Blue Cross Blue Shield insurance policies will provide a range of benefits that cover addiction treatment. The amount of coverage for different rehab services will depend on the state you reside in, as well as your individual plan.
Overall, Blue Cross Blue Shield companies nationwide cover over 100 million people. While many insurance policies provide a range of benefits that include addiction treatment, the options and programs will vary depending on the state in which you reside in and your individual plan.
Blue Cross Blue Shield will usually cover some of the costs associated with:
- Partial hospitalization
- Outpatient treatment
- Acute inpatient hospitalization
- Residential treatment
Our team here at Footprints to Recovery is here to help you discover the different insurance options that will be available to you once you decide on the type of treatment necessary.
Does Blue Cross Blue Shield Cover Detox Services?
Many Blue Cross Blue Shield companies are contracted with providers across the nation. Most who are insured under Blue Cross Blue Shield will be covered for inpatient professional visits, which does include detox. During the detox phase, the patient’s body will adjust to the lack of drugs or alcohol to which it had once become dependent on.
Withdrawal symptoms will vary depending on the substance used, how long the individual has been using, the average dose taken, and the individual’s physiology.
Depending on the drug use, withdrawal symptoms will include vomiting, nausea, bone and muscle aches, anxiety, depression, paranoia, irritability, tremors, and cravings.
Some of the more severe withdrawal symptoms will include hallucinations, delusions, seizures, and high blood pressure, high body temp, and pulse racing.
Blue Cross Blue Shield Addiction Resources
Due to the growing number of alcohol and drug-related addictions across the U.S., Blue Cross Blue Shield has increased its resources in identifying and helping with solutions for substance abuse issues. More recently, the insurance company has pushed out a prescription pain medication safety program, which helps reduce the risk of drug addictions to opioid painkillers such as Percocet or Vicodin.
Blue Cross Blue Shield’s mobile app One Health can also provide members and their families 24/7 support, education, and tools needed to help recover from substance abuse.
Blue Cross Blue Shield Policy Coverage for Substance Abuse
Blue Cross Blue Shield will offer multiple different plans, depending on the state in which you reside. The more basic layout will include bronze, silver, gold, and platinum plans. The minimum plan – bronze – will typically have the lowest monthly cost but the highest deductible. In contrast, the platinum plan will involve higher monthly fees with more comprehensive coverage and much lower deductibles.
The insurance company will also offer a federal employee program, which will consist of two plans: a basic and a standard option. Although the first option will require policyholders to use preferred providers, the standard option will allow members to choose between non-PPO and preferred providers. However, the insured member may be responsible for the difference between the plan allowance and amount billed if they choose not to use a preferred provider.
Do the Treatment Centers Need to be In-Network?
One more aspect of insurance policies is in regards to having a Health Maintenance Organization (HMO) plan or a Preferred Provider Organization (PPO) plan. Members with HMO plans are only covered at HMO contract facilities. However, members with a PPO plan will have more options regarding the number of providers they have access to.
This type of plan will allow members to visit a facility out of their network, but the expenses will be higher. It is essential to speak with your insurance provider about the specific details regarding the plan’s coverage. Selecting a treatment center will usually depend on what your insurance policy covers and what costs you will be responsible for.
You’ll have to contact your Blue Shield representative to find out the cost of treatments at our facilities. You still may have most, if not the full cost of treatment covered by your Blue Shield policy.
Insurance for Inpatient vs. Outpatient Addiction Treatment
Addiction isn’t something that is treated overnight. Still, with the proper assistance from treatment specialists at recovery centers, you could receive support to start working on sobriety and taking back your life. Whether or not your insurance provider covers inpatient or outpatient programs is vital to know, you’ll want to know which treatment option is best for you beforehand.
The ones who want to get away from friends and love ones who abuse alcohol and drugs will reside at a residential treatment center. This type of inpatient program will provide patients with 24/7 addiction treatment, support, and monitoring.
Most heavy using addicts will benefit from the structure of inpatient treatment programs. For the ones with a mild addiction, a healthy support system, and reliable transportation, and an outpatient rehab program may be best. Outpatient rehab programs allow you to schedule your treatment sessions around school, work, and other personal obligations while still going home at night.
Outpatient treatment programs range in terms of time intensiveness; a standard outpatient treatment program will require a couple of hours of treatment per week, while an intensive outpatient treatment program will include several hours per day of treatment.
Inpatient Rehab Service and Costs
Some approximate coverage options for the insurance companies more popular plans will include:
- Bronze plans- This plan will frequently require the policyholder to meet the deductible for in-network providers. Typically, out-of-network providers will not be covered.
