The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that of the more than two million American adults who need addiction treatment, a little more than 10 percent actually receive it. One of the primary roadblocks that those suffering from substance use disorder (SUD) face when they endeavor to get help is lack of access to quality programs. Whether it’s due to financial constraints, lack of local options, or an inability to find a treatment facility that can accommodate their care needs, millions of SUD sufferers routinely find themselves shut out of the treatment experience.
One of the mechanisms that stakeholders have employed to remedy this widespread lack of access is the use of health insurance coverage to treat addiction. Insurance providers like Blue Cross Blue Shield and others have been providing coverage to more and more patients seeking help for their SUD.
Recent healthcare legislation has made it more possible to find addiction treatment that accepts Blue Cross Blue Shield; however, not all insurance plans are created equal, and coverage is not guaranteed. It’s also important to know that plans vary from state to state. When assessing your health insurance options, it’s most prudent to reach out to individual facilities you’re considering to determine whether or not they accept your plan. These questions are covered during what is called the “insurance verification process,” performed by a treatment center’s admissions or intake team. It is important to know that some plans require you to pay a considerable amount of money out of pocket.
Blue Cross Blue Shield is one of the largest insurance providers in the nation, with thirty-six independent companies and licensees serving all fifty states.
Depending on the state in which the prospective patient lives, Blue Cross Blue Shield offers three or four tiers of plans—Bronze, Silver, Gold, and Platinum:
Patients can check their coverage by using the information on their insurance card to search for their specific company on Blue Cross Blue Shield’s website. Once the company is located in the directory, details such as prescription drug benefits or a list of providers in a specific area are readily accessible. Members can also access the cost estimator for treatment.
It may be easy to find treatment that accepts Blue Cross Blue Shield; however, specifics will vary according to each individual plan. If it is determined that patients need medically supervised detoxification or withdrawal management, most plans will cover that part of the treatment process; however, it may be more difficult or costly to obtain residential care under lower-tier insurance plans. Many insurance providers often require patients to seek outpatient treatment as a first means of treatment. The plan type will determine the scope of treatment. Patients who have HMO (Health Maintenance Organization) plans will face more restrictions while those with PPO (Preferred Provider Organization) plans will have a wider variety of selection. Generally speaking, individuals under the Blue Cross Blue Shield umbrella should be able to easily access some level of treatment; but they may only have part of their treatment covered, depending upon the scope and depth of their employer-based health insurance plan.
If you or a loved one is battling SUD, the most important thing is to get treatment right away. The quickest way to find a rehab center that accepts Blue Cross Blue Shield is by going to their website and searching for providers in your area. The recent explosion of opioid overdoses has led to the emergence of more and more treatment centers; however, it’s important to find a facility that works for your care needs and lifestyle. Don’t let insurance obstacles get in the way of you or a loved one getting the help you need for your drug or alcohol addiction. Help is available.
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