Blue Cross Blue Shield Drug and Alcohol Rehab Treatment Coverage

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Does Blue Cross Blue Shield Cover Drug Rehab and Alcoholism Treatment Services?

If you’re reading this page then chances are you, or a loved one, are battling with addiction, have a Blue Cross Blue Shield policy and are looking for help. BCBS owns 36 different insurance providers across the United States that make up the Blue Network. Most offer the same plans but their coverage may vary from state to state. In addition to pay out rates, copay and coinsurance may vary. This will affect how much you have to pay out of pocket. Read this guide to find out how much your policy covers, how to maximize your benefits and how to get the most out of your policy.

Blue Cross Blue Shield Rehab Coverage

Before you commit and head out to addiction treatment, there are several questions you must get answers to in order to avoid any unwanted surprises or extra charges.

• What addiction treatment services will my health insurance provider cover?
• Which substance abuse treatment facility will accept my Blue Shield health insurance plan?
• Is there a daily maximum my health insurance will pay for for residential treatment services?
• Does my Blue Cross Blue Shield insurance company cover specialty treatment programs and are there any limitations on types of therapy/treatment?
• Does my health insurance provider pay for out of state coverage?
• How long of a stay is covered?
• Does BCBS have insurance coverage for private or semi-private rooms?
• Is individual and group therapy included in my BCBS health insurance coverage?
• Does my health insurance policy cover mental and co-occurring conditions?
• Does my policy cover luxury rehab?
• Will my health benefits cover aftercare recovery programs?
• What will your out-of-pocket expenses will be if I have BCBS health insurance?
• Does the plan cover medications that may be used during detox and treatment?
• What facilities are BCBS in-network vs. out-of-network?
• Does my BCBS Federal Employee Program let me choose the rehab of choice?

Blue Cross Blue Shield Drug Rehab & Alcohol Addiction Treatment: What Is Covered?

The short answer is most rehab treatment centers accept Blue Cross Blue Shield. How much it covers and how much you’ll have to pay out of pocket depends on various factors. These factors include your insurance policy, the state where you reside or the state where you will receive treatment, the types of treatment you will receive and the duration of treatment, just to name a few.

With respect to duration of treatment, ideally, you want to go to a rehab that takes blue shield insurance where they will individualize a treatment program according to your needs. The standard in the addiction treatment industry is inpatient treatment which lasts 28 – 30 days. However, some individuals require longer treatment.

Generally, most addiction centers will provide some or all of the following services:

• Detoxification
• Hospital stays for case of medical problems
• Inpatient treatment services even at private high end rehab facilities
• Partial Hospitalization (PHP)
• Intensive Outpatient (IOP)
• Outpatient

BCBS Insurance has different reimbursement rates for each treatment phase. They usually have a maximum number of days that they’ll cover. This can make the process of quite complex.

How long you spend in each phase depends on each individual as they adjust to the recovery process. A good program should not rush their clients. They should focus on their recovery and not on the bottom line. As we know, not all treatment centers will do that. It’s crucial to find a treatment facility that will explain all the services and fees ahead of time. So, before you go to rehab, you’ll know how much you’ll have to pay out of pocket. You really don’t want to receive a surprise bill after you have completed treatment.

Blue Cross Blue Shield In-Network Rehab

If you have a BCBS PPO policy then treatment will be covered at both, In-Network and Out-of-Network treatment facilities. If you have HMO then treatment will be covered only at In-Network rehab facilities which are contracted with Blue Cross Blue Shield. Clearly, PPO plans allow you access to more rehabs. However, expect to pay more out of pocket if they’re not In-Network.

Finding good rehabs that take Blue Cross Blue Shield that are In-Network with your carrier is hard and takes a long time. We’ve created a free service that will find rehab treatment facilities which accept your policy. We will also verify your rehab insurance benefits before you commit to help avoid any surprises at the end.

Does BCBS Pay for Couples Drug Rehab Treatment?

BCBS Insurance will pay for individual or couple’s substance abuse rehab. You and your partner may receive treatment at the same facility or may be required to seek treatment at separate facilities.

BCBS Coverage for Substance Abuse

BCBS was created about 80 years ago. Today, it operates and is accepted across the United States. The Blue Cross Blue Shield Association is comprised of 36 different insurance companies. Together, they make up the Blue System, which covers more than 100 million people nationwide. About 1 in every 3 people in the US has a BCBS policy.

Types of BCBS Policies:

BCBS policies typically come in 3 to 4 plans.

