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Blue Cross Blue Shield Insurance Coverage for Rehab

Learn about Blue Cross Blue Shield drug rehab coverage levels, what benefits are included in your plan, and how to quickly check your benefits.
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Blue Cross Blue Shield Provider Overview

Blue Cross Blue Shield – also known in California as Anthem Blue Cross – has been providing healthcare benefits since 1929, covering a variety of healthcare-related services to meet a person’s needs. Blue Cross Blue Shield has more than 110 million members across the U.S., Washington D.C. and Puerto Rico.1

Blue Cross Blue Shield drug and alcohol rehab centers are located across the country, with many people seeking 28- or 30-day, 60-day and 90-day residential or inpatient treatment with Blue Cross.

You may be wondering, ‘what is my Blue Cross Blue Shield rehab coverage?’ or ‘can I get alcohol rehab with BCBS?’ Blue Cross Blue Shield drug rehab coverage is available under several different plans, which offer various levels of coverage to meet a person’s needs. Plan premiums and out-of-pocket costs for treatment vary depending on the plan.

To learn more about your Blue Cross Blue Shield substance abuse coverage, available programs and Blue Cross Blue Shield substance abuse providers, call the number on the back of your insurance card or reach out via their website.

Please note: American Addiction Centers (AAC) strives to provide you with the most updated information on each carrier’s addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels. AAC is not affiliated with or endorsed by the Blue Cross and Blue Shield Association or any of its licensees.

Coverage Plans

Blue Cross Blue Shield Drug Rehab Coverage Levels and Plans

While BCBS drug and alcohol rehabilitation plans can vary based on which state you are in, most plans are broken into 3 metal tiers: bronze, silver and gold. The general breakdown for each plan is as follows:7

  • Bronze plans have lower premiums, but higher out-of-pocket costs. BCBS pays about 60% of the costs of your medical care once your deductible is met.
  • Silver plans have higher premiums, but out-of-pocket costs are less than with a bronze plan. BCBS pays about 70% of your medical care after your deductible is met.
  • Gold plans have the highest premiums and lowest out-of-pocket costs. BCBS pays about 80% of your medical care once your deductible is met.

Deductibles may vary for each plan. Make sure to contact the BCBS representatives for your state as their plan offerings may be different from those above.

Using Medicaid and Medicare

BCBS participates in Medicaid, which is a state and federally funded health insurance plan to help people with low-incomes access necessary health insurance.2, 4 There are both mandatory benefits required by federal law and optional benefits, which vary by state.4

Medicare is a federal insurance program for people aged 65 and older and those under 65 with certain disabilities or medical conditions.2 Medicare has 4 parts (A, B, C and D), each intended to meet certain needs.2

Private insurance companies like Blue Cross Blue Shield offer coverage to pay for rehab that goes beyond Medicare parts A and B to include benefits you may not otherwise have with Original Medicare.2 Examples of insurance coverage that a BCBS Medicare plan provides are hearing aids, vision and dental care and long-term care.8

Policy Benefits for Rehabilitation Treatment

How to Check Your Blue Cross Blue Shield Drug Rehab Coverage

The most efficient way to check your Blue Cross Blue Shield alcohol or drug rehab coverage is to call the number on the back of your insurance card. You may have questions about what rehabs take Blue Cross Blue Shield insurance. You will be able to speak with a representative who can answer questions related to your specific healthcare coverage and plan and provide you with information on in-network providers and services.

Federal Employee Program

Blue Cross Blue Shield offers a Federal Employee Program (FEP) for federal workers, retirees and uniformed service members. Under the FEP, you can choose among 3 plans: standard, basic and FEP Blue Focus.9

With the FEP standard option, you can use in-network or out-of-network providers and, depending on your plan, you can expect to pay a copay for inpatient mental health or substance abuse services.9 It is the most expensive plan of the 3, and pre-certification is required for inpatient hospital services at Blue Cross Blue Shield drug rehab facilities.

The FEP Basic option requires that you use in-network providers for services to be covered.Pre-certification is also required for inpatient mental health and drug addiction treatment services at Blue Cross Blue Shield rehab centers and you can expect to pay a copay.

The FEP Blue Focus Plan is the least expensive option. However, services and providers must be in-network.7 While this plan has no copays for inpatient mental health or substance abuse services, you are required to pay a percentage of services rendered.

Checking your insurance coverage can be done online or over the phone by calling the number on the back of your BCBS insurance card. You can contact American Addiction Centers (AAC) for free at . Seeking treatment for an addiction can feel overwhelming, but understanding your insurance benefits can help minimize the stress around getting help for substance misuse.

Paying for Addiction Treatment with Blue Cross Blue Shield

Does Blue Cross Blue Shield Cover Drug and Alcohol Rehab Programs?

You may be wondering, ‘does Blue Cross Blue Shield cover drug rehab?’ or ‘what are some drug treatment centers that accept Blue Cross Blue Shield insurance?’ Perhaps you are wondering whether Blue Cross Blue Shield covers alcohol detox. While coverage may vary depending on your plan, BCBS plans typically cover some level of treatment for drug or alcohol addiction. You may be responsible for copayments or partial reimbursement of services rendered, so contact your state’s BCBS representative to learn about specific rehabilitation coverage and costs. The cost of rehab will also depend on factors such as program length.

Since BCBS offers plans on the Health Insurance Marketplace as part of the Affordable Care Act (ACA), many plans cover mental health and substance abuse services, which are considered an essential health benefit (EHB) per the ACA.10 However, coverage for certain types of treatment programs may vary depending on the plan you have and on factors like geographic location.

There are varying levels of care for addiction treatment, which can include medical detoxification, inpatient/residential treatment and outpatient treatment. Coverage for these different levels of care may depend on your plan, the state you live in and the facility you choose.

Additional Resources

Additional Insurance Providers With Addiction Coverage

Related Resources

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