Blue Cross Blue Shield (BCBS) health insurance provides coverage for mental and behavioral health services, including treatment for addiction and substance use disorders. If you have BCBS and need help recovering from drug and alcohol dependence, your insurance plan may cover some or all treatment costs.
Continue reading to learn more about addiction treatment coverage under BCBS, and how to confirm whether your plan can help you pay for treatment.
About Blue Cross Blue Shield Insurance
BCBS has been providing healthcare coverage to Americans in all 50 states since 1929. With more than 110 million members and more than 1.7 million doctors and hospitals contracted with its companies, BCBS is one of the largest insurance providers in the United States. BCBS owns 35 independent and locally operated health insurance companies, including Blue Cross Blue Shield of Arizona and Anthem Blue Cross in California.
Many drug and alcohol rehab centers accept BCBS health insurance, making it relatively easy for you to find high-quality addiction treatment if you have a BCBS plan. However, your coverage level and benefits will depend on the type of plan, so it helps to verify your benefits before seeking treatment.
Which Addiction Treatment Services Are Covered By BCBS?
BCBS provides coverage for services including medical detox, residential rehab, and outpatient rehab. The services and fees covered will depend on your individual plan.
Also known as withdrawal management under BCBS, medical detox helps patients safely withdraw from drugs and alcohol while supervised and cared for by trained medical professionals. Medical detox typically involves evaluating the patient, stabilizing the patient, and preparing them for entry into a drug and alcohol rehab program.
Every addiction treatment center has its own protocols and treatment methods for medical detox. Many recovery centers use medications to reduce withdrawal symptoms and make patients feel more comfortable as they go through withdrawal. Medications can also help reduce the risk of complications during withdrawal, such as seizures, heart failure, and dehydration.
Medical detox treats physical dependence on drugs and alcohol but does not treat addiction, which is psychological. Heroin, painkillers, alcohol, and benzodiazepines are examples of drugs that cause physical dependence. After medical detox, many patients transition into a drug and alcohol rehab program to receive behavioral therapy that helps them recover from addiction.
Residential rehab is a live-in treatment program where patients stay at the drug and alcohol rehab facility for anywhere between 30 days and one year. This home-like rehab program is ideal for patients who have been struggling with addiction for several months or years, and need help adjusting to a healthier, sober lifestyle without drugs and alcohol. Residential rehab is highly structured and gives patients access to 24-hour support in the form of counseling and therapy.
Patients who come from unstable or dangerous homes can benefit from recovering in a safe, quiet, and peaceful residential rehab environment. Residential rehab prevents patients from having access to drugs and alcohol and helps them develop productive daily routines complete with new hobbies and interests that replace drug use. Residential rehab aims to help patients change harmful behaviors and beliefs related to addiction and guide them toward achieving more fulfilling lifestyles and long-term sobriety.
BCBS provides coverage for residential rehab, but the number of treatment days covered will vary from one patient to the next based on their health plan.
Inpatient rehab provides patients with 24-hour medical treatment in a hospital or clinic where they can be closely monitored and supervised. Treatment programs usually last for several days or weeks as opposed to several months with residential rehab. Inpatient rehab is ideal for patients with co-occurring medical conditions requiring intensive care, such as severe mental health disorders or an eating disorder.
Patients recovering from addiction to stimulants including crack, cocaine, and methamphetamine can often benefit from inpatient rehab, as these substances produce withdrawal symptoms including extreme agitation, aggression, and paranoia.
Many of these patients are given medications that help sedate and stabilize them so they do not hurt themselves or others while in recovery. Inpatient rehab can also benefit patients recovering from severe alcohol use disorder, given how these individuals often face a high risk of complications including grand mal seizures.
Partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), and standard outpatient programs are all types of outpatient rehab programs that provide treatment and counseling for patients who are continuing to live at home.
PHPs offer the highest level of outpatient care and take place four to six hours a day on at least five days a week, according to the National Institute on Drug Abuse. Also known as day treatment, PHPs are usually ideal for patients who need several hours of therapy a day. Still, they can live safely at home without requiring 24-hour supervision or medical treatment. Patients in a PHP receive a variety of behavioral therapies that address harmful behaviors and co-occurring disorders that may be driving their addiction.
IOPs are the next lower level of care after a PHP and take place at least three hours a day on two to five days a week. IOPs generally last for 12 weeks and focus more on helping patients transition back into their communities and families after recovering from drug dependence. According to a 2014 study published in Psychiatric Services, an estimated 12% of patients in recovery from addiction join IOPs.
Standard outpatient programs offer the lowest level of care and usually take place a few hours a day on one or two days a week. Standard outpatient rehab is ideal for patients who are highly motivated to stay sober and resume work or school, and who have also learned essential skills for managing triggers and preventing relapse.
Therapies in standard outpatient rehab usually include 12-step support group meetings, medication management services, family behavior therapy, and relapse prevention training—all of which can continue to help patients rebuild their lives as they integrate fully back into society.
Sober Living Home
BCBS may cover some or all costs associated with sober living homes. Sober living homes provide patients with temporary housing in a facility where all residents are in recovery from addiction and need help adjusting to independent living.
Sober living homes are ideal for patients in an outpatient recovery program who need constant access to a strong support system while adjusting to a sober, independent lifestyle. These facilities are also ideal for patients who were previously homeless, or who came from unstable homes where drugs and alcohol were readily available.
Many sober living homes require residents to abide by a certain set of rules, such as being home before curfew and attending 12-step support group meetings at least three times a week. Many of these facilities also provide transportation to and from nearby drug and alcohol rehab centers.
Medication-Assisted Treatment (MAT)
MAT is a whole-patient approach to substance use disorders that combines medications with counseling and behavioral therapies. MAT is available only to those in recovery from opioid addiction and alcohol addiction, as there are no medications approved by the FDA for the treatment of other substance use disorders under MAT.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT is shown to improve retention in treatment and patient survival and can increase patients’ ability to find and maintain employment. MAT can also decrease illicit opioid use and criminal activity among patients and improve birth outcomes among pregnant women who suffer from addiction.
BCBS may cover the cost of MAT for patients who are eligible to receive this treatment.
How Can I Check My Coverage and Benefits With BCBS?
BCBS provides several ways to confirm your coverage and benefits included with your health plan.
First, go to your local BCBS company’s website. If you do not know your local BCBS website, visit the BCBS Member Services page and enter the Identification Number printed on your member ID card. Then, follow the instructions to view your plan details and benefits. You may also call the toll-free number on your member ID card to contact BCBS directly and talk to a representative about your benefits.
Another way to check whether addiction treatment is covered by your BCBS plan is to consult directly with your desired addiction treatment provider. Many drug and alcohol rehab centers will perform a free insurance benefits check for you, then discuss your available treatment options based on your coverage and benefits.
America’s Rehab Campuses accepts BCBS and can quickly and easily verify your insurance benefits and coverage so you begin to explore your addiction treatment options. Contact America’s Rehab Campuses at 833-272-7342 to verify your insurance coverage.
What If BCBS Doesn’t Cover My Addiction Treatment Program?
If your BCBS plan covers only a portion of the addiction treatment services you need or doesn’t provide coverage at all, most addiction treatment centers offer multiple financing options that can help you get treatment. CareCredit, monthly payment plans, and sliding scale fees that adjust the cost of treatment based on your income are some of the many financing plans available at drug and alcohol rehab centers.
Contact America’s Rehab Campuses at 833-272-7342 to speak with one of their healthcare professional and learn more about their financing options available to you.