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Blue Cross Blue Shield is one of the leading medical insurers nationwide. They provide insurance for over half of federal employees, and they serve over 62 million members. If you are one of the many people covered by this company, it’s helpful to learn a little about how their coverage works. This can make it easier to get care instead of worrying, “How much does rehab cost?” Whether or not they will cover your rehab depends on a few factors.
Does Blue Cross Blue Shield Insurance Cover Rehab?
Ever since the Affordable Care Act was finalized, BCBS has been legally required to provide addiction care for its members. Addiction is treated just like any other disease, illness, or mental health condition. It will be covered in the same way the insurance company would treat you for a problem like a broken leg or arthritis. The amount of coverage you get will depend on your type of insurance plan.
What Sorts of Rehab Does Blue Cross Blue Shield Cover?
When thinking about does Blue Cross Blue Shield insurance cover rehab, you need to remember that BCBS only covers treatment that is deemed medically necessary. This means that you may need to get authorization from Blue Cross or a referral from a doctor before they will cover your specific type of rehab. Blue Cross has a few things they consider when deciding whether or not your treatment is necessary. First, they will see if your desired rehab is in-network. Some plans may cover out of network rehab, but many do not.
They will also decide whether you need inpatient or outpatient rehab. Outpatient rehab, where you stay at home or in a sober living, is more affordable, so it is almost always approved by Blue Cross. If you want inpatient rehab, where you live on-site during treatment, you will need to show it is medically necessary. Typically, those with a severe or long-standing addiction will qualify for inpatient rehab. If you have relapsed after outpatient or your home environment encourages drug abuse, inpatient rehab may be covered. You can also get it covered if you do not live close enough to outpatient rehab.
Blue Cross will also consider the type of treatments provided. They usually approve treatments scientifically linked to substance use disorder recovery, such as cognitive behavioral therapy or medically assisted treatment. More holistic treatments, like acupuncture, may not be covered. Medically assisted detox is typically covered since detox can be life-threatening or affect your risk of relapse. However, in very mild cases, detox may not be covered.
The Far-Reaching Effects of Social Anxiety
As you can see, the answer to “does Blue Cross Blue Shield insurance cover rehab?” is that they theoretically do. However, getting coverage for your specific rehab can require a bit of paperwork and assistance. A good place to start is going to the Blue Cross website and logging in to your account. This will give you an overview of your member benefits. You can see if you need a referral from your primary care physician and locate in-network centers.
Next, you typically need a consultation where your level of addiction is assessed. Many people struggle with this because their first instinct is to minimize their problems and hide the severity of their usage. However, it is important to be honest. Openly explain how your addiction is harming your life and be upfront about what sorts of substances you are using. Clearly expressing that you have a problem will ensure that the full range of addiction treatment services are available to you.
Of course, all of this can feel a little easier said than done when you are in the depths of addiction. Many people delay seeking help specifically because they feel overwhelmed by the idea of handling insurance coverage and finding rehab. You should never let this keep you from getting help. The good news is that there are plenty of organizations available to help you. Most rehab centers will offer consultations free of charge, and then their office can handle insurance authorization and other paperwork for you. You can also call Blue Cross’ customer service team if you have any questions about how your insurance works.
Mission Harbor Behavioral Health Is Here to Help
At Mission Harbor Behavioral Health, we happily accept most Blue Cross plans. If you are struggling to figure out whether or not you are covered, our offices can go over your insurance plan with you and help you figure out how much does rehab cost. At our dual diagnosis treatment center, we focus on mental health care of all types. Our treatments focus on treating both addiction and other co-occurring disorders. Give us a call now to get started on the path to recovery.
The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.
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Alcohol addiction is extremely difficult to overcome on your own.. Seek specialized help and let professionals guide you in your recovery.