Do Drug and Alcohol Rehab Centers Take Blue Cross Blue Shield Insurance?
Blue Cross Blue Shield rehab coverage, including BCBS alcohol rehab and BCBS drug rehab, is accepted at Virtue Recovery Centers. The coverage details depend on your policy, the level of care needed, and whether or not the provider is part of the BCBS rehab provider networks. Below is all the information you’ll need regarding Blue Cross Blue Shield health insurance and the path to recovery.
Who is Blue Cross Blue Shield Rehab?Blue Cross Blue Shield (BCBS) is a trusted federation of 34 independent, locally operated health insurance companies in the United States. The companies that make up the BCBS association are licensed by the Blue Cross Blue Shield Association (BCBSA), a national organization headquartered in Chicago, Illinois.1 In 1929, BCBS was founded to offer prepaid hospital coverage to families and individuals. Today, it has become the largest health insurance provider in the US, with over 100 million members nationwide. Each BCBS company provides health insurance coverage to individuals and groups in their respective states while sharing a common brand and network. As a result, members can access healthcare services across state lines. Additionally, for those who live, work, and travel abroad, Blue Cross Blue Shield Global™ solutions offer a full range of foreign goods and services, providing them peace of mind that they can get high-quality care whenever and wherever they need it.2 BCBS offers various health insurance products, including individual and group health plans, Medicare, and Medicaid coverage. Many of their plans cover rehabilitation services, health and wellness programs, and other benefits aimed at helping members manage their health and access preventive care services.
What is Blue Cross Blue Shield Rehab Addiction Recovery Insurance Coverage?Blue Cross Blue Shield (BCBS) insurance coverage for addiction rehab can vary depending on several factors, including your particular policy and the state in which you live. However, many BCBS plans do offer coverage for addiction recovery. In addition, many BCBS plans also have resources available to help members find addiction treatment providers and rehab facilities covered under their plan. To determine what addiction recovery services are included under your BCBS plan, review your plan documents or contact Virtue Recovery Center at 866-461-3339.
Does Blue Cross Blue Shield Rehab Insurance Cover Drug and Alcohol Addiction Recovery?Almost all BCBS insurance policies include drug and alcohol addiction recovery. Although Blue Cross Blue Shield alcohol rehab and Blue Cross Blue Shield drug rehab can vary by state, most individual and family plans are divided into three levels. Below is a general overview of BCBS levels3 of coverage:
- Bronze: This plan could be ideal for you if you rarely visit the doctor or take many medications. Despite the higher cost of care, your monthly expenses will be reduced.
- Silver: This plan provides a more reasonable balance between your monthly payments and the expenses incurred when receiving medical coverage and care. If you require financial aid, this is the recommended choice.
- Gold: If you frequently visit the doctor or take a lot of medications, this plan may suit you. It offers more coverage with slightly higher premiums but can save you money on healthcare expenses.
- Inpatient care: Individuals can receive 24/7 medical care by being admitted to a hospital or clinic where they may stay for multiple days or weeks.
- Outpatient care: Therapy and counseling for patients who live in their own homes yet attend sessions at a treatment center.
- Interim Care: In situations where an individual cannot be admitted to a facility due to lack of availability or waitlist, interim care provides delivery of daily medication and emergency counseling from a facility.
- Residential Care: Residing in a facility and receiving extended treatment for a month or more or even a year.
- Medication-assisted treatment (MAT): The use of FDA-approved medications, counseling, and behavioral therapies to treat substance abuse problems on a "whole-patient" basis.
- Counseling/therapy: Counseling and therapy for substance use may involve different approaches, such as cognitive-behavioral therapy (CBT), motivational interviewing, or group therapy. Treatment may be provided in an individual or group setting, including ongoing support and follow-up care to help individuals maintain their recovery.
- Detoxification: The process consists of three essential components: evaluation, stabilization, and preparation for entering a substance abuse treatment and recovery program.
- Sober living home: Living in a temporary facility/home as a step towards transitioning from intensive treatment to being prepared for independent living.
