When searching for a substance abuse treatment program for yourself or a loved one, it’s important to understand your insurance options.
One of the most popular insurance providers in the United States is Blue Cross Blue Shield (BCBS). Consisting of 36 independent insurance companies, BCBS covers various behavioral health services, including drug addiction treatment.
What Treatments Does Blue Cross Blue Shield Cover?
Your specific insurance benefits depend on your insurance policy and the state you live in. To learn more about your insurance coverage, call the number on the back of your Blue Cross Blue Shield insurance card, visit the BCBS website, or contact us.
Does Blue Cross Blue Shield Cover Detoxification Programs?
Detox is often the first phase of addiction recovery, and these programs may be covered depending on your plan. During this phase, a team of health care professionals will help you monitor and manage withdrawal symptoms as you get the drug(s) out of your system.
You’ll usually need to attend a detox program if you’ve been abusing a highly addictive drug, such as alcohol, methamphetamine, opioids, or benzodiazepines.
Does Blue Cross Blue Shield Cover Inpatient Drug Or Alcohol Rehab?
BCBS plans may cover inpatient treatment, depending on your health needs and the specifics of your plan.
At an inpatient treatment program, you’ll live at a drug rehab treatment center so you can receive 24/7 monitoring and care. This type of treatment can work well if you have a moderate-to-severe addiction or an addiction alongside other mental health problems (also called dual diagnosis).
Does Blue Cross Blue Shield Cover Outpatient Drug Or Alcohol Rehab?
If you’ve already completed inpatient treatment or you have a milder addiction and a strong support system at home, your doctor may recommend outpatient treatment, which may be covered by a BCBS health plan.
This treatment option allows you to live at home while you attend an addiction treatment program about once or twice a week.
Does Blue Cross Blue Shield Cover Intensive Outpatient Treatment?
Intensive outpatient treatment, or IOP, may be covered by a BCBS. An IOP is similar to regular outpatient treatment, except you’ll attend the program more frequently (at least three days a week).
Does Blue Cross Blue Shield Cover Partial Hospitalization Programs?
BCBS plans may cover a partial hospitalization program (PHP), which is a form of outpatient treatment that you attend on a very regular basis (at least five days a week).
Does Blue Cross Blue Shield Cover Methadone Or Suboxone Treatment?
Does Blue Cross Blue Shield Cover Medication-Assisted Treatment For Alcohol Addiction?
Medication-assisted treatment (MAT) programs for alcohol addiction may be covered by a BCBS plan, depending on your treatment needs and type of plan. MAT programs combine medications like disulfiram with behavioral therapy to treat alcohol use disorder.
Where Are Blue Cross Blue Shield Plans Available?
Blue Cross Blue Shield plans are available in the following states:
- BCBS of Alabama
- BCBS of Arizona
- BCBS of California
- BCBS of Connecticut
- BCBS of Florida
- BCBS of Georgia
- BCBS of Illinois
- BCBS of Iowa
- BCBS of Indiana
- BCBS of Kentucky
- BCBS of Louisiana
- BCBS of Maryland
- BCBS of Massachusetts
- BCBS of Minnesota
- BCBS of North Carolina
- BCBS of New Jersey
- BCBS of New York
- BCBS of Oklahoma
- BCBS of Pennsylvania
- BCBS of Rhode Island
- BCBS of South Carolina
- BCBS of Tennessee
- BCBS of Texas
- BCBS of Virginia
- BCBS of Vermont
- BCBS of Washington
Blue Cross Blue Shield Plans
BCBS offers individual and family health insurance plans in four categories: Bronze, Silver, Gold, and Platinum.
This plan covers about 60% of medical costs. It has a low monthly payment and a high deductible (the amount you must pay out-of-pocket before BCBS will start covering your medical costs).
This plan covers about 70% of medical costs. Compared to the Bronze plan, it has a slightly higher monthly payment and slightly lower deductible.
This plan covers about 80% of medical costs. It has a higher monthly payment and lower deductible than the Bronze and Silver plans.
This plan covers about 90% of medical costs. It has the highest monthly payment and the lowest deductible of all plans. It’s only offered in some states.
In-Network Vs. Out-of-Network
An in-network treatment provider is a treatment facility or health care provider that has contracted with BCBS to accept discounted rates. That means you’ll usually pay less for an in-network provider than an out-of-network provider.
To determine how much you’d have to pay for an out-of-network provider, call the number on the back of your insurance card or visit the BCBS website.
Then, check whether you have a health maintenance organization (HMO) plan, exclusive provider organization (EPO) plan, point-of-service (POS) plan, or preferred provider organization (PPO) plan.
HMO and EPO plans typically don’t cover out-of-network providers, while POS and PPO plans typically do. However, if you have a POS plan, you’ll need a referral from your primary care physician to see specialists, including addiction treatment specialists
If you or someone you love struggles with drug or alcohol addiction, please contact an ARK Behavioral Health specialist to learn about our treatment centers and verify your insurance coverage.