If you are visiting this page, odds are you are struggling from a substance use disorder. We want you to know that is okay, in fact being here means you’ve started on the road to recovery. Recovery is a lifelong journey, and we’re glad you are on it. However, more stress in your life isn’t always a good thing, and sometimes things that are supposed to de-stress us bring more anxiety. Insurance is one of those things. However, you don’t need to worry. We at Northbound Treatment have a team who is always updating the tricky world of insurance, so your recovery journey goes swiftly and smoothly.
Blue Cross Blue Shield Insurance for Drug and Alcohol Treatment
Blue Cross Blue Shield is one of the biggest insurance companies nationwide, covering over 105 million people. While Blue Cross Blue Shield will most likely cover portions of acute inpatient, outpatient, residential/detox, and partial hospitalization; the amount it covers and the specifics vary depending on your plan and location. Our treatment specialists and insurance team are always available, the right time to get back on the track of recovery is always right now!
Since Blue Cross Blue Shield is so large, covering almost 1 in 3 people, working with 96 percent of hospitals, 92 percent of healthcare providers, and being accepted in all 50 states; you are most likely going to find a treatment center which BCBS covers. Having all these options enables patients to be able to choose facilities of their choice, however understanding the specifics of BCBS’s policy plans is imperative to know how you’ll pursue treatment. Before we get into the various policy plans, let’s look at BCBS’s addiction prevention resources.
Addiction Prevention Tools With Blue Cross Blue Shield
In order to combat the growing amount of patients struggling with a substance use disorder, Blue Cross Blue Shield has rolled out OneHealth. This program is designed to keep a closer watch on prescription drug abuse like opioids and Vicodin. OneHealth is offered for patients and families and is available for contact 24/7.
Policy Coverage for Substance Abuse with Your Policy
Blue Cross Blue Shield has four policy tiers. The four tiers are bronze, silver, gold, and platinum. A brief summary is below.
- Bronze: This level covers around 60 percent of medical costs, with a low monthly payment and a high deductible.
- Silver: This level covers around 70 percent of medical costs, with a slightly higher monthly payment and a lower deductible.
- Gold: This level covers around 80 percent of medical costs, with a higher monthly payment and low deductible.
- Platinum: This level covers around 90 of medical costs, with the highest monthly payment and the lowest deductible.
Something else to note is that federal employees get two options for plans. The Federal Employee Program consists of a Basic Plan and a Standard Plan. The only difference is the Basic Plan is your PPO, only. While the Standard Plan offers both PPO and Non-PPO.
How Policies Work For Treatment Centers
At some level, Blue Cross Blue Shield is accepted by most facilities. However, the level of care and treatment will be decided by your state and the specific policy. Most places will accept medical detox. This would most likely be the case for those suffering from benzodiazepine addiction, alcohol addiction, and opiate addiction. However, it is imperative that you know your plan, the specifics according to your state, and what kind of treatment you need. Contacting Blue Cross Blue Shield directly may not yield the best results, either. This is because they base their recommendations off past experiences from real clients who have gotten their treatment covered by insurance.
Does it Need to be in Network?
The short answer is “no,” however if you are looking to pursue treatment that is not within Blue Cross Blue Shield’s network, you may be looking at a ton of extra money. One aspect that needs to be addressed is the difference between HMO and PPO. An HMO is a Health maintenance organization. With this plan, you will only be covered at HMO-contracted facilities. On the other hand PPO, which stands for Preferred Provider Organization, lets you choose from a wider range of preferred providers. This is where you have the ability to go out of network, however, this will most likely result in you having to pay more money out of pocket.
About Coverage for Detoxification
Individuals who are seeking treatment for a drug or alcohol addiction will most-likely have to first go through a medical detox. This is usually an inpatient process, where the patient will flush all the toxins from their body. This process is usually very difficult due to the effects of withdrawal, and depending on the severity of the addiction, can be dangerous. This is why it is so important to pursue medical detox with a treatment facility of professionals.
Again, most detox facilities will be covered, at least in part, by your Blue Cross Blue Shield policy. The lengths at which it is covered depend on your plan and state. HMO coverage is only covered by HMO-contracted facilities, while PPO gives more freedom for choosing a preferred provider. However, going out of network with a PPO plan will result in the client having to pay more money out-of-pocket.
While Blue Cross Blue Shield does offer more flexibility than other insurance providers, it is imperative that you know how much is covered and which treatment plan you are under. For this reason it is recommended you get in contact with your service provider, or contact us at NorthBound Treatment for help navigating your plan.
Covers Inpatient Insurance
Inpatient insurance functions just like any other aspect of Blue Cross Blue Shield, most facilities are covered, but it all depends on your specific plan and location. Below we have the relative costs of an inpatient rehabilitation experience.
Costs and Services at Inpatient
- Bronze: Carry the minimum deductible for in-network providers. Any programs out-of-network are generally not covered.
- Silver: Usually a coinsurance percentage in addition to the plan’s deductible for in-network. Out-of-network is generally not covered.
- Gold: Requires a coinsurance percentage (usually smaller than that of silver plans), as well as the deductible. Out-of-network is generally not covered.
- Platinum: In-network services will have either a co-pay per day (with a maximum amount) or a co-insurance percentage. Out-of-network is sometimes covered; however, it comes with a higher coinsurance percentage in addition to the deductible.
Coverage for Mental Health Treatment
If you or a loved one are suffering from a mental illness, it is important to know that this too may also be covered by Blue Cross Blue Shield. Odds are, if you are struggling with substance abuse you are also familiar with mental illness. This is not to chastise anyone, instead, understanding the unfortunate connection between mental health and substance abuse can help people suffering from both.
When a substance abuse and mental illness are happening at the same time, instead of being two separate disorder; they intertwine and strengthen one another. This is what is known as a dual diagnosis, or co-occurring disorder. In order to treat one you have to treat both.
Blue Cross Blue Shield insurance plans should cover the same amount they do for mental health, as they do physical health. This means that whatever is covered physically is also covered mentally.
Helping You Understand Your Benefits
Here are some other benefits to being a BCBS policyholder and enlisting the help of Northbound Addiction Treatment Services:
· We’ll thoroughly review your Blue Cross Blue Shield health insurance plan.
· We’ll help determine if you are covered for substance abuse treatment.
· We’ll help determine what kind of treatment and how much is covered.
· Blue Cross Blue Shield health insurance is accepted by almost every treatment center in the U.S., so we’ll identify which ones will work best with your policy.
We know the specifics of your insurance coverage are confusing and not always easy to understand. Northbound Addiction Treatment Services will clarify your insurance coverage with Blue Cross Blue Shield for you and make sure you have a better understanding of what your insurance will cover and what may or may not come out of pocket.
Understanding how your treatment center operates is incredibly important for recovery, however sobriety requires you to also be less-stressed. Money can be a huge stressor. That is why having us help you understand the ins and outs of your insurance plan is incredibly important for continuing on a sober life.
The Northbound Addiction Treatment Services Promise
We won’t recommend a drug and alcohol rehab facility unless it meets or exceeds our own standards of what comprises an effective, comprehensive and client-centered program. At Northbound Addiction Treatment Services, we’ve been in your shoes and understands what you’re going through. Sometimes what you think you need for your recovery isn’t necessarily what’s going to work best.