- Access to behavioral health specialists: Healthcare professionals specializing in treating mental health and substance use disorders. They are trained and licensed to diagnose and treat various conditions, including anxiety, depression, addiction, and other behavioral and emotional disorders.
- Peer support groups: Groups of individuals with similar experiences or challenges who come together to provide mutual support, share information, and encourage one another.
- Telemedicine: Remote treatment and counseling services can be provided to individuals, even when local treatment resources are not easily accessible. These services can be delivered over the phone or the Internet.
Check Your BCBS Insurance for Addiction Treatment
Our admissions coordinators will interact directly with your insurance provider on your behalf, removing from your shoulders the burden of figuring out if your insurance will pay for your addiction treatment.
Does Blue Cross Blue Shield Rehab Insurance Cover Mental Health Rehab?
Mental health rehabilitation is usually covered by Blue Cross Blue Shield rehab coverage. BCBS plans often cover mental health services, such as inpatient and outpatient treatment, dual diagnosis, hospitalization, psychiatric consultations, aftercare, and therapy, such as evidence-based practices like cognitive-behavioral therapy (CBT).
In addition, the Affordable Care Act (ACA) deems substance use disorder and mental health treatment essential health benefits, even for pre-existing conditions.
Inpatient and Outpatient Addiction Recovery Centers That Take Blue Cross Blue Shield Rehab Insurance
Virtue Recovery Center has multiple treatment locations across several states and has supported individuals on their path to sobriety for years. The Joint Commission accredits all of our inpatient and outpatient facilities, and we are members of the National Association of Addiction Treatment Providers (NAATP) while also being HIPAA compliant.
Below you'll find links to all of the Virtue Recovery Center treatment facilities that are part of Blue Cross Blue Shield’s provider network:
How Much is Rehab with Blue Cross Blue Shield Insurance?
The cost of rehabilitation with BCBS insurance might differ based on many variables, such as your particular policy, the state where you reside, the kind of rehabilitation center you select, and the particular services and treatments you need. However, generally speaking, BCBS insurance plans may pay all or a portion of the cost of addiction treatment.
Although you have insurance, it's likely that you'll still have to pay some or all of your medical costs until you meet the deductible. After that, depending on your plan, you may be responsible for paying a copay or coinsurance for each service or treatment.
With that said, psychotherapy in the United States usually costs between $100 to $200 per session,[i] depending on the location and length of the session. Additionally, your copay with health insurance can vary between a few dollars to $50 or more a session. This out-of-pocket expense may be influenced by other variables, such as whether the therapist is part of BCBS’ provider network.
Several therapists offer a sliding scale payment plan to patients without insurance or who need financial assistance. Your income typically determines the fee.
How To Check My Blue Cross Blue Shield Rehab Insurance Coverage Levels for Addiction Recovery
Verify insurance coverage quickly by filling out our no-obligation online form. One of Virtue Recovery Center’s qualified staff members will contact BCBS to verify your healthcare benefits. We'll contact you as soon as possible to review your policy and discuss the next steps. Any information you provide or discuss will remain completely confidential.
How To Get Blue Cross Blue Shield Rehab To Pay For Addiction Recovery
If you’re seeking addiction recovery services, there are several steps you can take to ensure that your Blue Cross Blue Shield rehab coverage will cover the costs:
- Verify your insurance coverage: Contact your insurance provider or call 866-461-3339 to understand what services are covered under your plan.
- Choose a rehab facility: Research facilities in your area that are part of BCBS’ provider network, and that they provide the particular services and level of care you need. Selecting a facility that is in-network with your insurance provider is essential to maximize your coverage for affordable healthcare.
- Get pre-authorization: Many BCBS plans require pre-authorization for addiction recovery services. This means you must get approval from your insurance provider before receiving treatment. A healthcare provider, like Virtue Recovery Center, can help you with the pre-authorization process.
- Follow the treatment plan: Once approved for addiction recovery services, follow the treatment plan recommended by your healthcare provider. This helps ensure that your insurance covers your treatment and that you achieve the best possible outcomes.