1. Bronze – lowest monthly premium. It covers around 60% of medical costs.
2. Silver – more expensive than Bronze but cheaper than Gold. It covers 70% of medical costs.
3. Gold – highest monthly premium. It covers 80% of medical costs.
4. Platinum – not offered across the United States. It’s the most expensive plan but covers up to 90% of medical costs.

Blue Cross Blue Shield Substance Abuse Coverage & Costs 

Drug treatment ranges from $300 to $3,000 per day. Most BCBS policies will cover 50-90% of addiction treatment costs for a 30-day inpatient program. It’s imperative to find an accredited and quality rehab program that will customize treatment based on your needs and that also works within your budget. It is possible to have most or all of your treatment costs covered by your policy, depending on how much of your deductive and out-of-pocket costs have been met prior to going to rehab.

Does BCBS Pay for Luxury Rehab Treatment?

Do you need to go to a specialty program to overcome your addiction? Probably not. However, luxury substance abuse rehab centers make the process a lot more appealing. Previous clients have described luxury treatment as rehab at a five-start resort. Will your policy cover such treatment? It’s possible. It’s also possible that it will cover almost all your treatment. Again, how much will be covered depends on your individual policy and your home state.

Addiction Treatment Services That May or May Not Be Covered

• Psychodrama Therapy – acting out scenes from the past or acting out hopeful scenes of the future.
• Art & Music Therapy – allows to incorporate art such as drawing, painting, sculptures, etc. and music into treatment.
• Equine & Wildlife Therapy – connecting with horses and other animals may help individuals with beating their addiction.
• Faith Based & Non-Faith Based alcohol and drug treatment – religious belief has been successfully used in recovery. Non-faith based programs like SMART recovery can be just as successful.
• Behavioral Health Care – only a select number of programs specialize in treating co-occurring conditions properly.

Blue Cross Blue Shield Mental Health Coverage

As mandated by the Mental Health Parity and Addiction Equity Act (more information at mentalhealth.gov) a health insurance company must cover behavioral health and substance abuse related disorders the same way as they cover other medical issues and procedures. Blue Cross must cover conditions like Dual diagnosis. This is a tricky condition to treat effectively. You don’t want to go to just any substance abuse treatment centers that accepts Blue Cross Blue Shield insurance if you suffer from co-occurring conditions. By the way, most people who suffer from substance abuse also suffer from one or more mental health issues. It’s crucial to find alcoholism and drug treatment centers that accept BCBS that also specialize in treating addiction and mental health at the same time.

Find the Best Blue Cross Blue Shield Substance Abuse Providers

Finding a good substance abuse treatment center that will customize a treatment program to fit your needs is time consuming. Finding such a treatment center that is affordable and one that accepts your insurance plan is even more difficult. We created this free service to simplify the process of finding quality treatment.

Counselors are available 24/7. When you call a counselor will verify your insurance benefits and match you with one or more alcohol addiction treatment facilities that are within your budget and that fit your needs. This is a free resource and there is no cost and no obligation to commit.

How it Works:

It doesn’t matter where in the United States you are located. We can help. Chances are there is a treatment center near you that accepts BCBS insurance. Let us find you the best addiction treatment options that are available to you. When you first call us we will ask you a few questions to get a clear picture on how to best help you. The representative you will be speaking with will want to know which substances you abuse and how long has the problem been going on. He or she will also want to know if there is any history of mental illness and also if you’ve made any efforts to quit your addiction either on on your own, with the help of a substance abuse counselor or professional who specializes in addiction or if you’ve been to rehab before.

The next step is to verify your Blue Cross Blue Shield addiction benefits. Ideally, you will want to have your insurance card handy. Agents can verify most BCBS policies online and in some cases while they’re on the phone with you. It is OK if you don’t have that information handy. Each agent  speaks with hundreds, if not more individuals every month and since about one third of all policies they encounter are Blue Cross Blue Shield policies, chances are they will be able to give you pretty solid information when it comes to your coverage.

After they verify your coverage they’ll go over your options and what is covered under your policy. This information may include different medications that could be used during treatment, any specialty treatment programs that you may be eligible for, how long you can stay in rehab and any aftercare programs that you may be eligible for.

Once that information has been established they will look for a rehab treatment facility that will go over all your addiction treatment options that are covered BCBS health insurance.

Your health insurance coverage may offer you more options than you may be aware of. You deserve to get the best drug and alcohol treatment you’re entitled to. Get help. Contact us today.