Blue Cross Blue Shield Insurance Coverage for Gambling

Last updated on November 4th, 2019

(Please note: 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. 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 Gambling Addiction?

Gambling AddictionYou will have to check out your specific Blue Cross Blue Shield policy. Blue Cross Blue Shield works with a network of different providers across the country, so the coverage level of each plan differs depending on location and individual policy specifics. With gambling addiction becoming more recognized as an addictive disorder, you may qualify for coverage of treatment.

Gambling addiction has been added to the Diagnostic and Statistical Manual of Mental Disorders. This is the manual that psychiatrists use to assist them with their diagnoses. The latest edition lists gambling disorder as a behavioral addiction characterized by compulsive behaviors. Further, gambling addiction can be a co-occurring disorder alongside other mental health issues, such as bi-polar disorder or depression, both of which are covered by many Blue Cross Blue Shield plans.

Type of Rehabs Blue Cross Blue Shield Insurance Will Pay For

Blue Cross Blue Shield plans may cover, partially or in full, inpatient treatment or outpatient therapy for addictions. Since gambling addiction is often associated with other mental health issues, treatment might overlap with therapy for depression or anxiety. Blue Cross Blue Shield should at least partially cover medically necessary treatments, and it may cover parts of luxury or private treatments, depending on the individual plan.

How Much of the Cost is Covered by Blue Cross Blue Shield?

Every Blue Cross Blue Shield plan offers different coverage levels. Some doctors who offer therapy for gambling addiction are part of this insurance provider’s network, which may mean you will pay less, while others will offer services out-of-network, meaning you will pay more. This also depends on whether your particular policy offers coverage for gambling addiction therapy.

Can I Cover Above What Blue Cross Blue Shield Will Cover to Receive Treatment?

Most gambling addiction treatment facilities will allow you to make private payments. If luxury treatment, executive treatment, or other specialized or experimental treatments are sought, you most likely will have to pay out-of-pocket, even if your Blue Cross Blue Shield plan does cover treatment services.

What Treatment Lengths Will Blue Cross Blue Shield Pay For?

As with other considerations, your treatment length coverage will depend on your plan. Most likely, Blue Cross Blue Shield will pay for treatment that is considered medically necessary — which may include treatment for mental health issues that go along with gambling disorders. Depending on the severity of addiction and co-occurring disorders, treatment may be recommended for anywhere from 1 to 3 months. Longer stays are available for extreme cases, and outpatient aftercare generally follows a treatment period.

Gambling Addiction Inpatient Therapy vs. Outpatient Therapy

“With gambling addiction becoming recognized more as a substance abuse you may qualify for coverage. Gambling addiction has been added to the Diagnostic and Statistical Manual of Mental Disorders.”
You may find that there are more options for gambling addiction treatment on an outpatient basis rather than as an inpatient. Since gambling addiction has not been considered a medically diagnosable disorder for long, inpatient stay is not as likely as with other addictions. This will depend on whether this problem has led to additional conditions like substance abuse, for example. It will also depend on whether you feel treatment as an outpatient is going to be enough to help you overcome your disorder.

Should I Choose a Residential Rehab Center?

Anyone who suffers from a gambling addiction will most likely tell you that it creates a whole gambit of problems in their life. It not only affects them, but also their loved ones or others whom those they may live with or are close to. This can result in other problems like depression or anxiety. If your mental health condition(s) has become this severe, then you may benefit from a residential rehab center treatment, so that you can totally focus on your recovery on a full-time basis.

Will Blue Cross Blue Shield Pay for Local Rehab and Out of State Treatment?

Blue Cross Blue Shield has many different healthcare coverage plans, so be sure to contact your plan administrator directly for information about a specific treatment center. Generally, insurance coverage is extended to doctors and facilities on an in-network or out-of-network basis, rather than coverage based on location of services. Choosing a treatment provider that is in your plan’s network will offer you the most coverage. If you select an out-of-network rehab center, you may be able to receive partial reimbursement on your out-of-pocket expenses. Again, speaking with someone directly familiar with your plan is the best way to determine specifics.

Does Blue Cross Blue Shield Pay for Private or Luxury Treatment?

Your treatment options for gambling addiction may include rehab centers that offer private or luxury treatment. Medical coverage providers update their coverage options regularly, so there is a chance you will be covered for this treatment at some point. You would need to check your current policy then follow through to see if there have been any updates regarding this in relation to gambling addiction treatment. If these programs are not covered but you think they might be necessary for your recovery, you can figure out financing options with the specific facility or pay out of pocket.

What Does Executive Treatment Offer Over Other Rehabs?

Executive treatment is tailored for those with high-level careers who cannot take a leave from the essential duties of their work. Many corporations pay close attention to the mental health of their top executives, and if they are in need of help for gambling addiction, they want to encourage treatment for their executives. Keeping an executive in a treatment setting that understands the pressures and work style that an executive faces may provide a better opportunity for recovery for these individuals.

What if I Have No Insurance?

insurance-and-addictionYou may find that there are rehabilitation programs that will make payment arrangements for your needed treatment if you have no insurance. Then it is important to follow the changes that are taking place in the Affordable Care Act, which includes substance abuse and addiction treatment as essential health care – you may be able to find coverage through the public marketplace. If you do not have insurance, do not despair. Treatment is still available.

Questions and Answers

    • Will Blue Cross Blue Shield Cover Multiple Stays?

If you one stay is not enough for you to overcome your gambling addiction or mental health disorder, multiple stays may be covered if deemed medically necessary. Check with your Blue Cross Blue Shield agent and a medical consultant for more information.

    • Does Insurance Pay for Aftercare?

Your insurance might pay, at least partially, for any treatment that is necessary for your recovery, including aftercare therapies.

    • Could Rehab Make my Insurance Higher?

Generally, receiving treatment for a recognized medical condition should not increase your future insurance costs, but every plan is different. Regardless, don’t let fear of future premium increases deter you from seeking the help you need now.

    • Has the Affordable Care Act (Obamacare) Affected Gambling Addiction and Mental Health Insurance Coverage?

Obamacare has helped to make substance abuse and mental health insurance coverage qualify as essential coverage, meaning that insurance companies like Blue Cross Blue Shield have to cover it in some form.

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