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Blue Cross Blue Shield Insurance For Addiction Treatment

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Does Blue Cross Blue Shield Cover Drug & Alcohol Rehab?

Blue Cross Blue Shield (BCBS) provides healthcare coverage across the United States. They work closely with hospitals to develop personalized healthcare plans for members.

BCBS is widely connected and accepted in many addiction treatment facilities. This includes the American Addiction Centers (AAC). 

Check with BCBS first to get information on the plan’s coverage for addiction treatment. Customer service hotlines can be found on the reverse side of the ID cards or on their website. 

BCBS customer service can address the following: 

  • All coverage included in the plan 
  • Other benefits and services available 
  • Any additional details about the plan

Cost of Drug & Alcohol Rehab

The cost of drug and alcohol rehabilitation depends on many factors. It can be expensive without insurance. 

Factors that affect the cost of drug and alcohol rehab include:

1. Type of Treatment Facility

An inpatient facility, which houses people, will cost more than outpatient facilities, which do not house people. An inpatient facility provides meals and lodging for people while they receive treatment. 

Inpatient facilities are usually necessary for people with severe withdrawal symptoms, as they are able to receive around-the-clock medical care and treatment. 

2. Location of the Facility

Alcohol and drug abuse rehab facilities are all over the country. Facility location also impacts treatment cost. The cost might be higher at treatment centers in more remote areas. 

3. Program Size

The cost will also depend on the number of participants in the program. More intimate programs may cost more.

4. Treatments

Rehab program costs will depend on how many addiction treatment services are included in the package. A comprehensive program will cost more than a program that does not include many additional services.

5. Program Length

Depending on the person’s treatment needs, a rehab program can last between 30 to 90 days. Some people require extended care for 120 days or more. The longer the program is, the more costly it can be. 

6. Amenities

Most inpatient facilities offer additional amenities that outpatient sites don’t have. An inpatient facility’s rate will also depend on the amenities they offer. These amenities include: 

  • Swimming pools
  • Gyms
  • Massage therapy
  • Basketball courts
  • Sports and recreation
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Which Treatments Does Blue Cross Blue Shield Cover?

Blue Cross Blue Shield’s coverage for addiction treatment depends on the treatment type and its geographical location. 

For drug and alcohol rehabilitation, a treatment provider may offer:

Detox Programs

Detox programs cleanse the body from drugs and alcohol. Because of the possibility of harmful side effects, detox typically requires professional medical assistance. 

Some detox programs for drugs and alcohol can be uncomfortable, painful, or even life-threatening if not done right. 

Medically supervised detox ensures safer withdrawal. Medical assistance and medications are available if necessary. 

Inpatient/Residential Care

Blue Cross Blue Shield has partnered with many inpatient treatment centers nationwide. These live-in centers provide intensive treatment for drug and alcohol abuse. 

Participants stay in these facilities for 15 to 90 days or more. Program length depends on needs and the specific program. 

Intensive Outpatient Program (IOP)

Inpatient treatment is not suitable for everyone. Sometimes an intensive outpatient program (IOP) is the better option, especially for those with more stable home environments.

In IOPs, substance abuse treatment is required a few evenings a week. Then, participants return home. 

Outpatient Treatment

People who have undergone inpatient treatment often need follow-up outpatient treatment. This is for ongoing support and includes programs geared towards sobriety. 

Participants complete 10 to 12 hours a week of treatment in an outpatient facility. 

Partial Hospitalization Program (PHP)

Partial hospitalization is a hospital-based outpatient program. It includes medical health care services. 

The structure of a PHP may include:

  • Time with a physician on a weekly or twice-weekly basis
  • Nurse access 
  • Daily therapy sessions to address substance use issues
  • Treatment for any co-occurring conditions

How to Qualify for Blue Cross Blue Shield Insurance

As with other health insurance plans, verify member eligibility and benefits beforehand. This can be confirmed by calling BCBS or checking online. 

The eligibility and benefits quotation will include: 

  • Membership verification
  • Coverage status
  • Other important information

Providers will ask for the member’s ID card and photo ID to avoid identity theft. They will also notify members if they do not cover certain services. 

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How to Check Blue Cross Blue Shield Coverage 

The two most common ways to check BCBS coverage are: 

1. By Phone

Call the Interactive Voice Response for BCBS that is available Monday through Friday, from 6 am to 11:30 pm. They are also open Saturday, 6 am to 6 pm. 

2. Online

Providers should check the Availity Provider Portal to confirm member eligibility and benefits. With this portal, users can easily print important, updated benefit information. 

The information available in the portal includes:

  • Patient/Subscriber information
  • Group number
  • Group name
  • Plan/Product
  • Current effective dates
  • Copayment
  • Deductible (original and remaining amounts)
  • Out-of-pocket (original and remaining amounts)
  • Coinsurance
  • Limitations/Maximums
  • Pre-authorization indicators and contracts

Members need to register to the Availity portal first. There, they can check their eligibility and benefits. For exceptions, call customer service first for a more detailed explanation. 

For additional costs, it’s best to check with the provider and facility for a complete understanding of all included costs. Providers should make sure members are aware of all treatment options.

Updated on January 27, 2022
6 sources cited
  1. Substance Use Resource Center. "Supporting your Journey to Recovery." BCBS.
  2. Blue Cross Blue Shield. "Member Services."
  3. National Institute on Drug Abuse. "Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide: Treatment Settings." 2014.
  4. Blue Cross Blue Shield. "Understanding Eligibility."
  5. Blue Cross Blue Shield. "Medicare Coverage Options."
  6. Blue Cross Blue Shield. "Blue Cross Blue Shield Federal Employee Program: About Us."

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