Review and appeal claims: After receiving treatment, review your insurance claims to ensure that all services are accurately reflected and that you’re not charged for services your insurance should cover. If you notice any discrepancies, contact your insurance provider to appeal the claims.
How Many Times Will Blue Cross Blue Shield Rehab Pay for Addiction Recovery?
BCBS plans may cover multiple rounds of addiction treatment, including inpatient or outpatient rehab, detoxification, medication-assisted treatment (MAT), counseling, and therapy services. However, the number of times BCBS will pay for addiction recovery will depend on the specifics of your plan and your individual treatment needs.
Some BCBS plans may limit the number of treatment days or sessions covered, while others offer unlimited coverage. However, even if your BCBS plan limits the number of treatment days or sessions, you may be able to appeal for additional coverage if you and your healthcare provider believe that more treatment is necessary for your recovery.
Addiction Recovery Treatment and Insurance Statistics
- A report detailing the effects of opioid usage and opioid use disorder on Americans' health was published in 2017 by Blue Cross Blue Shield Association. This investigation looks at how far we've come in reducing the misuse of prescribed opioids. Although there has been improvement, 241,900 BCBS members had an opioid use disorder diagnosis in 2017.1
- In 2017, 67% of BCBS members completed their initial opioid prescription following the Centers for Disease Control and Prevention’s advice about dosage and duration. Some states performed significantly better than the national average, including Rhode Island (80%), Mississippi (74%), Vermont, and Massachusetts (73%).2
- The Centers for Disease Control and Prevention report that over 35% of all opioid-related fatalities in 2017 contained prescription opioids.3
- Blue Cross Blue Shield is one of the largest health insurance providers in the United States, with an estimated 1.7 million providers in its network.4
- Blue Cross Blue Shield operates in all 50 states, the District of Columbia, and Puerto Rico, providing coverage to individuals, families, and employers.
- Blue Cross Blue Shield offers a wide range of health insurance plans, including individual and family plans, Medicare Advantage plans, Medicare Supplement plans, employer-sponsored plans, and Medicaid plans.
- Nearly 119 million people were enrolled in Blue Cross Blue Shield (BCBS or Blues) as of September 30, 2022, accounting for 38% of all Americans with health insurance (individual plus employer-based, for all funding types, Medicaid, and Medicare).5
- To address the problem of health inequities in the country, the Blue Cross Blue Shield Association established a National Health Equity Strategy in 2021. The BCBS enterprises are actively moving toward a more equitable future. This includes $489 million allocated to community health programs that tackle issues like food insecurity, stable housing, and secure communities.6
- Recent estimates suggest that 85% of patients experience a relapse within a year after finishing addiction treatment.7
- The fast growth of substance abuse and the closing gender disparity in drug use rates are directly tied to women being more likely to have traumatic experiences and violence from intimate partners.8
- Higher depression ratings correlate with a lower chance of abstinence from substance use9 and a quicker time to relapse.10
According to a study by the Centers for Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA), 3 out of 4 people eventually overcome their addiction.11 While there is no cure, addiction can be managed successfully.
Check Your BCBS Insurance Coverage With Virtue Recovery Center
If you’re committed to recovery, submit a request to one of our professional admission coordinators today using the form below. Before discussing the next steps, a coordinator will address any inquiries regarding our programs, including interacting directly with Blue Cross Blue Shield Rehab on your behalf to check your insurance coverage levels for drug or alcohol addiction rehab.
Using your Health Insurance Card, fill out all of the fields on the confidential form.
A member of our staff will contact your insurer to verify if your policy will cover your treatment
We will contact you promptly with the results of the verification and discuss the next steps
*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note that this is only a quote of benefits and/or authorization. We cannot guarantee that payment or verification eligibility will be accurate and complete as conveyed by your health insurance provider. Payment of benefits is subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. Your health insurance company will only pay for services it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. Suppose your health insurance company determines that a particular service is not reasonable and necessary or that a specific service is not covered under your plan. In that case, your insurer will deny payment for that service, and it will become your responsibility.
