Blue Cross Blue Shield Insurance Coverage for Addiction Treatment Services
If you’re seeking support for your addiction recovery, you’re in the right place. Safe Haven Recovery has experienced, caring clinicians available to help you recover from the physical and psychological effects of a substance use disorder.
We’re also in-network with Blue Cross Blue Shield (BCBS), giving you access to a variety of affordable, high-quality treatment options.
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About Blue Cross Blue Shield Insurance
In 1929, administrators at Baylor University Hospital wanted to make health care more affordable for the people in their community. Blue Cross arose out of their efforts, giving Baylor patients access to 21 days of hospital coverage for just 50 cents per month. Around the same time, Blue Shield formed to provide health care to miners and loggers in the Pacific Northwest.
Blue Cross and Blue Shield eventually merged, forming the Blue Cross Blue Shield Association. By the early 2000s, BCBS had more than 100 million members, making it one of the top insurers in the United States. Today, BCBS offers a variety of health insurance options, including HMO, PPO and EPO health plans.
If you purchase BCBS health insurance on the federal Health Insurance Marketplace or your state health insurance exchange, you have access to plans in these tiers:
- Bronze. Bronze plans have high deductibles, but they also have the lowest monthly premiums. Bronze plans typically have a 40% coinsurance requirement, which means the plan covers 60% of the allowed amount for covered services.
- Silver. A silver plan is ideal if you’re looking for a balanced option. The premiums are higher than the premiums for the bronze plan, but the deductibles are slightly lower. Blue Cross Blue Shield pays 70% of the allowed amount for each covered service.
- Gold. If you have a chronic health condition, a Gold plan offers more coverage in exchange for a higher monthly premium. Gold plans also have an 80/20 split, which means BCBS covers 80% of the allowed amount for each covered service.
- Platinum: Platinum plans offer the highest level of coverage, but they also have the highest monthly premiums. If you have a Platinum plan, you’ll pay just 10% of the allowed amount of each covered service, meaning BCBS covers 90%.
Addiction Treatment Services Covered by BCBS
Under the Affordable Care Act, all ACA-compliant BCBS plans must cover treatment for substance use disorders. Your BCBS plan may cover the following services:
- Medical detox
- Inpatient rehab: 24/7 care, detox, structured recovery programs
- Intensive outpatient program (IOP): Flexible treatment while living at home
- Medication-assisted treatment (MAT): Buprenorphine, methadone, or naltrexone + therapy
- Dual diagnosis treatment: Mental health + substance use care
- Therapy and counseling: Individual, group, and family sessions
This place is awesome! Great techs, great therapists, great clients, great owners, and a great chef! It went beyond my expectations, and this was my first time in rehab. Safe Haven is highly recommended by me.
- Donna M.
Understanding Your BCBS Health Plans
BCBS covers many types of addiction treatment, but every plan has different limitations, exclusions, and cost-sharing requirements. This makes it important to verify the details for your specific plan. For example, it’s common for BCBS plans to have deductibles and co-pays.
A deductible is the amount of money you pay for health care before your insurance plan starts to cover your costs. If your BCBS plan has a $1,000 deductible, for example, you’ll pay $1,000 for physical or mental health care before your plan starts to pay for anything. A co-pay is the flat fee you pay for a covered service.
Some plans exclude certain types of care, such as experimental treatments, or limit the number of treatment sessions covered during the plan year.
HMO vs. PPO Health Plans
BCBS offers several types of health plans, but HMOs and PPOs are two of the most common options. An HMO, also known as a health maintenance organization, requires you to get care from in-network providers. You’ll also need to get a referral any time you want to see a specialist. Due to these limitations, HMOs typically have lower premiums than PPOs.
A PPO, or a preferred provider organization, gives you more flexibility. With some PPO health plans, there’s no need to request a referral for specialty care. A BCBS PPO plan may also cover out-of-network care. In exchange for this flexibility, PPO plans typically have higher premiums than HMO plans.
The Preauthorization Process
Also known as prior authorization, preauthorization is the approval of a specific treatment or service by your insurer. When a health care provider submits a request for preauthorization, a BCBS representative reviews it and determines if the desired service is medically necessary.
Preauthorization doesn’t guarantee payment, but it does make it more likely that BCBS will cover your treatment. Note that BCBS may only approve a certain length of treatment coverage, such as 30 days or 60 days.
How to Verify Your BCBS Health Coverage
The best way to find out what your BCBS plan covers is to have us verify your Blue Cross Blue Shield insurance coverage details. Safe Haven Recovery uses a confidential verification process to give you extra peace of mind. Simply call us or fill out the verification form on our website. A member of our admissions team will contact BCBS, verify your benefits, and explain exactly what’s covered by your plan.
What If You’re Out-of-Network?
An in-network provider agrees to accept a negotiated rate for each service provided to plan members. Out-of-network providers make no such agreement. Your BCBS insurance plan may require you to use in-network providers, or it may pay a higher percentage of your in-network claims.
However, Safe Haven Recovery may still be able to work with your out-of-network benefits. If necessary, we’ll also help you file reimbursement claims with BCBS.
We prioritize transparent communication about any costs that aren’t covered by your Blue Cross Blue Shield insurance plan, making it easier to get the care you need.
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Please complete the following information for the person seeking treatment. One of our dedicated team members will contact you immediately to go over your coverage, treatment options and information on admissions.
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FAQs About BCBS Insurance Coverage for Rehab
Does BCBS cover all addiction treatment programs?
All ACA-compliant plans cover some type of addiction treatment. However, the treatment must be medically necessary. Your plan may also have coverage limits or exclusions you need to know about.
What is preauthorization, and how do I get it?
Preauthorization is an approval for a specific health care service. If you decide to come to Safe Haven Recovery, we’ll take care of the preauthorization process for you.
How long will insurance cover rehab at Safe Haven?
It depends. It’s common for BCBS to cover 30, 60, or 90 days of rehab, but it depends on what type of plan you have.
What out-of-pocket costs should I expect?
It depends on your plan. You may have to pay your deductible before your BCBS plan starts to cover your costs. It’s also common to have co-pays or coinsurance requirements.
Can BCBS cover aftercare and relapse prevention?
Your BCBS plan may cover ongoing counseling and other aftercare services, reducing the risk of relapse. If you’re not sure what your plan covers, contact BCBS or talk with our admissions team.
Why Choose Safe Haven Recovery?
Safe Haven Recovery offers a safe, private environment where you can heal from your addiction. We also have compassionate staff members and an experienced clinical team, ensuring you have plenty of opportunities for growth. Our proven outcomes and high patient satisfaction demonstrate our commitment to helping you recover.
Find Support and Healing At Safe Haven Recovery With Your BCBS Health Insurance
If you’re struggling with an addiction to drugs or alcohol, you’re not alone. Financial concerns shouldn’t stop you from seeking support and guidance.
Call us or verify your BCBS coverage now to take the first step toward lasting recovery.
