BCBS Drug Addiction and Mental Health Rehab
Drug addiction and mental health illness are chronic and complex conditions requiring a comprehensive treatment plan for successful recovery. However, some people fail to seek professional help because of the high cost of rehab.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), only a fraction of people battling substance use disorders (SUD) in the U.S. seeks rehab services. This is primarily because of the stigma and expenses associated with addiction treatment.
At Icarus Behavioral Health, we accept drug and alcohol rehab insurance, including Blue Cross Blue Shield (BCBS), to ensure our clients have access to affordable treatment services. If you or someone you care about needs treatment for substance abuse, read on to learn more about Blue Cross Blue Shield drug rehab services in Nevada.
About the Blue Cross Blue Shield Insurance Company
Blue Cross Blue Shield Insurance was founded in 1929 and is a conglomerate of many affiliated healthcare organizations providing medical insurance to people across the United States. BCBS is one of the largest health insurance providers in the country, serving approximately a third of all Americans.
Blue Cross Blue Shield’s extensive network includes most U.S. doctors and hospitals. Millions of federal government employees choose Blue Cross Blue Shield as their health insurance provider. A person struggling with mental health issues or addiction may benefit from the various features of BCBS insurance policies.
Most Blue Cross Blue Shield plans include drug or alcohol addiction treatment, but the details will vary by state and policy. Icarus Behavioral Health is here to help you or a loved one through your substance abuse or mental illness struggles.
Key Health Insurance Terms
Health insurance is a broad and complex field. Here are some of the most common terms you need to know for you to understand the specifics of your Blue Cross Blue Shield drug rehab insurance coverage:
- Benefits: These are the services that your insurance will pay for.
- Premium: You must pay a monthly fee, known as the premium, in exchange for the coverage provided by your insurance policy. Whether or not you use your health insurance, you still have to pay the monthly cost.
- Covered service or person: This refers to the people and the services covered by the policy.
- Group: Employees of a single company are an example of a group because they have identical health insurance requirements.
- Insurance deductible: “Deductible” refers to the out-of-pocket expense you must pay before your health insurance kicks in. Suppose your health insurance plan has a deductible of $500 per year. You’ll have to pay the first $500 of any medical bills you incur in that time frame out of pocket.
- Coinsurance: After you meet your deductible, you’ll be responsible for paying some of your medical expenses. This payment is known as “coinsurance.”
- Deductible: Once you meet your annual deductible, your out-of-pocket costs for inpatient rehabilitation may be as low as 20% if your insurer covers 80%. You will be liable for paying the total price of the service until your deductible has been satisfied. After that point, your insurance will begin paying 80% of the cost.
- Copay: A copayment, or “copay,” is a fixed cost paid at the time of service, either at the healthcare facility or the doctor’s office.
- Annual limit: The maximum amount your plan will pay for a given service or operation in a single year is called the “annual limit.”
- Out-of-pocket maximum: Maximum annual out-of-pocket cost refers to the most money you will have to pay each year before. The remaining out-of-pocket costs for covered medical treatments once the deductible has been met are subject to the predetermined coinsurance percentage up to the annual maximum.
- Primary care physician: Primary care physicians are the MDs you choose to be your primary caregivers. If more medical expertise is required, this doctor will also coordinate that.
- In-network: Providers who are “in-network” with a given insurance company have negotiated more favorable patient reimbursement rates. Maximize your savings by only using in-network service providers.
- Out of network: When a healthcare professional is “out of network,” they aren’t part of a contracted network with a specific insurance company.
Does BCBS Cover Drug Addiction Treatment Services?
Blue Cross Blue Shield insurance plans usually cover drug and alcohol addiction treatment or mental health disorders. Substance abuse treatment coverage varies widely depending on the specifics of the insurance plan.
The Mental Health Parity and Addiction Equity Act (MHPAEA) state that there must be no difference in coverage between physical and mental health care, including drug addiction treatment.
This law helps ensure that more people needing help with drug abuse or mental health issues can get it. Nonetheless, many Blue Cross Blue Shield plans offer coverage at affordable rates.
Insurance coverage for drug addiction differs based on factors like:
- Your geographic location will affect the total amount of your insurance coverage.
- Whether or not the facility is part of a network
- How long you’ll get treatment
- Your insurance policy’s specifics
The cost of rehab also between different treatment facilities.
Impact of Choosing a Provider Within Your Insurance Network
In-network healthcare providers usually adhere to a predetermined fee structure. Your out-of-pocket expenses will be cheaper if you receive care at an in-network institution rather than an out-of-network hospital or clinic.
You may have to pay the total therapy cost out of pocket if you choose a facility, not in your insurance’s network.
When choosing a rehab facility, consider one that accepts Blue Cross Blue Shield, insurance patients. If you require medical care but cannot find an in-network doctor or preferred facility, the healthcare facility may be willing to work with you to establish a payment plan.
Types of Blue Cross Blue Shield Policies
The most common types of Blue Cross Blue Shield health insurance plans include:
- Preferred Provider Organization (PPO) plans
- Health Maintenance Organization (HMO) plans
- Catastrophic plans
Each plan type has unique features and benefits.
Blue Cross Blue Shield HMO Plans
Policyholders with a BCBS HMO plan can access tens of thousands of physicians in the network. However, these plans will pay for services provided by doctors who are not in their network in the case of an emergency.