*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.
- “BCBS® Companies and Licensees.” Blue Cross Blue Shield, www.bcbs.com/bcbs-companies-and-licensees.
- BCBSGlobal | Solutions for International Healthcare Needs. www.bcbsglobal.com.
- “Individuals and Families.” Blue Cross Blue Shield, www.bcbs.com/individuals-families.
- “Substance Use Resource Center.” Blue Cross Blue Shield, www.bcbs.com/SURC.
- “Mental Health and Substance Abuse Health Coverage Options.” HealthCare.gov, www.healthcare.gov/coverage/mental-health-substance-abuse-coverage. Accessed 3 May 2023.
- Lauretta, Ashley. “How Much Does Therapy Cost?” edited by Alena Hall, Forbes Health, 2021, https://www.forbes.com/health/mind/how-much-does-therapy-cost/
- “The Opioid Epidemic in America: An Update.” Blue Cross Blue Shield, 12 July 2018, www.bcbs.com/the-health-of-america/reports/the-opioid-epidemic-america-update#one.
- U.S.Department of Health and Human Services “Annual Surveillance Report of Drug-Related Risks and Outcomes.” Centers for Disease Control and Prevention, 31 Aug. 2017, www.cdc.gov/drugoverdose/pdf/pubs/2017-cdc-drug-surveillance-report.pdf. Accessed 3 May 2023.
- “Using a Multi-pronged Approach to Fight Substance Use Disorder.” Blue Cross Blue Shield, www.bcbs.com/the-health-of-america/articles/using-multi-pronged-approach-fight-substance-use-disorder. Accessed 3 May 2023.
- Kissell, Chris. “Largest Health Insurance Companies 2023.” Forbes Advisor, 3 Jan. 2023, www.forbes.com/advisor/health-insurance/largest-health-insurance-companies.
- “Trends in Profit Margins for Leading Blue Cross Blue Shield Plans.” Mark Farrah Associates, 30 Jan. 2023, www.markfarrah.com/mfa-briefs/trends-in-profit-margins-for-leading-blue-cross-blue-shield-plans-.
- “Investing in Healthier Communities.” Blue Cross Blue Shield, www.bcbs.com/corporate-social-responsibility. Accessed 3 May 2023.
- Brandon, Thomas H., et al. “Relapse and Relapse Prevention.” Annual Review of Clinical Psychology, vol. 3, no. 1, Annual Reviews, Mar. 2007, pp. 257–84. https://doi.org/10.1146/annurev.clinpsy.3.022806.091455.
- Bravo, Fabián, et al. “Gender Differences in the Long-term Outcome of Alcohol Dependence Treatments: An Analysis of Twenty-year Prospective Follow Up.” Drug and Alcohol Review, vol. 32, no. 4, Wiley-Blackwell, July 2013, pp. 381–88. https://doi.org/10.1111/dar.12023.
- Dodge, Rebecca, et al. “The Role of Depression Symptoms in Predicting Drug Abstinence in Outpatient Substance Abuse Treatment.” Journal of Substance Abuse Treatment, vol. 28, no. 2, Elsevier BV, Mar. 2005, pp. 189–96. https://doi.org/10.1016/j.jsat.2004.12.005.
- Greenfield, Shelly F., et al. “The Effect of Depression on Return to Drinking.” Archives of General Psychiatry, vol. 55, no. 3, American Medical Association, Mar. 1998, p. 259. https://doi.org/10.1001/archpsyc.55.3.259.
- Jones, Christopher W., et al. “Prevalence and Correlates of Ever Having a Substance Use Problem and Substance Use Recovery Status Among Adults in the United States, 2018.” Drug and Alcohol Dependence, vol. 214, Elsevier BV, Sept. 2020, p. 108169. https://doi.org/10.1016/j.drugalcdep.2020.108169.
- NIDA. "Treatment and Recovery." National Institute on Drug Abuse, 9 Mar. 2023, https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery Accessed 3 May 2023.
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