Does Blue Cross Blue Shield Cover Drug Rehab? 2019 BCBS Rehab Coverage Guide

Does Blue Cross Blue Shield Cover Drug Rehab? 2019 BCBS Rehab Coverage Guide 2019-07-10T17:06:30+00:00

Does Blue Cross Blue Shield Cover Drug Rehab? If you have Blue Cross Blue Shield rehab insurance and if you’re wondering if it covers addiction treatment then the answer is generally yes. How much you will have to pay out of pocket for rehab treatment depends on your policy type, home state, your deductible and max out of pocket fees and how much the rehab treatment center’s pricing model.

Blue Cross Blue Shield Rehab Coverage

blue cross blue shield rehab coverage logoThe Blue System is a national network comprised of 36 insurance companies that are owned by the Blue Cross Blue Shield Association. The Blue Care system covers over 105 million people nationwide. About one half of all federal employees have a BCBS policy. This is known as the Federal Employee Program®.

Generally, Blue Cross Blue Shield offers four different types of insurance plans. They are the Bronze, Silver, Gold and Platinum plans.

  • BCBS Bronze Plan: This insurance offers the lowest monthly premium and highest out of pocket expense. It is recommended for people who don’t visit the doctor very often. Bronze covers 60% of medical costs.
  • BCBS Silver Plan: This plan features higher monthly premiums and lower max out of pocket expense. It is recommended for people who visit their doctor somewhat more frequently. Silver covers 70% of medical costs.
  • BCBS Gold Plan: Has a higher monthly premium than the Silver Plan but a lower max out of pocket. It is recommended for people who frequently visit the doctor. Gold covers 80% of medical costs.
  • BCBS Platinum Plan: This plan comes with the highest monthly premium and lowest copay and coinsurance. Platinum covers 90% of medical costs. It is not offered in every state.

Using Blue Cross Blue Shield for Drug Rehabilitation

In general, Blue Cross Blue Shield insurance policies pay for substance abuse treatment.  As mentioned above, how much you will have to pay out of pocket depends on several factors as mentioned above. Your BCBS policy should pay for detoxification treatment if it’s deemed to be necessary. If you have any substance, such as alcohol, prescription or illicit drugs when you enter treatment, then detox may be necessary. What comes next is inpatient or outpatient treatment. Which type of treatment is ideal for an individual depends on the severity of that person’s addiction. Both, inpatient and outpatient treatment should be covered by most BCBS plans.

  • BCBS PPO Addiction Coverage

If you have a PPO policy then you have a broader array of options. Most addiction treatment centers accept Blue Cross Blue Shield PPO policies. It’s generally easier to find an open bed if you have a PPO policy. Oftentimes, you could be placed in treatment the same day. However, there is no agreed upon price between a treatment center and Blue Cross Blue Shield. Treatment centers bill BCBS for services rendered. BCBS will pay in full or a portion of treatment costs. The treatment center may bill you the difference that is not covered by your insurance company. This is in addition to your copay and coinsurance.

  • BCBS HMO Addiction Coverage

A lot, if not most drug and alcohol treatment facilities do not accept PPO policies by Blue Cross Blue shield. Rehab centers that take HMO plans have a contract with BCBS and they must follow their fee schedule. Generally, they charge less than treatment facilities that only accept PPO policies. There are no last minute surprises. However, they may skimp on certain services or they may not feature as many amenities as those that take PPOs. That’s not to say that PPO approved centers are better than HMO approved centers. It may come down to one center offering a private room vs a shared room, or holistic treatment, experiential therapy, yoga, beachfront property, acupuncture etc.

Blue Cross Blue Shield Approved Rehab Centers – How to Find the One

Whether you have a PPO or HMO policy it is important to make the right selection. If you have HMO and would like to go to a treatment center on the beach that offers top of the line amenities and have your own private room then it might be challenging to find one. It is possible if you know where to look. It’s important to find a trustworthy treatment center that is accredited and has a positive track record. You can search the internet, which could take hours, and you may end up disappointed. Or, you can call us and we’ll verify your insurance policy and match you with the right rehab treatment center for you. We will do all the legwork for you and match you with the right rehab center for your situation. There is no cost to use our service and no obligation to commit.


Next article: Blue Cross Blue Shield Substance Abuse Programs

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