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Blue Cross Blue Shield Insurance Coverage for Rehab

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Patient giving insurance card while discussing the insurance coverage for addiction treatment

Navigating the world of insurance benefits can be overwhelming. However, knowing how to use your insurance coverage can greatly reduce the cost of addiction treatment. Companies like Blue Cross Blue Shield provide coverage for several levels of rehab programs.

Drug And Alcohol Rehabs That Accept Blue Cross Blue Shield

More than 22 million Americans suffer from substance use disorders. Many may want to seek help, but financial worries keep them from enrolling in treatment. Luckily, insurance companies like Blue Cross Blue Shield help ensure affordable treatment for its members.

While coverage details vary by plan, Blue Cross Blue Shield provides coverage for a variety of behavioral health services, including treatment for substance abuse.

Does Blue Cross Blue Shield Cover Addiction Treatment?

Yes. Since 2008, insurance companies have been required to offer coverage for behavioral health services at the same level they cover other physical health conditions.

Since 1929, Blue Cross Blue Shield has been one of the best-known insurance providers in the U.S. Blue Cross Blue Shield insures more than 107 million members across all 50 states, Washington D.C., and Puerto Rico. Members benefit from a wide network of providers, including 95 percent of all hospitals, doctors, and specialists across the country.

When it comes to paying for addiction treatment, coverage details differ by plan. Drug and alcohol rehab services covered by Blue Cross Blue Shield may have specific deductible, copay, and coinsurance requirements. Members should contact a Blue Cross Blue Shield representative to verify their exact level of coverage.

Addiction Treatment Services Covered by Blue Cross Blue Shield

Experts agree there is no one right way to seek treatment, as every person’s situation is unique. Because of this, insurance companies like Blue Cross Blue Shield provide coverage for several levels of rehab programs, including inpatient (residential) and outpatient treatment.

Blue Cross Blue Shield plans may also provide coverage for more specific services, including:

  • medical detoxification
  • partial hospitalization programs (PHPs)
  • intensive outpatient programs (IOPs)
  • prescription medication management
  • individual, group, and family therapy
  • mental health assessments
  • community treatment and support

Some Blue Cross Blue Shield plans may require pre-authorization or a medical referral before they will cover drug or alcohol addiction treatment. However, if you attend treatment at an in-network rehab facility, you may be able to bypass these requirements.

Medically Assisted Detox

The first step of addiction treatment is detoxification. When a person is physically dependent on a substance like alcohol, their body needs the drug in order to function. If they stop drinking abruptly, they could experience dangerous withdrawal symptoms.

These symptoms can include shakiness, headache, nausea, and hallucinations. Drugs like alcohol and benzodiazepines can even cause life-threatening detox symptoms like seizures. Although these symptoms can be scary, they are the body’s way of naturally detoxing from the drug.

Because withdrawal can be so uncomfortable from opiates and prescription drugs, many people relapse (return to the drug) to cure the detox symptoms. This can keep a person stuck in a pattern of dangerous drug-related behaviors.

Medical detox programs exist in order to help people through this initial phase of sobriety. Emotional support and medication-assisted treatment (MAT) is provided to reduce the symptoms of acute withdrawal. Once a person completes detoxification, they are in a much steadier place to begin recovery.

Many Blue Cross Blue Shield plans provide coverage for medical detoxification. To avoid any unexpected costs, it’s important to verify your coverage details before enrolling in a detox program.

Inpatient Rehab Programs

Inpatient treatment programs are residential and provide temporary living accommodations for patients. By receiving treatment on-site, patients are provided a safe haven where they can focus on maintaining their sobriety.

Inpatient rehab programs offer traditional therapies like individual counseling, as well as creative arts and nature-based therapies.

The daily structure of inpatient programs will often include motivational interviewing, therapeutic groups, and 12-Step support meetings. In this type of residential setting, patients often build a network of peer support that lasts long after the program ends.

Depending on your plan, your Blue Cross Blue Shield benefits may cover all or a portion of your treatment stay. If you find an inpatient program that is in-network, it could save you even more in the long run.

Outpatient Treatment

Outpatient treatment is a great option for people who need addiction treatment on a flexible schedule. These programs may provide treatment in full-day or half-day sessions, and often include addiction education classes and recovery speakers.

The main difference between inpatient and outpatient is that participants don’t stay overnight. Intensive outpatient programs are scheduled two to five days per week, and partial hospitalization programs are usually five full days per week.

Outpatient programs may be a better fit for those who have recently completed inpatient treatment and are looking for continued care. People who require detoxification or 24-hour support may benefit from starting at an inpatient facility.

Blue Cross Blue Shield will usually provide coverage for each level of outpatient treatment. Depending on your plan, your benefits may cover the cost of drug screenings, medication-assisted treatment, and aftercare therapy.

Prescription Drugs and Medication-Assisted Treatment (MAT)

Recovering from addiction is a lifelong process. For many people, getting started is the toughest part. Active addiction and early sobriety can have significant impacts on a person’s mental and emotional wellness. For this reason, many people benefit from using medication-assisted treatment (MAT) to help stabilize their mood.

MAT can also be used to reduce withdrawal symptoms. People who suffer from opioid dependence may be prescribed buprenorphine-based MAT, which relieves withdrawal symptoms and reduces drug cravings.

Additionally, MAT can be used to treat people with dual diagnosis. This happens when a person who abuses substances also suffers from a co-occurring mental health condition. Nearly 8 million people in the U.S. suffer from dual diagnosis. People with co-occurring disorders, such as depression and opioid use disorder, may find that MAT helps them feel more well-adjusted.

Because of the Mental Health Parity and Addiction Equity Act, insurance providers are required to provide coverage for these medications. Check with a Blue Cross Blue Shield to verify your plan’s exact level of coverage.

Questions to Ask Blue Cross Blue Shield about Addiction Treatment

Verifying insurance benefits and tracking your deductible can be a challenge. However, understanding your insurance is an important step in securing the help that you or your loved one deserve.

Before you call Blue Cross Blue Shield to verify your plan, prepare a list of questions to have on hand. This way, you are able to get a solid understanding of how best to utilize your coverage.

You may want to ask a Blue Cross Blue Shield representative questions such as:

  • Does my plan require pre-authorization?
  • What is my plan’s deductible?
  • Do my benefits allow for inpatient addiction treatment?
  • Which rehab centers are in Blue Cross Blue Shield’s network?
  • Does my primary care physician need to refer me to treatment?
  • Do my benefits cover medication-assisted treatment?
  • What copays will I be responsible for?

How to Find a Drug and Alcohol Rehab That Accepts Blue Cross Blue Shield

For many people, getting treatment is an essential part of their recovery process. While finding the right rehab center can be stressful, knowing how to use your insurance benefits can empower you to feel much more comfortable about the treatment.

To learn more about drug and alcohol rehabs that accept Blue Cross Blue Shield, reach out to one of our treatment specialists today.