Do You Have to Pay for Rehab if You Have Blue Cross Blue Shield Insurance?

If you have a Blue Cross Blue Shield insurance plan and you or a loved one are struggling with alcohol or drug addiction, you may be wondering if you have to pay for rehab. It really all depends on your individual policy. Many people find that their Blue Cross Blue Shield plan does provide coverage for drug and alcohol treatment, while others may be disappointed with how it all shakes out. Because there are so many variables, it's important to know exactly what your insurance coverage provides. That way, you can make informed decisions about your care. Knowing the ins and outs of your coverage can help you make the best choice for you and your family.

What is Blue Cross Blue Shield Insurance?

Blue Cross Blue Shield is one of the largest healthcare insurers in the United States, providing health coverage to more than 100 million people across the country. BCBS insurance plans are provided by independent organizations, and not all of them have the same coverage policies. Insurance is designed to provide coverage for medically necessary services, and most policies include a deductible and coinsurance which must be met before coverage begins. Thankfully, due to the Affordable Care Act of 2008, substance abuse treatment is legally considered a medically necessary service and must be offered at the same level as medical and surgical procedures. 

Will My Blue Cross Blue Shield Policy Cover the Cost of Rehab?

The short answer is…maybe. Since every insurance plan is different, it is important to determine what services and treatments your specific policy covers. While every company has a different way of categorizing their benefits, most Blue Cross Blue Shield plans fall under either a Major Medical or an Advantage plan. The Major Medical plan is meant to cover chronic and lifelong illnesses and conditions, while the Advantage plan is designed to provide coverage for short-term illnesses and injuries. Some Blue Cross Blue Shield policies will provide coverage for in-patient or residential treatment, but others may only cover outpatient treatment. It's important to read your policy thoroughly and talk to your insurance representative about your coverage. Another option is to call the admissions department at a residential addiction treatment program. They work with insurance companies all day, and with just a quick verification of your benefits, they will be able to explain what may or may not be covered. They’ll also give you clarity on any out-of-pocket costs. 

How Do You Determine Your Insurance Coverage for Rehab?

Since Blue Cross Blue Shield is one of the major insurance providers, there is a good chance that any addiction treatment program that accepts insurance will be able to accept your policy. If you have a number of treatment providers that you are considering, a quick scan of their website will often give you the information you need. Most residential addiction treatment programs list their in-network insurance contracts on their homepage or elsewhere on their site. You also can call the facilities directly to ask. Any reputable admissions department will be more than happy to assist you in navigating your benefits — and doing so does not require any commitment from you.

If you still are unsure about your BCBS plans coverage, you can read through your policy yourself. Setting up an appointment with your health insurance representative or calling the customer service number located on the back of your insurance card could be beneficial. It may be helpful to make a list of the different kinds of treatment you are considering. This can help you answer all your questions with one call. Once you know what coverage you have, you can start to compare treatment providers against your available coverage to determine the best option for you.

What to Do If You Don’t Have Enough Coverage for Rehab?

While most substance abuse treatment facilities accept BCBS, your specific policy may not cover the entire cost of rehab. Luckily, there are a few different ways to get help paying for addiction treatment if you don't have enough coverage. The first step is to talk with your BCBS representative. There may be extensions or add-ons that could benefit you. This is a quick and easy way to provide yourself with more coverage. If that doesn’t work, additional funding options may be available. Depending on the state where you live, the local government will sometimes be able to offer assistance in the form of grants and/or scholarships. 

In the rare event that your Blue Cross Blue Shield plan doesn’t cover treatment at all, you should be aware that there are other ways to pay for rehab. From cash payments and credit cards to collateralizing an asset and financing through the facility itself, there are many ways to make addiction treatment affordable. You can even apply for a low-interest loan through your health insurance provider or with a patient financing company. These organizations specialize in healthcare financing, so they are a good option for people who may find themselves needing treatment but unable to cover the full cost. Whether your BCBS insurance policy covers the entire program or you piece it together through several resources, having insurance makes the entire process of getting into rehab easier and cheaper than without it. 

Start Getting Answers Today

If you have a Blue Cross Blue Shield insurance policy and are ready to pursue the healthy, drug-free life you deserve, reach out to our admissions staff today. They are ready and waiting to answer all your insurance questions and get you on the path to recovery!