Using Blue Cross Blue Shield Coverage for Behavioral Health
You are not alone if you’re curious about rehab centers that take Blue Cross Blue Shield. Many people with this form of coverage inquire about whether their policy covers substance abuse or alcohol rehab, though some form of coverage is standard among carriers due to the ACA.
Too often people assume that their company might not cover it because substance abuse rehab is not a “conventional” or “everyday” form of medical treatment. However, according to the Affordable Care Act, every licensed insurance company in the United States must offer some coverage for rehab.
This could include full coverage or just a portion, but they must assist. Naturally, some providers provide better coverage than others, and some require that you choose from in-network facilities with which they are under contract.
Nearly every Blue Cross Blue Shield plan includes some form of substance abuse and behavioral health coverage. However, your coverage depends on your specific policy, and there would be a wide range of potential coverage amounts.
Does Every Insurance Company Provide Coverage for Rehab?
According to a law passed by the government under the CARES Act, every rehab must provide insurance coverage to individuals with a policy. In addition, most companies must provide equal coverage for healing as they do any other medical procedure or appointment.
With BCBS (Blue Cross Blue Shield), the amount you must pay out of pocket varies depending on your policy. In-network and out-of-network options will also have different price points. But this is all hypothetical, and a call to Icarus directly will be needed for exact details.
You could also be required to obtain prior authorization to outline the treatment you will receive. Insurance agents review this information to ensure that you receive helpful treatment and enroll in a program that produces positive results. Icarus Behavioral Health works closely with Blue Cross Blue Shield to make sure authorization goes smoothly and hassle-free.
The length of your stay and the state you reside in will also significantly affect what you end up paying. No two people will pay the same out of pocket, so it is important not to base your determination on someone else’s experience.
Why Choose an Out-of-Network BCBS Rehab in New Mexico?
This is a common question regarding insurance coverage.
In-network facilities have contracts with certain insurance companies. The agreement states that they must charge a uniform amount for treatment stays, regardless of what the client’s time might entail. This gives the insurance company a concrete idea of what they will pay and allows them to pass this price to their clients.
You could try to select a treatment center that exists in-network with BCBS, though they are rare in New Mexico. Icarus Behavioral Health offers affordable, accessible care as an out-of-network BCBS provider for Albuquerque and NM as a whole.
If you cannot afford the out-of-pocket costs associated, speak with our Admissions team and ask about a payment plan, allowing you to pay back the cost of your treatment slowly as you recover.
Although the cost varies from person to person regarding the coverage type, the programs BCBS covers are universal for everyone. Expect access to the following programs while you are in a rehab covered by BCBS.
What Types of Rehab Programs Does Blue Cross Blue Shield Cover?
Regardless of whether your policy covers the maximum or the minimum, you will have the option of these different programs during treatment, either at Icarus itself or at a partner facility:
During detox, you’ll spend time overcoming the most difficult withdrawal symptoms. The point of a detox is to eliminate all traces of your substance of choice from your system. During medical detox, you will be monitored by health professionals around the clock, who can prescribe medication when withdrawal symptoms become uncomfortable.
This is the safest way to detox, considering the number of complications and physical side effects. Medical detox does not eliminate all the side effects of withdrawal, but it does them manageable.
Inpatient or Residential Rehab
Inpatient rehab consists of you residing at the facility for 30, 60, or 90 days. During this period, you will have regular meetings with counselors and have access to group recovery meetings and possibly family sessions. Certain rehabs also offer holistic treatment options as part of their program, depending on where you attend.
If you have a significant addiction issue or are dealing with multiple substances at once, inpatient rehab is likely to be recommended. Sometimes, committing to 30, 60, or 90 consecutive days in a treatment center might be difficult. During these cases, outpatient rehab and partial hospitalization are available to help accommodate the right balance between treatment and cost.
Partial hospitalization programs, also known as PHP, are typically used as a step down from a traditional inpatient rehab program. During partial hospitalization, clients attend the rehab facility for five days each week. This is typically for 30, 60, or 90 days. For eight hours, the client remains in the rehab facility, participating in the same activities as someone in the inpatient program.
In the evening, the client is allowed to return home and typically is not required to participate on the weekends. Partial hospitalization is a good option for a client who must be home in the evenings for responsibilities regarding children or managing their household. In addition, someone who works the third shift at a job could potentially continue to work and attend this type of rehab, although the schedule would be quite difficult in most cases.