- Silver plans- This plan may require a coinsurance percentage in addition to the plans deductible for services that aren’t in-network. Out-of-network is usually not covered.
- Gold plans- Once the deductible has been paid, there is still sometimes a coinsurance percentage required. Most often, any services out-of-network are not covered.
- Platinum plans- This plan offers varying co-pays or coinsurance percentages for anything that’s in-network. While out-of-network providers could be covered, it will often come with a higher deductible or coinsurance percentage.
In regards to the federal employee program with Blue Cross Blue Shield, outpatient professional treatment care services will differ based on the type of plan, which includes:
Standard option: This will cover roughly fifteen percent of the plan’s allowance.
Basic option: This will typically involve a copayment daily, per facility.
Length of Addiction Treatment Blue Cross and Blue Shield Plans Cover
Not everybody recovers from drug addiction at the same pace, which is why Blue Cross Blue Shield insurance companies offer plans that may consider other factors regarding private addiction treatment. Rather than giving a set time length, like five days, the company will cover some of your stay based on your amount of coverage and deductible.
The ones with additional coverage through their employer may qualify for a more extended stay. Your insurance provider and treatment center will keep your information discreet as a patient privilege.
Specialty Alcohol and Drug Treatment
It is required by The Mental Health Parity and Addiction Equity Act that group healthcare plans and health insurance companies must provide equal coverage for mental health services, including substance abuse treatment, similar to as they do with medical coverage.
The act was created to expand substance abuse and mental health coverage for people across the U.S.
The result becomes many Blue Cross Blue Shield companies can provide members with affordable coverage, which is reflected in the pricing.
For example, to receive extensive treatment at an approved inpatient treatment center can cost patients $250.
Out-of-network treatment centers might cost patients $350 plus a set fee based on the plan allowance. When the member can choose their treatment center, they’ll get the chance to choose from a variety of exclusive centers.
Most high-end luxury treatment centers will have a wide array of amenities which include:
- Holistic treatments
- Elegant dining rooms.
- Designer linens.
- State-of-the-art fitness centers
- Spa treatments
Verifying Coverage and Seeking the Best Treatment
Studies from the Substance Abuse and Mental Health Services Administration state that nearly 22 million U.S. citizens required substance addiction treatment in 2015, but only about 10% had received treatment. At this rate, it should be clear that a majority of Americans are in the same situation as you are.
There are multiple barriers to addiction treatment like cost, but the price shouldn’t keep individuals from getting clean and going back to living a healthy and happy lifestyle.
You can contact your addiction treatment center of choice directly with any payment questions or you can contact your plan administrator to find out what rehab facilities accept your Blue Cross Blue Shield insurance.
Questions to Ask Your Insurance Company
Individuals struggling with substance abuse and are actively seeking professional treatment, the more you understand about what your insurance plan covers, the better.
This information can act as a guide in your search for a rehab treatment facility that is best for you.
Some critical questions to ask your healthcare insurance company include:
- Which facilities are out-of-network vs. in-network?
- Are there limitations on different types of therapy/treatment?
- The length of stay that is covered?
- Which programs does my plan cover?
- Does the current plan cover medications which are used during detox and treatment?
Before You Call
It is incredibly beneficial to have relevant information with you when calling an addiction treatment center. The admissions consultant will ask you multiple questions that surround the subject of substance abuse. When calling, you should have your insurance card in hand so the admissions consultant can verify your plan and benefits through your policy information.
Information that will be helpful includes the specific substances taken along with the length of using, the usual dose is taken, and the method of administering such as snorting or injecting. It is also vital to provide the admissions consultant with info in regards to any co-occurring mental disorders, such as anxiety, depression, schizophrenia, or a personality disorder, as most addiction treatment centers also specialize in treating dual diagnosis.
Get Help Today
At Footprints to Recovery, our team is here to ensure that you are receiving every bit of financial help you are entitled to with your Blue Cross Blue Shield coverage plan. There is no need to prolong your choice to enroll in drug treatment. Footprints to recovery and Blue Cross Blue Shield will work together in making drug rehab treatments available and accessible through your insurance coverage. Our team understands the importance of being a rehab treatment facility that caters to your health condition and your budget simultaneously.
If you or someone you know is contemplating attending our addiction treatment programs but are still unsure if it’s affordable, please contact us today. Our staff will respond to your questions free of charge and give you the answers you seek about your health insurance coverage options for addiction treatment.