(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.)
Does Blue Cross Blue Shield Insurance Cover Treatment for Opiates/Opioids Addiction?
Opioids, also known as opiates, are a class of drugs that includes morphine, codeine, Percodan, oxycodone, and heroin. These drugs are highly addictive and can cause severe damage to the user's physical and mental health. Some Blue Cross Blue Shield insurance plans do provide coverage for opioid addiction treatment. To learn how much of the cost of rehab is covered, you need to check with your specific plan.
Type of Rehabs Blue Cross Blue Shield Insurance Will Pay For
Opioid addiction can be treated on an inpatient or outpatient basis, depending on the severity of drug abuse. When determining which one is right for you, consider your specific insurance policy and the types of programs that are covered. Your policy documents will detail the treatment options that are covered and list a phone number that you can call for more information.
How Much of the Cost is Covered?
The cost covered by Blue Cross Blue Shield depends on the treatment you receive and the type of insurance plan you have. Treatment for opioid addiction will typically fall under the mental health portion of your coverage benefits. Your plan may or may not cover certain amenities such as extended inpatient stays, luxury facilities, or non-traditional therapies such as yoga or acupuncture.
Can I Cover What Blue Cross Blue Shield Cant Cover to Receive Treatment?
If you feel that you need additional services beyond what your insurance plan will cover, you can absolutely pay the remaining cost out of pocket. You can work with your chosen rehab facility to set up a payment plan, or you can seek financial assistance from a healthcare loan, scholarship, or line of credit.
What Treatment Lengths Will Be Paid For?
Treatment for addiction to heroin or other opioids can last for 1 to 3 months, or even longer depending on your needs and resources. Every Blue Cross Blue Shield plan is a little different, so it's important to consult your policy document or plan administrator before committing to a rehab program. Your plan may require you to pay for rehab up front and submit for cost reimbursement after treatment is complete, or it might require a doctor's referral to the treatment program in order to qualify for coverage. Understanding your insurance coverage is just 1 factor to consider when determining how long to enter rehab for.
Inpatient Addiction Therapy vs. Outpatient Therapy
"Treatment for opioid addiction will typically fall under the mental health portion of your coverage benefits."
Inpatient addiction therapy involves the patient living at the treatment center and becoming secluded from outside triggers and pressures. Outpatient therapy, on the other hand, involves the patient visiting counsellors and treatment experts while still living at home and possibly even working. Inpatient treatment is typically recommended for opiate addiction cases, but the intensive nature of this 24/7 care also makes it the more expensive option.
Should I Choose a Residential Rehab Center?
Discussing your needs with your healthcare provider, primary care doctor, or a medical treatment professional will help you to gain a full understanding of how severe your addiction is, as well as the challenges you will face overcoming your dependency on opiates/opioids. A residential rehab center is best for those who experience extreme withdrawal symptoms when they stop using opioids. Though not life threatening, opioid withdrawal symptoms can be extremely unpleasant and difficult for patients to manage on their own in an outpatient setting.
Will Blue Cross Blue Shield Pay for Local Rehab and Out-of-State Treatment?
Blue Cross Blue Shield contracts with a network of providers across the country, so selecting a a treatment facility in this network will enable you to get greater coverage than selecting an out-of-network provider, regardless of location. This affords you some amount flexibility when choosing your rehab facility. Some patients prefer going out of state for treatment to completely separate themselves from their familiar drug-use environments. Others choose to stay close to home where they can receive support from friends and family members.
Does Blue Cross Blue Shield Pay for Private or Luxury Treatment?
As with most addiction treatment issues, this comes down to what your policy specifies. It is important to remember that not all insurance plans are the same, so if you know of someone who was not covered for private or luxury treatment, that doesn’t mean you won’t be covered. Since these specialized facilities offer more amenities, you may have to pay more out of pocket even if the provider is in the Blue Cross Blue Shield network.
What Does Executive Treatment Offer Over Other Rehabs?
Executive treatment is designed for people with high-level or high-profile jobs. This type of treatment provides you with extra privacy while undergoing treatment. Moreover, executive treatment was made with the high-pressure life of an executive in mind, meaning this treatment is tailored to help relieve the unique pressures and stressors of executive work. If you are an executive or other high-level worker who is afflicted by opioid addiction, this may be the best option for your treatment.
What if I Have No Insurance?
If you don’t have Blue Cross Blue Shield or other insurance, you can still get help. Many rehab facilities will work with you to set up a payment plan that works for you. Further, there are some non-for-profit facilities that will help you for free. Talk to a doctor or treatment expert to learn how you can get help without insurance.
Question and Answers
- Will Blue Cross Blue Shield Cover Multiple Stays?
Should you need a repeat stay due to relapse or other issues, Blue Cross Blue Shield may cover the additional treatment, depending on your specific plan.
- Does Insurance Pay for AfterCare?
Some Blue Cross Blue Shield plans might pay for aftercare therapies that are deemed an essential part of your recovery. Your policy administrator will be able to tell you for sure.
- Could Rehab Make my Insurance Higher?
Enrolling in a rehab program should not cause an immediate increase in your premiums, especially if your insurance is provided through your employer.
- Has the Affordable Care Act (Obamacare) Affected Substance Abuse and Mental Health Insurance Coverage?
Obamacare has effectively expanded substance abuse and mental health insurance coverage by making such coverage an essential benefit.