Blue Cross Blue Shield Insurance Coverage for Addiction Treatment

Blue Cross Blue Shield (BCBS) is a well-known insurance company, accepted at many addiction treatment facilities, including Elevate Addiction Services.

Individual coverage will vary from plan to plan, and it is best to contact a BCBS representative directly with any questions you have about your coverage. You can also call us directly to determine how your insurance coverage works with our facility.

In general, most health insurance plans will cover some of the following:

detoxification
outpatient care
residential treatment
partial hospitalization

Will My Blue Cross Blue Shield Plan Cover Drug Rehab?

Blue Cross Blue Shield insurance plans provide a range of drug rehab benefits. However, actual coverage will depend on the state you live in and your plan.

The Blue Cross Blue Shield Association owns 36 separate health insurance companies that are independently owned and operated. Together, these companies comprise the Blue Cross Blue Shield network.

Will My BCBS Plan Cover Mental Health and Detox Services?

Yes, most BCBS plans provide some coverage for mental health conditions, but the amount of coverage for addiction treatment will depend on your policy.

For detox services, some Blue Cross Blue Shield companies have contracted with detox providers across the county. In some cases, you may need to get prior authorization before enrolling in a detox program to ensure coverage.

How to Check Your Blue Cross Blue Shield Coverage

There are a few ways to determine your Blue Cross Blue Shield plans benefits or coverage, including:

Contacting a rehab facility you are interested in to see if they can verify your coverage, obligation-free.
Entering the three-letter prefix before the identification number on your member card on the Blue Cross Blue Shield website. https://www.bcbs.com/
Finding your insurance carrier directly on the website’s listing of 36 member companies by state. https://www.bcbs.com/bcbs-companies-and-licensees
Calling the number on your insurance card and speaking with a BCBS representative.

Questions to Ask Your Insurance Company

If you decide to contact your insurance company directly, here are some questions you will want to keep in mind to determine what your plan provides for addiction treatment services:

What kind of substance abuse treatment program will my plan cover?
How many days will my plan provide coverage?
Which rehab facilities are considered in-network and out-of-network?
Are there any limitations on the type of therapy or treatments I can use?
Will my plan cover the cost of medications that may be used during detox and treatment?
Does my plan require my substance abuse treatment to be deemed medically necessary before I enroll in treatment?

Blue Cross Blue Shield Plan Tiers

Blue Cross Blue Shield offers different tiers of coverage as follows:

Bronze: Covers about 60 percent of medical costs, with a low monthly payment and a high deductible.
Silver: Covers roughly 70 percent of medical costs, with an increased monthly payment and a lower deductible.
Gold: Covers around 80 percent of medical costs, with an increased monthly payment and lower deductible than the Bronze/Silver plans.
Platinum: Covers 90 percent of medical costs with the highest monthly payment and lowest deductible.

Blue Cross Blue Shield Insurance in California

Two companies in California provide Blue Cross Blue Shield insurance options:

Anthem Blue Cross
Blue Cross Blue Shield of California

To improve the use of counseling with drug therapy, Anthem health plans recently updated to include access to telehealth MAT programs in several markets. This was done to ensure convenient options, and insurance providers have committed to growing treatment access post-pandemic.

About 19 to 25 percent of those receiving MAT began to receive their counseling via telehealth, compared to about one percent before the COVID-19 pandemic.

Getting a Prior Authorization for Detox

Anthem also plans to monitor non-fatal overdose metrics to assess holistic strategies’ real-world impact, including provider and consumer-based interventions.

If you have a plan from Blue Cross Blue Shield of California, you can determine if you need a prior authorization on their site.

Most detox and inpatient treatment programs will need to be deemed medically necessary by a primary care provider or an addiction treatment specialist. It is essential to get prior authorization before you begin treatment, or your insurance may not cover any of the costs of treatment.

How To Pay for the Costs Not Covered by Insurance

Insurance is perhaps the most reliable way to pay for substance abuse treatment. However, there may be costs outside of your plan’s coverage that will need to be covered. Examples of expenses not covered by your insurance include:

your deductible
medications (during treatment)
airfare & travel costs (if attending treatment out of state)

If you have a plan with a higher deductible, and you cannot pay it out-of-pocket, many rehab centers will provide financing options so that you can get the treatment you need.

Contact an admission specialist at Elevate today to learn more about how to cover additional costs that fall outside of your current coverage.

Verifying Your Insurance and Finding the Right Addiction Treatment

Addiction is complex to treat but not impossible. At Elevate, we know that a holistic treatment approach is more flexible in helping meet the addicted individual where they are and not forcing them into a plan that simply doesn’t work for everyone.

No one will recover in the same way, and if you or your loved one is serious about quitting substances and regaining control, we are here to help. You can confidentially verify your insurance on our site.

After this form has been submitted, one of our admissions staff will contact you to explain the exact details of your coverage at our facilities and answer any questions you may have.

Don’t wait. Call us today for help.