bcbs coverage for rehab

Blue Cross Blue Shield rehab coverage insurance policies provide a variety of benefits that cover substance addiction treatment. The amount included for different rehab services depends on the state you reside in, as well as your plan.

Overall, Blue Cross Blue Shield companies will cover over 100 million people across the nation. While numerous insurance policies provide a range of benefits that include substance addiction treatment, the options and programs will vary depending on which plan you have.

Blue Cross Blue Shield ordinarily covers costs associated with:

Our team here at Harmony Ridge can help in sorting out the different insurance options available once the type of treatment is decided.

Does Blue Cross Blue Shield Cover Detoxification Services?

Many Blue Cross Blue Shield has contracts with providers across the U.S. Most people insured with Blue Cross Blue Shield rehab coverage allows coverage for inpatient treatment services, which includes medical detoxification. During the detoxification process, the patient’s body starts to adjust to the lack of substances in which it had previously become dependent on.

Withdrawal symptoms will fluctuate depending on the substance used, how long the person has been using, the standard dose taken, and the person’s physiology. 

Depending on the substance use, withdrawal symptoms may include:

  • Vomiting
  • Nausea
  • Bone and muscle aches 
  • Anxiety
  • Depression 
  • Paranoia
  • Irritability 
  • Tremors 
  • Cravings

Some severe withdrawal symptoms include:

  • Hallucinations
  • Delusions
  • Seizures 
  • High blood pressure 
  • High body temp 
  • Racing pulse

Blue Cross Blue Shield Addiction Resources

Because of the growing number of drug and alcohol addictions across the nation, Blue Cross Blue Shield has expanded its resources. This initiative helps in identifying and assisting with substance addiction solutions. 

As of lately, many insurance companies have started prescription pain medication safety programs. This was done in an effort to help reduce the risk of addictions to opioid painkillers like Vicodin or Percocet.

BCBS’s mobile app One Health is another method members and their families receive round the clock support, education, and tools needed to recover from substance abuse successfully.

Blue Cross Blue Shield Policy Coverage for Substance Addiction

Blue Cross Blue Shield offers many different plans, depending on the state in which you’re living. The more basic insurance plans are bronze, silver, gold, and platinum programs. The minimum program, bronze, usually has the lowest monthly cost and the highest deductible amount. The difference is, the platinum plan has higher monthly fees while including more comprehensive coverage at a much lower deductible.

Blue Cross Blue Shield also offers a federal employee program, which consists of two plans: a standard and basic plan option. Although the basic option requires policyholders to use their preferred providers, the standard option allows members to choose between preferred providers and non-PPO. But, the member could be held accountable for the difference in the plan allowance and amount billed if they use their preferred provider.

Must the Addiction Treatment Center be In-Network?

Another thing to understand is, does the insurance policy includes a Health Maintenance Organization (HMO) plan or a Preferred Provider Organization (PPO) plan. People with HMO plans are solely covered at HMO contract facilities only. But, members with a PPO plan will have access to more options for providers they can use. 

PPO plans allow members to visit out of network facilities, but the cost is higher. That is why it is vital to speak with your insurance provider about the particular details regarding your plan’s coverage. Selecting a treatment center usually depends on precisely what your insurance policy covers and what costs you’ll pay out of pocket. 

Members must contact their Blue Cross Blue Shield rehab coverage representative to find out the cost of addiction treatment. Members usually have most, if not the full cost of treatment covered by their Blue Cross Blue Shield policy.

Coverage for Mental Health Treatment

Regarding health insurance coverage, the Blue Cross Blue Shield plan you choose will sequentially determine the out of pocket cost you will pay for treatment received. The cost will vary depending on several factors. 

  • Which type of treatments are required? 
  • What is the length of rehab stay? 
  • Will you be prescribed any medication during and after treatment?

Blue Cross Blue Shield’s mental health coverage will be determined by which type of treatment is required. The majority of the time, the policy will cover the full cost of therapy and hospital stays for mental health disorder treatment. Policyholders will have to pay the copayment for both inpatient and outpatient addiction treatment services.  

Coverage for Dual-Diagnosis Treatment 

Substance disorders often co-occur with mental health disorders. Here at Harmony Ridge Recovery Center, have dual-diagnosis programs that treat both conditions at the same time. 

When being admitted into our facility, remember that although these conditions are being treated together, the cost of this treatment type may be higher than being treated for a mental health disorder alone. 

The reason is because of the length and extensiveness of the treatments patients undergo, along with the kinds of medication you might be prescribed while in our treatment center.

These are things Harmony Ridge Recovery Center encourages you to consider while looking into all options. While your Blue Cross Blue Shield plan might cover the cost of mental health disorder treatment, it is not guaranteed that the policy will also cover substance addiction treatment. 

Because of this, our staff evaluates and discusses what the total out of pocket cost could be if you are determined to need a dual diagnosis treatment program.

Insurance for Inpatient vs. Outpatient Addiction Treatment

Addiction isn’t a disease that can be treated overnight. However, with the proper form of addiction treatment and with help from addiction treatment specialists, it is possible to start working on a renewed lifestyle of sobriety. 