BCBS PPO Plans
The PPO plans provided by BCBS offer more freedom of choice. Policyholders have access to a sizable pool of medical facilities from which to choose. Out-of-network visits to specialists or primary care physicians will incur higher out-of-pocket costs than in-network facilities or providers.
BCBS PPO coverage gives the policyholder the most flexibility and access to the best care for mental health and addiction treatment.
Beneficiaries of PPO plans are not required to seek medical attention from providers in their insurer’s network and are free to do so at any facility they need to. PPO insurance is the best option for clients who need to travel out of state for treatment because the broadest network of Blue Cross Blue Shield-approved rehabs accepts it.
Those needing mental illness or substance abuse care should consider getting a PPO policy.
Catastrophic Insurance Plans
Young adults are likelier to choose catastrophic policies because of their lower premiums than comprehensive coverage. But, it is essential to remember that the deductibles for these plans are more significant than average.
Blue Cross Blue Shield’s Metal Tier System
Other than the Catastrophic plans, all health insurance policies are categorized into one of four tiers, or “metal levels,” under the Affordable Care Act (ACA). The four tiers, Bronze, Silver, Gold, and Platinum, basically offer the same core benefits.
The only variation is in the percentage of your healthcare bills that your plan will cover. Your monthly premiums and deductibles will change as you go up the plan’s tiers.
- Bronze: Bronze plans cover around 60% of healthcare costs. While they have hefty deductibles, bronze plan monthly rates are comparatively low.
- Silver: Silver plans cover around 70% of medical costs for a higher premium and a lower deductible.
- Gold: Gold plans have high premiums each month but minimal deductibles. Almost 80% of healthcare costs are covered.
- Platinum: The highest monthly rates are reserved for Platinum plans, which also have the lowest deductibles.
Those who don’t need regular doctor visits are encouraged to join up for the least expensive choice, bronze plans, because of their low monthly premiums and high deductibles.
Most countries can access bronze, silver, and gold plans, but platinum plans are available in some areas.
Drug Addiction Treatment Under BCBS Coverage
There is a wide range of treatment options for mental illness and addiction. The best person to offer advice on treating your disease is your doctor or treatment provider.
While a thorough clinical evaluation is needed to determine the optimal treatment plan, below are some of the most commonly used approaches to rehabilitation:
Medically-supervised detox can help reduce the severity of adverse withdrawal symptoms as the body rids itself of the drugs. The medical professionals at Icarus will monitor you closely to ensure safe and comfortable withdrawal at our drug rehab treatment facility.
Inpatient Rehab Programs
Inpatient rehab requires the patient to reside at the facility 24/7. You will learn to cope with your emotions, establish new habits, and adjust to life without alcohol or drugs. Clients with life-threatening illnesses who require medical care around the clock should consider inpatient treatment.
Outpatient Rehab Programs
If you need to continue your regular life responsibilities, such as family, school, or work, while getting help, an outpatient program may be the best option. These programs allow you to continue living at home while getting better.
Intensive Outpatient Programs (IOP)
People who have a solid support system at home but need more intensive treatment than a regular outpatient program typically can consider an intense outpatient program. The benefit of an IOP is that patients can go about their daily schedules without interrupting their treatment.
Partial Hospitalization Programs (PHP)
Partial hospitalization programs are more helpful for people who need round-the-clock care but can go home at night. Many hours every day, up to five days per week, will be devoted to your treatment when you enter a PHP treatment plan.
After completing therapy, it’s essential to have access to aftercare services that can help you maintain sobriety and the changes you’ve made in your life. Being a part of an aftercare program will provide you with the support and advice you need to keep up with your new routine and remain sober.
Get the Help You Need at Icarus Behavioral Health in Nevada
Drug addiction and mental health illnesses can have devastating effects on your health. If you or a loved one are struggling with such conditions, you shouldn’t battle drug and alcohol abuse alone.
The compassionate and dedicated team at Icarus is here to help you get out of your comfort zone and begin the journey toward complete recovery.
Blue Cross Blue Shield Drug Rehab FAQs
Here are some of the most frequently asked questions about BCBS drug rehab:
How much of the drug rehab costs are covered by Blue Cross Blue Shield?
Each BCBS policy has distinct coverage benefits and limitations for rehab and related services. The total cost of recovery covered depends on the specifics of your plan. Have your BCBS information handy when contacting our drug rehab center. Our admissions team can help you determine your level of drug and alcohol rehab coverage.
What can I do if Blue Cross Blue Shield doesn’t cover all of my drug rehab needs?
At Icarus, we offer a highly personalized experience for different clients. BCBS may cover All or some of your rehabilitation costs, depending on the details of your policy. But there are other costs associated with treatment at a drug or alcohol rehabilitation center that insurance may not cover.
Talk to one of our admissions counselors about your insurance and any potential out-of-pocket expenses.
While not everyone has insurance that will pay for the entire expense of therapy, nobody should be denied the chance to get better because of a lack of financial resources. It would help if you didn’t let the cost of therapy prevent you from seeking help when you need it.
Rehab can be more affordable with sliding scale payment arrangements, where the total cost of therapy is set depending on the patient’s income and financial circumstances. Other payment options include scholarships and grants.