(Please note: Rehabs.com strives to provide you with the most updated information on each carriers' addiction insurance coverage but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels. Rehabs.com is an informational site only and is not affiliated or sponsored by Blue Cross Blue Shield.)
Alcohol abuse involves neglecting your important obligations due to drinking, including drinking and driving. Alcohol abuse can include drinking even though it is having a negative impact on work and relationships, legal problems, and drinking as a way to de-stress. Alcoholism involves an increased tolerance to alcohol — meaning it takes more alcohol in order to feel the same effect. Withdrawal symptoms when alcohol is not consumed can include uncontrolled shaking, irritability, jumpiness, sweating, nausea, depression, fatigue or headaches. Loss of control, inability to stop drinking and neglecting activities that used to be important are all signs of alcoholism.
Does Blue Cross Blue Shield Cover Treatment for Alcohol Addiction?
Blue Cross Blue Shield encompasses many different providers across the country, and each provider's coverage is a little bit different. Many do offer coverage for treatment of alcohol related problems in both group and individual policies. Group plans often offer coverage similar to hospital stays for medical issues. Each policy will have individual limits, co-pays, deductibles and maximums per day and per stay. These limits will vary depending on the policy and the state. Coverage can also vary depending on the treatment program. If the program is considered in-network, coverage will be higher than for programs that are deemed out-of-network.
Type of Rehabs Will Blue Cross Blue Shield Pay For
Treatment programs can include counseling, behavior modification treatment, inpatient and outpatient care. Coverage for these programs varies between plans. In addition to rehab plans, 12-step programs through Alcoholics Anonymous have also provided ongoing support and have a great deal of success for those who take the program seriously. Unlike physical disorders where medication can solve the problem, alcoholism requires a lot of work from the person who is suffering from the illness.
How Much of The Cost of Rehab is covered by Blue Cross Blue Shield?
Blue Cross Blue Shield plans might cover various treatment programs at different levels. Reviewing your policy will provide guidance as to what is covered and what costs will be out of pocket. As treatment programs can be very expensive, understanding what is covered can prevent unexpected financial expenses. Each policy can have out of pocket expenses that include co-pays, deductibles and maximum daily limits. There may also be different coverages based on the type of rehab program selected.
Can I Pay Above What my Insurance Will Provide to Receive Treatment?
While each policy is different, most do not cover 100% of the treatment costs. Some policies will cover expenses much like other hospital stays. Others will provide less coverage depending on the policy that was selected. Understanding out-of-pocket expenses ahead of time is best. Reviewing the policy with the treatment provider will provide a clear picture of how much it will cost above the insurance coverage. Treatment centers often offer payment plans, accept credit cards, and can offer financial assistance for those in need.
Inpatient Addiction Treatment vs. Outpatient Treatment
"Alcoholism involves an increased tolerance to alcohol — meaning it takes more alcohol in order to feel the same effect."
Inpatient treatment programs offer a safe environment which enables the user to break the addiction and become sober. Patients also learn valuable life skills to help manage stress and recognize triggers that will create the strong urge to drink again. With both inpatient and outpatient programs, maintaining abstinence after treatment is the key. Taking alcohol out of the picture and staying away from environments that trigger drinking provide the highest levels of success. Outpatient programs offer many of the same treatment options without the overnight stay. This allows the patient to fulfill other obligations like work and family, while getting the help they need. Deciding on which treatment program is best depends on the severity of alcohol abuse and the individual’s commitment to changing behavior.
Should I Choose a Residential Rehab Center?
Choosing a residential program is a personal decision. It provides an alcohol free environment in which to change behavior. After the treatment program has been completed, it is necessary to re-enter the real world and handle everyday stresses in a responsible way. There are many factors to consider including family needs, work needs, treatment costs, and commitment of the individual.
Will Blue Cross Blue Shield Pay For Local Rehab and Out-of-State Treatment?
This will depend on the coverage of the particular policy in question. Some of the coverage options center on whether the program is considered in-network or out-of-network. For in-network programs the coverage will be much higher than an out-of-network choice. Since insurance typically does not pay for transportation to and from the treatment center, finding a program that will provide the maximum level of insurance coverage balanced with the best treatment option for the individual are all things to consider when choosing a particular program.
Does Blue Cross Blue Shield Pay For Private or Luxury Treatment?
Some Blue Cross Blue Shield plans might cover services at private and luxury treatment centers based on the policy of the individual. Policies may cover whole or partial costs for private rooms and luxury services. Any remaining charges will be required to be covered by the policyholder. Luxury treatment options can increase the level of success by encouraging the patient to remain in the program for its full duration. A private room, spa treatments, and gourmet meals within the facility provide an environment where the person wants to be. This helps with the success of the program.
What Does Executive Treatment Offer Over Other Rehabs?
Executive programs are best for those who have work or school obligations that would suffer if they were not kept up during the patient's time in a treatment program. Business executives, business owners, and others with obligations that cannot be put on hold benefit. Executive programs provide the resources needed to complete work obligations while also completing all elements of the treatment program.
What Treatment Lengths Will Blue Cross Blue Shield Pay For?
Programs vary in length depending on the need of the patient. Most programs are either 30, 60 or 90 days in length and can be extended if needed. Some individuals can stay as long as a year for particularly severe cases. Once again, coverage will be determined by the individual policy and can include either partial or full payments. Looking at daily maximum amounts and annual maximum amounts will help determine the length of stay your policy will cover.
What If I Have No Insurance?
Treatment programs are expensive, even for those who have insurance. There are a number of organizations that can help provide less expensive options, scholarships, or financial assistance to help cover the cost of treatments. Speaking with the program director and discussing options is a good starting point. Most programs also offer payment plans and other resources to work with those who might otherwise struggle to pay. For those suffering from alcohol abuse or alcoholism, 12-step program through Alcoholics Anonymous is a free way to begin to break the grip of this debilitating disease.
Questions and Answers
- Will Blue Cross Blue Shield Cover Rehab Stays?
For many policy holders, Blue Cross Blue Shield will cover at least some of the cost of rehab stays.
- Does Insurance Pay for Aftercare?
Follow up care or aftercare is essential to success. Many who leave a treatment program will enter the 12-step program to continue to get the support needed. Additional services may also be available based on the policy coverages.
- Could Rehab Make My Insurance Premiums Higher?
The cost of insurance is based on many factors. Most of these involve the overall cost of healthcare and the healthcare use of the group as a whole on group policies. This means that getting treatment is likely to have no impact on the policy rates. For individual policies it may have an impact but it should not be significant.
- Has The Affordable Care Act (Obamacare) Affected Alcohol Addiction and Mental Health Coverage?
The Affordable Care Act requires insurance companies to cover mental illnesses at similar levels as other medical care. This has increased coverage for illnesses like alcoholism.
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