Last Updated on May 18, 2021 by Ben Lesser
Determining what coverage Blue Cross Blue Shield offers can be difficult, when it comes to substance abuse treatment. Each state has different insurance requirements, plus it offers a variety of policies that differ from state to state as well.
As an example, consider Blue Shield of California. Insurers cover substance abuse treatment with at least 14 policies. The amount paid for each type of treatment varies depending upon the plan, as well as the duration of the treatment.
There Are Some Differences Between Policies:
- Paying co-payments
- Providers of outpatient services
- Partially hospitalized
- Benefits for physicians
- Benefits from hospitals
Co-payment and out-of-pocket expenses for services will differ considerably depending on the specific treatment, the location, and the professional. Unlike other health insurance providers, Blue Cross Blue Shield guarantees the same coverage for comparable medical services, including copayments and coinsurance. Medically necessary services are not subject to annual maximums, either.
The issue of “medical necessity” is something to keep in mind when trying to understand what Blue Cross Blue Shield insurance covers and what it does not. If a drug or alcohol rehab program is determined to be necessary, physicians and therapists may have to prove it is truly medically necessary to the insurance company.
Although physical dependence and withdrawal symptoms may indicate that inpatient care is medically necessary, they are not always enough to prove such a necessity. If treatment takes place outpatient, there is a higher chance of relapse, but this does not guarantee approval for inpatient rehab. If they want insurance to help pay for outpatient services, patients may have to prove that these services are ineffective or utilize these services first.
In order to ensure coverage of the treatments they need before starting treatment, patients are encouraged to get preauthorization before beginning treatment.
With Anthem Blue Cross Blue Shield, we have access to therapists, psychiatrists, medical professionals, psychiatrists, and mental health professionals trained in the treatment of substance abuse. Despite the fact that they may not be specialists, they offer treatment for drug and alcohol addictions and are a part of the network; therefore, consumers under this coverage may have an easier time getting a greater percentage of the cost of treatment covered by insurance when they utilize these specific providers. Consumers are encouraged to call the confidential helpline for more information on the specific coverage provided by network providers versus other providers.
Health Insurance After: How to Pay
Even when health insurance policies are adequate, inpatient addiction treatment is not covered in totality. In addition to the remainder of the bill, patients’ families are responsible for the rest. Even though it may seem daunting, especially when in the midst of an active addiction crisis, it’s definitely possible.
Some patients forgo health insurance coverage entirely in order to save time and/or money because it could delay entry into rehab and/or the final payout may not be worth the effort.
Instead, the Cost of Care Is Covered Through a Variety of Resources, Such As:
- Savings by individuals and families
- Loans from family and friends
- Obtaining financing
Does Blue Cross Blue Shield Cover Rehab?
Indeed, practically the Blue Cross Blue Shield protection plans’ entirety incorporates treatment for substance misuse and psychological wellbeing issues. Yet, the measure of inclusion for recovery relies upon your strategy. The federal workers’ plan covers gathering and one treatment meeting that they go to during outpatient recovery, yet they are liable for the copay.
They might be needed to acquire pre-confirmation before looking for private treatment. Once more, the sum you should pay for Blue Cross Blue Shield medication and liquor compulsion recovery treatment can fluctuate unfathomably, so it’s essential to check the subtleties of your one arrangement.
Some Blue Cross Blue Shield organizations have committed with suppliers the nation over. Numerous administration workers have protection under its federal worker’s plan, which enfolds inpatient professionals look in on and can incorporate detox. Some protection plans cover Blue Cross Blue Shield liquor recovery or medication recovery.
A portion of the more extreme withdrawal manifestations incorporates significant mal seizures, fantasies, daydreams, and deregulation of circulatory strain, heartbeat, and internal heat level. Seizures and wooziness are related to severe liquor or narcotic withdrawal.
The Blue Cross Shield union comprises 36 medical coverage organizations that are autonomously claimed and worked. BCBS gives inclusion to the more significant part of all government representatives who are taking a crack at an organization. They are covered under the Federal Employee Program.
BCBS has individual and family designs that incorporate the bronze, silver, gold, and platinum plans (classes are reliant on your state). Bronze plans have the least expensive, and the cost of plans goes up from that point.