Intensive outpatient is the program between inpatient and outpatient and involves attending three days weekly for 20 hours. Sometimes the schedule may go past 24 hours, depending on the clients’ personalized treatment plan demands.
In intensive outpatient, you could still hold down a job and get half of your week to continue with everyday activities. Many clients attend intensive outpatient that has tried outpatient and were not successful or would like to attend inpatient, but their schedule doesn’t allow it.
Outpatient treatment requires weekly attendance, from five to six hours per day. These hours typically include several one-on-one meetings with counselors, participating in a minor amount of additional therapy activities, and possibly group recovery sessions.
Many clients in outpatient rehab are required to attend group meetings outside of recovery if they are not participating in the rehab itself. This can be via NA or an equivalent program. If you have a solid support system outside of treatment, at home, or otherwise, outpatient treatment could be an option.
What Will My Out-of-Pocket Expenses Be for Rehab with a BCBS Policy?
Your out-of-pocket expenses for rehab depend heavily on the plan you selected when you enrolled. All costs associated with your insurance provider fall on the type of policy you have, including copays, premiums, deductibles, and any other expenses you might incur.
The specific plan you receive is difficult to gauge, considering that BCBS consists of 36 different health insurance organizations, all owned independently. BCBS has solo and family plans of bronze, silver, gold, and platinum. These plans depend on your state, with bronze having the lowest cost and elevating from there.
Bronze will cover about 60% of your costs and have the lowest monthly payments, but the deductibles are higher. Silver covers about 70%, with a higher monthly payment but lower deductibles. Gold will cover 80% of treatment, with high monthly payments but low deductibles. Platinum isn’t offered in every state but will cover 90% with the highest monthly amount and lowest deductible.
Any BCBS plan you select includes mental health coverage and covers an equal amount of mental health services as they do substance abuse.
A Clear Need for Rehab Insurance Coverage
The need for insurance should never be underestimated, especially when you consider the following stats:
In 2019, 20 million people aged 12 and over admitted to some type of substance abuse issue. However, only 4 million of those people received any form of treatment. This leaves 16 million people who went without any kind of professional help.
It is true; that roadblocks and our own mental defenses can make getting into rehab difficult. However, these should not stop you.
Contact the Icarus Admissions staff today and get answers to any inquiries regarding the amount of money you’ll be required to pay out-of-pocket, plus more policy details and program options.
Remember, even as an out-of-network facility for BCBS, your Blue Cross Blue Shield policy for rehab may cover your entire stay at Icarus. However, you should also be prepared in the case that they cover only a portion of your treatment. Our Admissions team can help you by providing details regarding the remaining costs and letting you know about the possibility of a payment plan, as mentioned earlier in the article.
New Mexico Rehab that Accepts Blue Cross Blue Shield
At Icarus Behavioral Health in New Mexico, we accept Blue Cross Blue Shield and work with them regularly. In addition, we also provide multiple treatment options, regardless of whether you or your loved one are attending inpatient, outpatient, or any other form of rehab.
We offer cognitive-behavioral therapy, dual diagnosis treatment, and multiple types of holistic therapy. If you require a pre-authorization form, our staff is quick to provide this and send it back to your insurance provider.
At Icarus, it is our job to give you the most successful treatment experience possible, and we go above and beyond in every category, including insurance and helping you get your treatment covered.
Find a Foundation for Recovery with Your BCBS Policy
Regardless of your insurance or the route you take to get here, long-term recovery is possible with the staff at IBH on your team. Together, we will create a personalized treatment plan to meet your needs, ensuring you receive the substance abuse and mental health care required to prepare you for a return to everyday living.
We’ll also provide you with aftercare resources to ensure you’re 100% ready to re-enter society after graduating. Getting your family involved (when possible and productive) is also encouraged to give you the best odds for long-term success and help establish a sober support network in early recovery.
Contact a member of our Admissions staff today to find out how we can help you achieve long-term recovery. Now is the time to act and start your journey!
* Disclaimer: Icarus Behavioral Health is not affiliated with or endorsed by Blue Cross Blue Shield. Details about BCBS’s coverage are intended for informational purposes only. The specific details of your plan may vary and the specific treatment services you require may or may not be covered. Please call our Admissions team for more definitive details on your plan and options.