For an individual who is ready to get rid of alcoholism and substance abuse through professional addiction treatment, one of the main concerns for them may be the mode or ways of payment for treatment services. There are many insurance companies such as Blue Cross Blue Shield that provide at least some level of coverage for drug rehab treatment.
Blue Cross Blue Shield is one of the oldest and largest health insurance provider companies in the United States. The Blue Cross and Blue Shield Association owns a total of 36 health insurance companies nationwide which incorporates the Blue System. This company covers more than 105 million Americans and function in all 50 states. As part of the Federal Employee Program, the Blue System has more than half of the federal employees enrolled in its network.
Many hospitals, healthcare service providers, and rehab facilities work directly with Blue Cross Blue Shield insurance company. Behavioral healthcare services, including mental health issues and substance abuse, are covered under Blue Cross Blue Shield. While many of its policies cover a wide range of benefits to treat alcohol addiction, options and programs mainly depend on the state you reside in and on the individual plan chosen.
Blue Cross Blue Shield covers some of the costs associated with the following programs:
• Residential treatment and detox
• Partial hospitalization
• Outpatient treatment
• Acute Inpatient hospitalization
Addiction Resources of Blue Cross Blue Shield
Blue Cross Blue Shield Resources has increased over the years in identifying and finding help for substance abuse problems as the number of drug or alcohol addictions across the nation is growing. Specifically for painkillers like Percocet and Vicodin, the company recently has introduced a prescription pain medication safety program to help an individual to reduce the risk of drug addictions.
Blue Cross Blue Shield Levels of Coverage Plan
Blue Cross Blue Shield provides two levels of coverage named: HMOs and PPOs
Health Maintenance Organizations (HMOs): While receiving care for services, a health maintenance organization requires its members to stay in-network to get the coverage of the insurance plan. Patients also need a referral drive for their primary care physician for services like drug or alcohol rehab.
Preferred Provider Organizations (PPOs): Due to its more flexible, this organization allows its members to seek care outside the network also. Although there is a very less percentage covered out of the system, treatment services provided to a patient could be costly for those who are not in the order.
Plan Tiers of Blue Cross Blue Shield
This organization provides different tiers plan, and these tiers vary from state to state. The four standard options offered by the organization are Bronze, Silver, Gold, and Platinum. Deductibles, premium, co-pays, and coverage amounts vary according to the coverage of drug and alcohol rehab plan a patient has chosen:
• Bronze: Monthly premiums are low for this plan, but deductibles are high. The costs coverage of the project is 60 percent of the treatment program.
• Silver: The level of the amount covered is around 70 percent of the medical costs. The monthly payment is slightly higher and lower deductible.
• Gold: With a higher monthly payment and a low deductible, this plan level covers around 80 percent of the program costs.
• Platinum: With the lowest deductible and highest monthly fee, this level covers approximately 90 percent of the program costs.
Is Treatment Centers Need to be In-Network?
Another insurance policy aspect is whether you choose an HMO (Health Maintenance Organization) Plan or a PPO (Preferred Provider Organization) Plan. Under the HMO Plan, an individual is covered at HMO contracted facilities. And with a PPO Plan, an individual can access the more options in regards to the number of providers. It is advisable to consult the insurance provider about the specific details covered under the plans.
Blue Cross Blue Shield Coverage provided for Inpatient Treatment
Blue Cross Blue Shield policies depend mainly on the laws and regulations of each state. Coverage plan also impacted by the location of the treatment facilities either it is a physician’s office, hospital, or treatment facility.
Inpatient rehab treatment costs depend on the plans tiers: Bronze plan, Silver plan, a gold plan, and platinum plan. Pre-certification is often required for any inpatient rehab services for substance abuse. Some of the other inpatient treatment benefits include:
• Standard Options- It starts at $35 per admission for unlimited days.
• Basic Options- The cost per ticket is up to $875 for endless days, and co-payments is approximately $175 per day.
Blue Cross Blue Shield Coverage for Outpatient Treatment Plan
Treatment services for outpatient rehab services are similar to that of inpatient services. The cost and treatment options mainly fluctuate significantly due to the physician’s office or facilities at the hospital or office. Outpatients rehab services also depend on the plan chosen: Bronze plan, Silver plan, Gold Plan, and Platinum plan. Some of the other options are:
• Standard Option- It roughly covers 15 percent of the plan’s allowance.
• Primary Option- It generally provides a co-payment per day and per facility.
The Options for Plan Not Covered Under Blue Cross Blue Shield Insurance Plan
There is no need to face hassle regarding cost on the path to recovery. Our team of dedicated experts or specialists will help you find better options that are the best fit according to your income and needs. We will help you with the insurance provider’s coverage options.
Any time to get help regarding insurance plans and treatment options, you need to contact us.