Using Blue Cross Blue Shield for Drug Rehab: How Will It Work?

Many Blue Cross Blue Shield health insurance plans offer comprehensive coverage that includes drug abuse and addiction treatment services. There are many different plan options based on where you are seeking coverage and care.

You can work with a representative from Blue Cross Blue Shield as well as a representative from your prospective drug rehab center to get details on your exact level of coverage. This ensures you will know exactly what you will be expected to pay out of pocket.

Blue Cross Blue Shield

As one of the biggest health insurance companies in the United States, Blue Cross Blue Shield (BCBS) provides health insurance coverage for more than 100 million members in all 50 states and several countries around the globe.

The 36 BSBC providers around the United States operate locally as community-based and independent operators overseen by the Blue Cross Blue Shield Association.

Coverage for drug rehab is provided through Blue Cross Blue Shield health insurance plans, but the level of coverage will be highly variable based on the state and county you live in, the BSBC provider offering coverage, and your specific plan.

Drug addiction treatment is considered one of the 10 “essential health benefits.” All BCBS plans sold on the federal marketplace offer some level of coverage for addiction treatment as a result. The Affordable Care Act (ACA) ensures that mental health, behavioral health, and substance abuse treatment services are covered the same as other medical and surgical services.

Steps to Use Blue Cross Blue Shield Coverage for Drug Rehab

To best understand your coverage, what plan you have, and how it might work to cover expenses related to drug rehab, your insurance provider can directly offer you the most information. Call BCBS to get specifics on your plan.

In general, coverage can be applied to detox services, outpatient services (including counseling), medication management, evaluations, therapy sessions, and inpatient drug rehab programs.

To use BCBS to cover drug rehab services, follow these steps:

Be sure you understand your coverage and manage payment information before entering a drug rehab program.

Understanding Coverage Amounts

There are many Blue Cross Blue Shield plans to choose from, including those for individuals and families, groups (under employers, most often), and Medicare/Medicaid.

Medicare and Medicaid are government-funded health insurance plans for individuals who have limited financial resources, children, families with children, older adults, and people with disabilities.

Group, individual, and family plans may include both HMO (health maintenance organization) and PPO (preferred provider organization) plans. With an HMO, you will use providers that are in your network for all services, and often, you will need a referral for specialty services. A PPO will allow you to see providers outside of the network for a higher cost, and often, a referral will not be needed for specialty services.

You can also use an HSA (health savings account). This is a special account you can put tax-exempt dollars into use for medical expenses. There are varying degrees of plan coverage and levels of care. BCBS uses a “metal” tier system that ranges from platinum at the highest to bronze at the lowest.

Blue Cross Blue Shield health insurance offers a variety of options that may cover drug rehab services. Your provider can help you determine how much and what types of services will be included.