BCBS Substance Addiction Treatment Coverage

Blue Cross Blue Shield is one of the biggest carriers of health insurance in the U.S. Blue Cross Blue Shield represents 36 locally and independently owned groups operated underneath various plan names. Through the Healthcare Marketplace, individuals are able to acquire Blue Cross Blue Shield coverage. However, Blue Cross Blue Shield also gives a ton of company group coverage plans – both for-income and nonprofit organizations.

At Pax Riverbend, we are dedicated to ensuring every individual has the opportunity to get the help they need for addiction today, which is why we work with Blue Cross Blue Shield and many other verified insurance providers. 

Blue Cross Blue Shield Coverage for Substance Abuse

Alcoholism was categorized as a disease via the American Medical Association in 1956, and 30 years later, addiction followed. In 2010, the Affordable Care Act — Obamacare — increased the scope of behavioral health requiring advantages to cowl substance abuse treatment as well. Officially defined as a disease, dependency can not be defined as a pre-current condition. In other words, substance use disorder cannot be denied and plans at the Health Insurance Marketplace at the moment are required to offer coverage for at least a portion of drug rehab. Companies like Blue Cross Blue Shield of Indiana, are required by the Affordable Care Act to apply the premiums of its policyholders closer to dependency 

Blue Cross Blue Shield offers several forms of insurance plans. Health Maintenance Organizations, or HMOs, require the coverage holder to stay in-network while receiving care. This manner the coverage holder must select from the available companies “in-network” to acquire monetary compensation for coverage. HMO insurance plans additionally require a referral from a primary care doctor to see a specialist.

Blue Cross also offers Preferred Provider Organizations or PPO plans. This sort of coverage provides more flexibility whilst choosing a provider. These specific plans cover specialists (commonly with a demand for a referral) even if they’re no longer in the network.

When looking over your coverage, it is crucial to take note of what insurance coverage your plan offers. Here are a few of the most common Blue Cross Blue Shield plans:

• Bronze Coverage – Premiums under the Bronze plan are usually the lowest. However, these plans often include excessive deductibles that have to be met before insurance is provided. Bronze plans through Blue Cross Blue Shield typically include coverage of 60% of the overall clinical bill
• Silver Coverage – Blue Cross silver gives a slightly better premium however has a tendency to offer more coverage for clinical services after the deductible is met. This coverage commonly covers 70% of your healthcare bill.
• Gold Coverage – Deductibles on this individual plan are normally extra affordable. Benefits are normally the same, however, the charges on Gold guidelines are much better. This plan is most usually used due to the 80% coverage of scientific bills.

Keep in mind that each Blue Cross Blue Shield policy typically includes co-pays as well as different benefits varying from every tier. You might also locate varying partial hospitalization, detoxification, and hospital benefits with every plan.

Levels of Care Available With Blue Cross Blue Shield

The Affordable Care Act (ACA) requires insurance organizations to provide services and benefits to those struggling with substance abuse/mental illness disorders. This legislation ensures that people receive the same level of coverage for mental health disorders just as if it were medically necessary. Here are a few of the most commonly covered services through Blue Cross Blue Shield for drug and alcohol rehabilitation.

• Drug/Alcohol Detoxification – Due to the painful withdrawal symptoms, many addicts require assistance with the detoxification process. This level of care consists of managing the stages of acute withdrawal symptoms while making sure the protection and comfortability of the individual improving from substance abuse disorder is a top priority. Detox may also require care from professional and emergency personnel of the rehab facility. The staff at PAX Riverbend is trained to coordinate an appropriate treatment plan that includes a full drug and/or alcohol detoxification.
• Medication-Assisted Treatment (MAT)– Many Blue Cross plans cover medication-assisted treatment packages for those suffering from substance abuse. This method of substance abuse treatment also includes medication therapy of Suboxone or Methadone in order to mitigate withdrawal symptoms and cravings. Your doctor will need to offer a referral to Blue Cross Blue Shield about why this specific type of treatment is necessary in order for you to obtain coverage.
• Inpatient Rehabilitation – This particular level of care at PAX is normally presented to individuals once detox is completed. Blue Cross Blue Shield coverage for residential treatment at PAX Riverbend in Jefferson Indiana is covered when an individual is deemed impaired and unable to function in the community. PAX Riverbend’s residential program normally includes a structured, therapeutic environment presenting 24-hour, around-the-clock services.
• Intensive Outpatient Program (IOP) – Intensive outpatient program services are often covered by Blue Cross Blue Shield for individuals who need assistance with stabilization, symptom reduction, or relapse prevention services. Typically, clients at PAX Riverbend will transition from residential treatment to intensive outpatient treatment services.

Pax Riverbend is proud to accept Blue Cross Blue Shield health insurance. In order to make the Jefferson, Indiana addiction treatment process as stress-free as possible. Our team will help you contact your insurance provider to find out more about what your specific plan covers. At Pax Riverbend, we are dedicated to working with multiple insurance providers to better service our clients. Give our facility a call today to verify your insurance with a member of our professional team.