Blue Cross Blue Shield Insurance Coverage for Heroin

Last updated on March 16th, 2021

  • Does Blue Cross Blue Shield Insurance Cover Treatment for Heroin Addiction?
  • Inpatient Addiction Therapy vs. Outpatient Therapy
  • What if I Have No Insurance?
  • Questions and Answers

Does Blue Cross Blue Shield Insurance Cover Treatment for Heroin Addiction?

doctor talking to patientIndividuals using heroin will likely experience both short- and long-term effects. According to the National Institute on Drug Abuse, the long-term effects can include addiction, infectious diseases, liver and kidney disease as well as other medical problems.

Blue Cross Blue Shield (BCBS) is a nationwide network of insurance providers that offer a wide range of plans and levels of coverage, many of which may include treatment for heroin addiction. Your specific policy will lay out the details of exactly the amount of coverage available to you.

Type of Rehabs Blue Cross Blue Shield Will Pay For

Some Blue Cross Blue Shield plans cover the different forms of rehab treatment and addiction therapy. Depending on your plan, you may be covered for inpatient therapy, outpatient therapy, or other options like luxury and executive facilities.

How Much of the Treatment Costs Will Be Covered by Blue Cross Blue Shield?

This will depend on your particular state and policy. If your coverage is provided through your employer, then you should find a close correlation between the types of coverage you would have for standard medical treatment.

If you have obtained private Blue Cross Blue Shield coverage, then check to see what it will cover for mental health and addiction issues. Your chosen rehab center should be able to help you decipher this in accordance with what it offers.

Can I Pay Above What My Blue Cross Blue Shield Will Cover?

Once you have determined which treatment program is best suited for your needs, you can then check your policy to determine the coverage level. Once you know how much is covered, you can ask the facility if it will accept personal payment for those areas or lengths of time not covered under your plan.

Inpatient Addiction Therapy vs. Outpatient Therapy

“Your specific policy will lay out the details of exactly the amount of coverage available to you.”
Inpatient addiction therapy requires you to live in a rehab facility, while outpatient therapy involves visiting counselors and sessions while still living at home.

Inpatient therapy is best for severe cases of addiction, and outpatient therapy is suitable for those who have more control over their addiction. The level of treatment required often depends on the duration and dosages of your drug use. Rehab professionals can help you determine whether an outpatient or inpatient program would be best for you.

Should I Choose a Residential Rehab Center?

A residential rehab center offers you more options and more intensive therapy. While there are many good outpatient choices, the 24/7 support you receive in a residential setting is helpful for those who are struggling on the road to recovery.

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

Many Blue Cross Blue Shield policyholders have coverage for out-of-state care, with many in-network provider options. The types and levels of coverage vary, so check with your plan administrator.

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

Some treatment centers pay extra attention to the atmosphere and additional amenities. Some recovering heroin addicts prefer this type of upscale setting, as they find it helps them to deal with the various stages of recovery. Whether you’re covered for these plans depends on your policy. You should check with your provider for coverage and payment options.

What does Executive Treatment Offer Over Other Rehabs?

Executive treatment offers individuals with high-level careers the ability to continue working while receiving addiction treatment. Executives may find it easier to participate in a rehab program that caters specifically to them as they tackle drug-use stressors caused by their busy lives.

What Treatment lengths will Blue Cross Blue Shield Pay For?

Everyone recovers from heroin addiction differently, and treatment programs vary in length to account for these differing needs. Policy coverage and deductibles vary as well. You may consider:

    • 28-30 Day Residential Treatments

This short-term stay is considered to be the minimum treatment length for heroin addiction. It involves a detoxification process and a recovery phase.

    • 60 Day Residential Treatments

This length of stay may work well for addicts who feel that a shorter-term treatment program will not be beneficial to them, yet don’t feel they want or will need to stay in a facility for a longer time

    • 90 Day Residential Treatments

These are long term treatment programs. Many heroin addicts find them beneficial because this therapy delves deeper into the underlying issues related to the addiction.

Other options

There are, of course, variations on each of these plans. For instance, you may feel that a holistic approach would be of greater benefit to you. Check with your doctor to determine the best path for you.

What if I Have No Insurance?

does-insurance-cover-drug-rehabMany rehab centers offer services for those willing to pay themselves or who only have insurance that will only cover a portion of the treatments offered. Many centers also offer different levels of treatment programs, which will give you the opportunity to choose a program that will be of most value to you.

Questions and Answers

    • Will Blue Cross Blue Shield Cover Multiple Stays?

There are times when heroin addiction treatment has not been totally successful or you have relapsed but are ready to try again. You may be eligible for coverage for repeated rehabilitation stays depending on your plan and where you live. If you are not covered, there may be alternatives, such as out-patient therapy. If you are not covered for repeat rehab treatments, you could utilize some of the payment options that many of the facilities have to offer.

    • Does Insurance Pay for Aftercare?

In some cases aftercare may be covered by your Blue Cross Blue Shield plan. This depends on whether you are going through a facility that is part of their network or if you are going with an out-of-network program. In any case, taking part in this extended therapy is important.

    • Could Rehab Make My Insurance Higher?

Using your insurance benefits to treat addiction should not immediately raise the cost of your premiums. That being said, don’t let fear of future charges prevent you from seeking quality care today.

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

Obamacare has expanded coverage for substance abuse and mental health insurance due to provisions in the law. It has made this coverage more readily available to policyholders.

(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.)

Verify Your Benefits at an American Addiction Centers Facility

The cost of alcohol or drug addiction treatment may appear to be an obstacle, but we are here to help. Insurance may cover all or some of your rehab.

Find out if your insurance covers long-term addiction rehabilitation.

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