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Blue Cross Blue Shield Insurance Coverage for Drug and Alcohol Rehab

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 8 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 8 minutes

Learn more about Blue Cross Blue Shield drug & alcohol rehab coverage.

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Blue Cross Blue Shield

Blue Cross Blue Shield insurance covers many addiction treatment services.

Rolling Hills Recovery Center accepts a variety of Blue Cross Blue Shield insurance coverage.

Paying for Treatment

Drug Rehab That Accepts BCBS Insurance

Deciding to get help for drug or alcohol abuse is fantastic, but you can have doubts about the process. It might not be easy to understand how much your therapy will cost and how your insurance will pay for it.

Blue Cross Blue Shield (BCBS), a well-known insurance company, is committed to delivering superior medical protection to its customer by offering some of the most comprehensive insurance products.

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Families & Addiction

Understanding Insurance

Does Blue Cross Blue Shield Cover Drug and Alcohol Addiction Treatment?

The Mental Health Parity and Addiction Equity Act and the Affordable Care Act have been particularly helpful in encouraging persons struggling with SUDs to get the care they need.

These laws have required that all health insurance policies include coverage for behavioral health services, including those related to mental health and drug abuse. Because of this, private and group health insurance is required to pay for mental health treatments, including drug and alcohol abuse treatment, on par with other medical services.

Therefore, substance abuse and mental health disorders are covered under the vast majority of Blue Cross Blue Shield policies. Your insurance policy will determine how much of the cost of addiction treatment it will cover.

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How Does Insurance Work

Understanding Your BCBS Health Insurance

Some health insurance-specific verbiage is crucial to grasp to understand the various coverage options available through BCBS:

Premiums

Policyholders make regular (mostly monthly) payments to keep their insurance plan active.

Deductibles

To reduce your premium, health insurance plans often include a deductible you must meet before the insurance company pays any of the costs associated with your treatment. It is the yearly amount you are responsible for paying for medical treatment before your medical insurance kicks in.

Preferred Provider Organization (PPO) vs. Health Maintenance Organization (HMO)

You may only use coverage under an HMO plan at affiliated service providers. It is common practice for a person to choose a primary care physician to act as their primary care provider. Unless it’s an absolute need, services rendered outside the plan are not covered. Most HMO plans have larger deductibles but cheaper monthly premiums.

PPO plans allow you the freedom to see any doctor, not just those in the insurer’s network. You are free to seek treatment from any doctor, facility, or specialist clinic. Premiums for PPO plans are much more costly than those for HMO plans, but the deductibles for PPO policies are often substantially lower.

Out-of-Pocket Costs

Out-of-pocket expenditures are any medical expenses incurred by a policyholder not covered by their insurance plan and for which the policyholder is personally responsible.

Out-of-Pocket Maxium

A policyholder must shoulder the maximum annual out-of-pocket expense before an insurance provider begins making payments.

Did You Know Rolling Hills Recovery Center Accepts Blue Cross Blue Shield Insurance?

A patient navigator is ready to help. Our team of dedicated professionals are here to help 24 hours a day.

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What are my options?

What Will BCBS Cover?

Blue Cross Blue Shield Insurance might pay for all or a large chunk of your drug treatment expenses, depending on your policy. The rehabilitation care levels that your plan may cover include the following:

Inpatient Treatment Programs

Participating in an inpatient rehab program entails living at the institution full-time for weeks or months. You will work through feelings, establish healthy routines, and get used to a life without drugs or alcohol. This may be viable if you need medical attention all day and night.​

Outpatient Programs

Outpatient programs are a good option if you need to maintain other responsibilities, such as those at home, work, or school, while receiving treatment. You may continue living at home while committing several hours each week to therapy. Outpatient programs are often a transitional step for patients after completing inpatient care.

Intensive Outpatient Programs (IOPs)

Intensive outpatient programs are designed for people who can live at home but need more support than a standard outpatient program. Since an IOP takes place during the day, you may spend your nights at home after each session.​

Partial Hospitalization Programs (PHPs)

Patients who need full-time medical attention during the day but can go home at night may be good candidates for partial hospitalization programs. Generally, you’ll have to come in for therapy up to at least five days per week, and each session will last for several hours.

Aftercare

The improvements you’ve made throughout therapy have a better chance of sticking around with the aid of aftercare services. You will get the necessary assistance to continue your new lifestyle and behaviors free of alcohol and other addictive substances.

Medication-Assisted Therapy

Medication-assisted therapy (MAT) combines traditional behavioral treatments with FDA-approved medications to treat substance use disorders from a more “whole-patient” perspective.

What To Know About Your BCBS Insurance

Our Admissions Experts Will Help You Navigate This Difficult Information.
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Co-Insurance

Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.

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Deductibles

The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.

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Copayment

Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.

Did You KNow?

Most Major Insurance Will Help Cover the Cost of Treatment
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Does Insurance Cover Detox?

Will BCBS Cover Detox Services?

Yes, BSBC can cover your detox expenses. Detoxing from alcohol and other drugs can be unpleasant, painful, and even dangerous without medical supervision in certain situations. Due to the constant medical monitoring provided by medical detox, the withdrawal process from alcohol and narcotics is safer for patients.

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What My Plan Covers

What Kinds of Coverage Plans Does Blue Cross Blue Shield Offer?

There is a range of BCBS Healthcare plans to choose from, each with its premium rates, deductibles, and other details. A summary of BCBS’s tiers of coverage include:

Bronze Plans

The coverage in bronze plans usually is about 60 percent, but they have substantial deductibles but cheap monthly premiums.

Silver Plans

The usual coverage for a silver plan is about 70%. Regular premiums are higher than bronze packages, but deductibles are much lower.​

Gold Plans

Policies with a gold rating often cover around 80 percent of the service cost, have lower out-of-pocket thresholds, but have higher premiums than silver and bronze products.

Platinum Plans

These plans’ monthly premiums are much higher than those of gold, silver, and bronze. Platinum plans generally cover roughly 90% of medical costs.

BCBS is part of the Medicaid program. Medicaid provides health coverage to low-income individuals, many of whom have chronic or life-threatening illnesses. Medicare, the government health insurance program for those over 65, is also accessible via Blue Cross Blue Shield.

Having a national insurance carrier like BCBS means you have the option of receiving treatment for substance abuse at a facility outside of your home state.

Through the BlueCard program, you may take advantage of the local BCBS drug and alcohol treatment plan prices if you want to see a doctor in the Blue Cross Blue Shield network in a state other than your own.

BCBS Insurance’s monthly premium and deductible are decided not only by the plan level selected but also by the kind of network selected, either an HMO or a PPO.

Our Admissions Process

We are a rehab that takes BCBS Insurance

The Bottom Line

Whether you need assistance with medical detox, individualized outpatient rehabilitation, or mental health care, the experts at Rolling Hills Recovery Center are here to guide you through your Blue Cross Blue Shield insurance coverage.

Worries about cost and insurance shouldn’t prevent you from starting your road to recovery. Get in touch with us now to learn more about how we can assist you in overcoming your addiction.

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Written By:

Geoffrey Andaria

Geoffrey Andaria mental health writer at rolling hills recovery center
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Geoffrey Andaria is an experienced mental health content writer and editor. With a B.A. in English and Journalism, Geoffrey is highly educated in freelance articles and research. Having taken courses on social work, Geoffrey is adamant about providing valuable and educational information to individuals affected by mental health and the disease of addiction.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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