Trying to understand what is covered by your health insurance coverage can be overwhelming. This is because it can be challenging to figure out what is available to you when accessing substance abuse and mental health services.
There are several types of addiction and mental health treatment facilities, and each one offers various levels of care and therapeutic modalities. Some centers provide round-the-clock care, intensive outpatient programs, partial hospitalizations, or dual diagnosis treatment. Typically, substance abuse services include detoxification, counseling, medications, and aftercare planning. All of these help people manage problems with addiction and mental health.
When seeking treatment, you will typically be required to provide your insurance information and a referral from your doctor. The facility will then submit a claim to your insurance, which will determine the amount of coverage you are eligible for.
What are the Types of Addiction Treatment Facilities?
Addiction treatment facilities come in many different types. It may range from conventional to luxurious, teen- and gender-specific, dual diagnosis, and holistic.
- Traditional addiction treatment facilities typically follow a 12-step model and emphasize the importance of abstinence. These facilities often offer detoxification, counseling, and aftercare planning.
- Holistic addiction treatment facilities focus on treating the “whole person” and emphasize the importance of lifestyle changes. These facilities often offer detoxification, counseling, and aftercare planning.
- Luxury addiction treatment facilities are typically more expensive but offer a higher level of comfort and amenities. These facilities often offer detoxification, counseling, and aftercare planning.
- Teen-specific addiction treatment facilities are tailored to the needs of adolescents and young adults. These facilities often offer detoxification, counseling, and aftercare planning.
- Gender-specific addiction treatment facilities are tailored to the needs of either men or women. These facilities often offer detoxification, counseling, and aftercare planning.
- Dual diagnosis facilities are designed to treat individuals with both substance abuse and mental health issues. These facilities often offer detoxification, counseling, and aftercare planning.
Your coverage from these facilities may vary depending on your insurance plan and the type of treatment you will need; some may have limitations and exclusions. It’s always a good idea to check with your insurance provider to understand what is covered under your specific plan.
What is Blue Cross Blue Shield?
Blue Cross Blue Shield (BCBS) is a federation of 36 independent, locally operated health insurance companies in the United States. It is one of the largest and most recognizable health insurance providers in the United States, serving millions of members across the country.
BCBS drug rehab coverage and benefits differ depending on the specific state and plan.
Typically, it offers a range of health insurance products, including:
- Individual and family health insurance plans
- Employer-sponsored health insurance plans
- Dental and vision insurance plans
- Prescription drug coverage
- Medicare Advantage plans
- Medicaid plans
Blue Cross Blue Shield's Addiction Treatment Benefits
Blue Cross Blue Shield (BCBS) rehab plans have a wide range of addiction treatment and mental health services offered. These include, but are not limited to, the following programs:
Individuals may receive Blue Cross Blue Shield Drug rehab coverage for inpatient and outpatient services, including detoxification. This is most likely the case for people experiencing alcohol addiction, benzodiazepine addiction, or opioid addiction.
Medical detox is a treatment program designed to help individuals safely and effectively withdraw from drugs or alcohol. It is occasionally uncomfortable, painful, or even life-threatening; therefore, it should always be done under medical supervision.
Inpatient or residential care is a type of addiction treatment that allows you to live onsite for a period of time. Depending on your program and specific needs, most inpatient treatments span 15 to 90 days. Inpatient or residential care is frequently advised for individuals with severe addiction who relapse after receiving prior treatment or those with a co-occurring mental health disorder.
Partial hospitalization programs enable you to receive treatment during the day and return home at night. This type of program does not require 24-hour medical care. It is typically a step down from inpatient or residential care. PHP programs may also be used as a standalone treatment for individuals who require more support than traditional outpatient treatment can provide.
Intensive outpatient programs include attending drug and alcohol rehab centers a few evenings a week. While enrolled in an intensive outpatient program, you are free to spend the day at home or even go to work. IOP treatment may include individual therapy, group therapy, medication management, and other supportive services such as family therapy, life skills training, and behavioral therapies.
After completing inpatient care, patients frequently continue their sober support through outpatient care. One can reside at home and spend 10–12 hours per week there while receiving therapy and support at the same time in the treatment center.
It is critical to check with your insurance provider to see which of these programs may receive Blue Cross Blue Shield Drug rehab coverage. Your total out-of-pocket costs, monthly premiums, copays, deductibles, and other potential costs will all vary depending on your specific plan. What is good is that BCBS insurance will surely cover at least some of your expenses.
MaineCare also covers medication-assisted treatment (MAT) for individuals struggling with opioid addiction. This type of treatment combines medications such as buprenorphine, naltrexone, or methadone with therapy and other forms of support in order to help individuals overcome their addiction and improve their overall health.
Blue Cross Blue Shield’s Insurance Plans and Covering Level
The choices you have under Blue Cross Blue Shield depend on your circumstances and your level of benefits. Here are some of their most common insurance plans and general coverage levels:
- Bronze Plans: Bronze plans are the most affordable BCBS plans and typically cover 60% of medical costs, with the remaining 40% paid by the member through deductibles, copays, and coinsurance.
- Silver Plans: Silver plans offer a higher level of coverage than bronze plans, covering around 70% of medical costs, with the remaining 30% paid by the member.
- Gold Plans: Gold plans offer even higher levels of coverage, covering around 80% of medical costs, with the remaining 20% paid by the member.
- Platinum Plans: Platinum plans are the highest level of coverage offered by BCBS, covering around 90% of medical costs, with the remaining 10% paid by the member.
In addition to these metal-tiered plans, BCBS also offers other types of health insurance plans, such as Health Savings Account (HSA) plans, Preferred Provider Organization (PPO) plans, and Health Maintenance Organization (HMO) plans. Each of these plans may have different coverage levels and benefits, depending on the specific plan and state of residence.
Verifying your Blue Cross Blue Shield Drug Rehab Coverage
You have several options to verify your eligibility and coverage:
- Contact BCBS customer service. The best way to verify coverage is to contact the BCBS customer service department directly. The phone number for customer service is usually located on the back of the insurance card.
- Electronic or Email inquiry.: You may also want to consider verifying your coverage electronically or via email. Electronic or email addresses are usually listed on the BCBS website.
- Visiting BCBS portal or Availity. You can also obtain your eligibility and benefit information by logging in to the BCBS member web portal or Availity.
Casco Bay is In-Network with Blue Cross Blue Shield
In-network providers are bound by contract to deliver services at a certain cost. As a result, you can expect to pay less out-of-pocket than if you choose an out-of-network facility. Casco Bay Recovery is an in-network provider of Blue Cross Blue Shield. Contact our team and learn more about it here!