Whether or not your insurance provider covers inpatient or outpatient programs is very important to know. You’ll want to understand which treatment option works best for you.

For people wanting to get away from friends and family who abuse drugs and alcohol, will choose to live at a residential treatment center. This kind of inpatient treatment program will provide patients with round the clock monitoring, treatment, and support. 

Most people who used heavily during their substance abuse will prefer the structure of an inpatient treatment program. For people with a mild form of addiction, and have a healthy support system and reliable transportation, an outpatient rehab program might be a better fit. This is because outpatient rehab programs allow people to schedule their treatment sessions around their day to day responsibilities. 

The length of an outpatient treatment program will vary. A standard outpatient treatment program requires a few hours of treatment per day, a few times per week. An intensive outpatient treatment program requires several hours per day of addiction treatment. 

Inpatient Addiction Treatment Services and Costs

Some coverage options for insurance companies plans will usually include:

  • Bronze plans: This plan will usually require the policyholder only to use in-network providers. Typically, out-of-network providers are not covered.
  • Silver plans: This plan requires a coinsurance percentage and the plans deductible for services that are not in-network. Out-of-network services are usually not covered. 
  • Gold plans: Once the deductible has been met, often, there is a coinsurance percentage also required. Frequently, any services out-of-network will not be covered.
  • Platinum plans: This plan offers different copayments or coinsurance percentages for treatments that are in-network. While out-of-network providers might be covered, it usually comes with a higher deductible or coinsurance percentage.

Length of Addiction Treatment Blue Cross and Blue Shield Plans Cover

Everybody recovers from drug and alcohol addiction at a different pace, which is why Blue Cross Blue Shield insurance companies offer plans that cover addiction treatment. Rather than giving an amount of time covered for, the insurance company will cover some of the treatment based on the amount of coverage and deductible. 

People with additional coverage through their employer could qualify for a greater length of treatment. The insurance provider and treatment center must keep all information discreet as a patient privilege.

Specialty Drug and Alcohol Addiction Treatment

It is required by The Mental Health Parity and Addiction Equity Act that group healthcare plans and health insurance companies are required to provide equal amounts of coverage for mental health services. This includes substance abuse treatment like they do with medical coverage.

The act was created to increase substance abuse and mental health coverage for people across the nation that need help. 

The result was that many Blue Cross Blue Shield companies could provide members with affordable coverage, which is indicated in the pricing. 

Most luxury addiction treatment centers will offer amenities which include:

  • Designer linens
  • Elegant dining rooms
  • Holistic treatments
  • Spa treatments
  • State-of-the-art fitness centers

Using Blue Cross Blue Shield Rehab Coverage

Generally, Blue Cross Blue Shield plans will cover addiction treatment, at least partially, but the specifics are based on the personal policy. Most programs include treatment for medical detox if determined to be necessary. 

This would most likely be the case for those suffering from benzodiazepine addiction, alcohol addiction, and opiate addiction. Detoxing from these substances can be dangerous and should always be monitored by medical professionals.

The type of treatment center you choose and the specific professionals who treat your plan will determine you. If you have an HMO (Health Maintenance Organization) plan, you are only covered at HMO-contracted facilities. If you have a PPO (Preferred Provider Organization) plan, you can see a list of providers and all out-of-network providers at a higher rate. 

As with a majority of medical issues, only a portion of detox or addiction treatment is covered by insurance. It’s essential to speak with Blue Cross Blue Shield to determine your exact level of coverage. Learn what that means in terms of the specific dollar amount you will pay out of pocket.

The options available to you under Blue Cross Blue Shield are dependent upon your situation and the coverage you have. However, the Blue Cross Blue Shield network is quite extensive, meaning that those who have this particular insurance will have little trouble finding a center for treatment. The fastest way to go about finding a center for treatment is by using the Blue Cross and Blue Shield Association’s website to search locally for providers near you.

Information to Have Available When Calling

It is imperative to have relevant information with you when contacting an addiction treatment center. 

The admissions counselor will ask you various questions that surround the person suffering from substance abuse. So, when reaching out, make sure your insurance card is in hand so the admissions consultant can verify the plan specifics and benefits of your policy.

Helpful information includes the exact substances used, the length of use, the usual dose used, and the administering method, like snorting or injecting. It is also imperative to provide the admissions consultant with information about any co-occurring mental disorders, like depression, anxiety, schizophrenia, or a personality disorder. The reason being is because most addiction treatment centers also specialize in treating co-occurring disorders and dual diagnosis. 

Get Help Today

At Harmony Ridge Recovery Center, our team is here to ensure that you receive every bit of financial help you are entitled to with your Blue Cross Blue Shield coverage plan. Do not hesitate any longer. 

Harmony Ridge Recovery Center is in-network with Blue Cross Blue Shield. Therefore, we will work together to make addiction treatment coverage accessible and available. Our team recognizes the importance of catering to the patient’s health status and budget simultaneously.

If you or a loved one requires an addiction treatment program, but are still unsure if it’s affordable, contact us today for a free consultation. Our staff will answer any, and all your questions. get you the answers you seek about your Blue Cross Blue Shield rehab coverage options.