- Bronze plans cover near 60% of clinical expenses and have low regularly scheduled installments and high deductibles
- Silver plans cover near 70% of clinical expenses, with a relatively higher regularly scheduled installment and lower deductible
- Gold plans cover near 80% of clinical expenses and have higher regularly scheduled installments and low deductibles
- Platinum plans (which aren’t offered on the whole state) cover near 90% of clinical expenses and have the most elevated regularly scheduled installment with the least deductible
All Blue Cross Blue Shield protection plans incorporate psychological wellness benefits, and most plans cover probably some part of compulsion treatment. Particulars in regards to your inclusion depend on your approach. Similarly, as with most clinical issues, just a segment of detox or substance misuse treatment is covered by protection.
Blue Cross Blue Shield Rehab Coverage Length
Not every person recuperates from habit at a similar speed, which is why Blue Cross Blue Shield organizations may offer plans that should think about different components with regards to private compulsion treatment.
Rather than giving you a set period, like five days, the organization will cover a segment of your visit dependent on your deductible and measure of inclusion. If you have extra inclusion through your manager or pick a more appropriate treatment office, you may meet all requirements for a more extended stay.
The treatment community and your Blue Cross Blue Shield substance misuse protection supplier will keep your data attentive, paying little heed to the term of your visit.
The Mental health union necessitates that health care coverage organizations and gathering wellbeing intend to give equivalent inclusion to psychological wellbeing administrations, for example, substance misuse therapy, as they do clinical coverage.
This demonstration was made to grow psychological wellness and substance misuse inclusion for individuals the nation over. Subsequently, many Shield organizations may furnish you with good inclusion, and that is return in the estimating. For instance, a limitless stay at an endorsed inpatient care focus may cost $250 from cash on hand. Numerous individuals profit from the design of inpatient programs. If you have gentle enslavement, a solid emotionally supportive network, and dependable transportation, outpatient recovery might be suitable for you. You can plan your treatment meetings around work, school, or other individual commitments, while as yet getting back in the evening.
For an out-of-network care focus, you may pay $350 in addition to a set expense dependent on your arrangement stipend. By allowing you to pick any treatment community, you find the opportunity to browse some special focuses.
Some Extravagance Treatment Focuses Have an Exhibit of Conveniences, Including:
- Graceful lounge areas
- Entire medicines
- Workmanship wellness focuses
- Good quality materials
- Additional Payment Options for Rehab
Not everybody approaches special protection through a regarded supplier. However, those individuals merit treatment from an incredible recovery place.
If you’re an individual in the massive numbers of uninsured united, this is the ideal opportunity to cooperate out an installment plan with the office. For instance, on the off chance that you will pay a limited quantity consistently and make portions until you’ve taken care of the stay’s complete expense, a few habitats may consent to begin treatment right away.
Much programs additionally offer sliding scale choices, in which the care cost is changed by your compensation and what you can reasonably amount. Different choices incorporate awards and grants.
Verifying Blue Cross Blue Shield Substance Abuse Coverage
There are numerous boundaries to dependence care, involves cost. However, you don’t need to allow the cost to hold you back from terminating the pattern of misuse and carrying on with a more joyful and better life. You can discover what recovery offices acknowledge your Shield drug recovery protection by reaching your arrangement manager, or you can work with the care community straightforwardly to respond to all your installment queries.
My Insurance Plan Does Not Cover the Costs of My Procedure. What Can I Do?
Start your journey toward recovery without breaking the bank. Dedicated treatment providers can help you find treatment options that are affordable and appropriate for your needs. In addition to showing you your insurance coverage, they can also show you additional private costs involved.
Do Depression Treatment Programs Cost a Lot?
Some 30-day inpatient rehab programs cost about $6,000 per person. The average cost of a 30-day program at a reputable center is more than $20,000. Those who require 60- or 90-day programs can expect overall costs ranging from $12k to $60k.
These options can offer coverage for treatment costs, whether health insurance is used or not, so families can focus on helping their addicted loved ones recover. Call us today to find out how we can help your loved one get the treatment they need to overcome addiction and start a healthy life in recovery. Contact us to know more about Blue Cross Blue Shield.
Ben Lesser is one of the most sought-after experts in health, fitness and medicine. His articles impress with unique research work as well as field-tested skills. We are honored to have Ben writing exclusively for Dualdiagnosis.org.