.2290

Safe and Effective

Verify Your Insurance Coverage.

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Remember, the specifics of coverage can vary based on your individual plan and location. It’s always a good idea to confirm coverage with both your insurance provider and Fusion Recovery.
See if You’re covered

What We Treat

Alcohol Treatment

Alcohol is widely available, which can make harmful patterns harder to spot early.

Learn More

Opiates Treatment

Often prescribed for pain, opiates carry a high risk of dependence.

Learn More

Heroin Treatment

Heroin is a fast-acting opioid that can quickly reshape the brain and body.

Learn More

Fentanyl Treatment

Fentanyl is a potent synthetic opioid linked to high overdose risk, even at small amounts.

Learn More
VIEW ALL TREATMENT SERVICES

Disclaimer: The information provided on this website regarding insurance coverage is only a summary. It does not include all limitations, exclusions, or qualifiers that may apply to your actual coverage. Please refer to your health plan’s Evidence of Coverage or Summary Plan Description for the full details and specifics of your benefits. Treatment services must be medically necessary to be covered by your health plan. Whether a treatment or service is medically necessary will be determined based on a review of clinical information provided by your provider. Any treatment decisions must be discussed and determined in conjunction with your health provider. We cannot guarantee any coverage or reimbursement. Please contact your health plan directly for the most accurate and up-to-date information regarding your benefits and coverage for addiction treatment services.

 

Take the first step

Providing hope to all. Compassionate outpatient care for our community.
Ready to talk?

Recovery begins when you reach out. Questions?
Call anytime to speak with an Admissions
Specialist, or request a consultation and we’ll follow up.

David Sietz, M.D.

Chief Medical Officer, Fusion Recovery

Email us or Call

Contact Form

"(Required)" indicates required fields

01. –– Your name(Required)
(Required)
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