Blue Cross Blue Shield (BCBS) is a national association of 35 independent, community-based and locally operated companies that provide health insurance in the United States. BCBS has tens of millions of members and offers coverage in all 50 states.
If you have coverage through BCBS, the name of your insurance company will vary depending on where you live. For example, the BCBS providers in California are Anthem Blue Cross and Blue Shield of California. In Alabama, coverage is provided through Blue Cross and Blue Shield of Alabama, a non-profit, private company.
The BCBS network is vast, with more than 1.7 million doctors and hospitals—more than any other provider in the nation. BCBS offers a wide range of policies and insurance coverage for its members.
Does Blue Cross Blue Shield Cover Addiction Treatment?
Yes, BCBS insurance policies generally cover addiction treatment services, and many rehab facilities accept Blue Cross Blue Shield plans.
Addiction treatment is considered an “essential health benefit” under the provisions of the Affordable Care Act (ACA). That means all insurance companies—including Blue Cross Blue Shield—must provide some coverage for addiction treatment services.
This is true whether you purchased a BCBS plan on your own, signed up through the federal marketplace (healthcare.gov), or are on a group plan through your employer.
In general, BCBS covers a range of addiction treatment services, which may include:
- Addiction screening and referral
- Medically supervised detoxification
- Inpatient residential programs
- Partial hospitalization (day treatment) programs
- Intensive outpatient programs
- Outpatient individual therapy or group therapy
- Medication-assisted treatment (MAT)
Coverage for these services varies from state to state and plan to plan. You should contact BCBS directly to find out which services are covered, how much is covered, and what you are responsible for paying out of pocket.
How to Check Your Insurance Benefits
Adelante Recovery Center accepts BCBS plans. Our administrative team can help you make sense of your benefits, but it’s best to contact your insurance provider directly.
Log in to your account online to check your benefits or call the number on the back of your insurance card.
Here are some questions to ask when you call:
- Do you cover substance abuse assessment?
- Do you cover detox services? How many days?
- Do you cover outpatient rehab?
- Do you cover inpatient rehab?
- How many days of rehab do you cover?
- Which programs in my area accept Blue Cross Blue Shield?
Make sure to write down the name of the person you speak with and the details of your conversation.
Finding out about your BCBS policy coverage before you enter a rehab program will give you greater peace of mind, allowing you to focus completely on treatment.
Does BCBS Cover Mental Health Treatment?
Millions of people struggle with mental health issues like depression and anxiety, and it’s common for mental illness and substance abuse issues to occur together. This is sometimes called “dual diagnosis.”
It’s critical to treat both conditions at the same time, since substance abuse can worsen mental health issues, and vice versa.
Insurance companies are required by law to cover mental health services, just as they would other health conditions.
Your BCBS plan should cover both mental health services and treatment for substance use disorders (SUDs). Make sure to look for an addiction treatment center that is qualified to provide mental health care.
How Insurance Works for Addiction Treatment Centers
Most BCBS plans cover substance abuse treatment in both residential inpatient programs and outpatient programs. But some plans require precertification or “pre-admission” for residential treatment services. Precertification means a doctor has assessed your condition and recommends inpatient treatment for you.
Your policy might only cover a certain number of days at a residential treatment center or a certain number of outpatient sessions. Find out exactly what your policy covers so you can plan for out-of-pocket costs.
Do Treatment Centers Need to Be In-Network?
HMO plans are usually more restrictive than PPO plans. Your coverage is usually limited to specific addiction treatment centers within the network. If you choose an out-of-network treatment center, you may be responsible for the total cost of treatment.
PPO plans typically offer more flexibility. You may even be able to get care with an out-of-network provider, but your costs will likely be higher than if you used an in-network provider.
If you’re having trouble figuring out what kind of plan you have or understanding your benefits, contact us at Adelante Recovery Center. Our administrative team will help you determine what’s covered.
What If BCBS Doesn’t Cover the Total Cost of Treatment?
Even if your plan doesn’t cover everything, don’t let it stop you from getting help. There are alternative ways to finance your treatment. Here are some options:
- Payment plans that allow you to pay in monthly installments
- Sliding scale fees that allow you to pay what you can, based on your income level
- Grants or scholarships through the Substance Abuse and Mental Health Services Administration (SAMHSA) or participating rehab centers
- Healthcare loan or credit card
- Savings, or a money loan or gift from trusted family members
Get Help Now
Adelante Recovery Center offers comprehensive drug and alcohol rehab programs at our Orange County drug treatment center. We create individualized therapy programs for our clients. Individual counseling, group therapy, and family therapy form the core of our inpatient residential programs.
If you’re concerned about a loved one or you’re ready to begin a treatment program, contact our administrative team to find out about coverage for rehab with Blue Cross Blue Shield. Help is just a phone call away.