Anthem/Carelon Commercial, Marketplace, and Medicaid Benefits FAQ
Does Indy Counseling currently accept Anthem Commercial, Marketplace, and Medicaid Benefits?
Yes we do. We signed a 3 year group contract with Anthem in September of 2024 that allows everyone at ICP to accept Anthem commercial benefits. We have been able to secure some of the Marketplace contracts and in April 2025 we were accepted into Anthem HIP. We are out of network with select Anthem Marketplace plans with reduced provider networks. Therapists at Indy Counseling get to choose to participate or decline to be on any insurance contract. As long as Anthem continues to honor that contract, we will continue to participate. Anthem allows supervisory claims, which means a clinically licensed provider (LCSW, LMHC, LMFT, HSPP) can supervise a provider that has their Masters level license (LSW, LMHCA, LMFTA) which allows more access to therapists. (See below under “Carelon” to read their change to NOT allow these claims).
Is Anthem now called Elevance?
Yes, in October of 2024 Anthem publicly announced that it was restructuring and the company would be renamed Elevance.
Who is Carelon?
Carelon is an acquired company of Elevance that manages former Anthem EAP, (Employee Assistance Program) and is taking over management of enrolling new providers, Anthem Medicaid, and some Anthem Self-Funded plans. Carelon will now offer commercial and marketplace plans in Indiana. On June 27th, 2025, Elevance sent out new contracts to some Anthem providers to begin their process of having them become Carelon providers. The reimbursement for the same services Anthem pays for currently is proposed to be cut by around 50-63% of current rates.
Does Indy Counseling have a Carelon Contract?
No, we have not been invited into the Carelon network at this time, but have already decided to NOT secure a group contract with Carelon. We cannot sustain our expenses as a company with their rates, and our therapists (who are paid on commission) cannot afford to live on what they are offering. Customers that have these benefits will have the option of staying with their therapist at the self-pay rate. Carelon has already received a number of therapists in private practice declining to join its network due to reduced rates, elimination of supervisory claims and questionable contract clauses.
Will Anthem Commercial plans cease to exist?
Elevance has not officially announced an end date for Anthem plans or how they will vacate our contract, but they have stopped allowing new providers to join the Anthem network. In other states they have turned over all their behavioral health benefit contracts to Carelon. Based on their business behaviors in other states, we are planning for an end of Anthem benefits by January 1, 2027. Elevance has started to offer employers, unions, and other plan brokers the Carelon plans to try to get them to end their selection of Anthem benefits. Employees will not have a choice if their companies switch. Employees should talk with their HR departments and stay aware of their plan’s benefits.
Will Anthem Medicaid cease to exist, and will Indy Counseling take Carelon Medicaid Plans?
Elevance is not being transparent with the State of Indiana or Anthem providers about how Medicaid benefits will be managed. On June 27th, 2025, Elevance announced to a small number of Anthem providers that Carelon would be offering Medicaid benefits starting September 1, 2025 at drastically reduced rates. They later stated this was a mistake and have yet to clear up their plan for the future. Each state sets their own Medicaid, HIP (Healthy Indiana Plan), and HHW (Hoosier Healthwise) rates and benefit management entities cannot change that rate. No one from the State of Indiana has publicly acknowledged which division at Elevance will be managing Medicaid benefits. If Elevance ends Anthem Medicaid benefits and rates, only Carelon providers can accept those benefits and provide therapy services. Indy Counseling will NOT be acquiring a group contract with Carelon, and will NOT be able to offer Carelon Medicaid as a practice. It is possible 1-2 Indy Counseling therapists will consider an individual Carelon contract to provide services to those with Carelon Medicaid but NONE of our therapists being supervised will be able to provide those services. This is going to have wide-spread effects at Hospitals, Community Mental Health, Non-Profits and Private Practice. If you have Anthem Medicaid, we encourage you to select a different Managed Care plan during November enrollment. It is highly likely that Carelon will be the only division on Elevance offering Medicaid plans in 2026, and the number of providers will be drastically low!!!
What will happen January 1, 2026, and what will I be responsible for?
You will need to remain clear on any changes to your mental health benefits for 2026, and realize that YOU are responsible to pay for services if your insurance company does not. January 1, 2026 will be a confusing time for providers and clients. You may have an insurance card that states Elevance (or possibly still Anthem), however, if your mental health benefits become Carelon, Indy Counseling will NOT be able to provide you services covered by Elevance. You will have to sign a self-pay financial agreement, pay self-pay rates at times of service, and get a Superbill to turn into Carelon for possible reimbursement that goes directly to you. Please be AWARE - Each Indy Counseling Professionals client signs a contract stating that if your insurance does not pay your claims, YOU are responsible for that service at the non-contract rate. ALSO - There are contract allowances for Elevance (actually any insurance company) to take back payments they have made in error up to 2 YEARS after the service was provided. Providers call these “CLAWBACKS!!” If Elevance confuses which department should pay the claim and the wrong department pays the claim, or if the employer or employee has not paid for benefits during a certain period of time, or if the service is later denied, Elevance will simply subtract the money they declare they are owed from the therapist’s payments for current clients and services. They will give us the option to file the claim with the correct department, but if it is past 6 months from the date of service, or if the claim should be paid by Carelon, it will be denied. Elevance doesn't allow disputes from the practice/therapists before they take the money or before the practice/therapists can check with the client regarding coverage. YOU will ultimately have to pay for the services, and this can be a large bill. Many clients after 2 years are done with services and hard to find. If Indy Counseling faces large CLAWBACKS we may have to close our doors.
It is imperative that you know if you have Carelon Mental Health benefits through Commercial, Marketplace, or Medicaid coverage, or if you have Anthem coverage!!!
Please continue to check our site, stay connected to your HR/Benefit Administrator, and look for MailChimp emails from Indy Counseling Professionals. We will inform you of major updates and roll out our formal plan in November 2025 of how we’ll assist in checking benefits for 2026.
Our goal is to continue to provide services for you at a price we ALL can afford!