Drug & Alcohol Rehab Covered by BCBS North Carolina

Yes, BCBS of North Carolina covers drug and alcohol addiction treatment to some degree.² Thanks to the Affordable Care Act, you can access partial or full coverage for essential health benefits (EHBs) through all marketplace health plans.³ This includes substance use disorder treatment and mental health services.⁴ That said, your coverage level will vary depending on your specific plan.⁴

BCBS of North Carolina covers multiple types of addiction treatment to some extent.² Recovery is different for everyone, and what works for someone else may not work for you.⁵ Several levels of care are available to meet your unique needs.⁵ 

Medical detox from drugs or alcohol is often the first step in treatment.⁵ During this stage, you safely withdraw from substances under medical supervision.⁶ People typically move onto another level of inpatient or outpatient care after detox.⁵ 

Common types of addiction treatment that may be covered by your BCBS North Carolina healthcare plan include:^2,5

• Inpatient drug and alcohol rehab. Inpatient and residential programs provide a safe, highly structured living environment with 24/7 care. You’ll often participate in evidence-based treatment services, including cognitive behavioral therapy (CBT), motivational interviewing (MI), and dialectical behavioral therapy (DBT).
• Outpatient addiction treatment programs. Outpatient programs offer treatment approaches similar to inpatient rehab, but patients can return home at the end of the day. Partial hospitalization programs (PHPs/HIOPs), intensive outpatient programs (IOPs), and standard outpatient care are the different levels of outpatient rehab. Each varies in intensity and frequency of required attendance.

Addiction experts recommend rehab aftercare programming, such as a 12-Step program or sober living home, after completing a treatment program.⁵

Your doctor or an addiction specialist can help you understand the best level of care for you.⁵ Mental health experts use the American Society of Addiction Medicine (ASAM) criteria to place, transfer, and discharge those seeking treatment.⁷ By following these guidelines, your healthcare provider can recommend an appropriate level of addiction treatment from early intervention to inpatient rehab.⁷ You’ll also undergo an assessment to diagnose substance use disorder and assess your treatment needs.⁵

Learning more about your BCBS North Carolina coverage for rehab is the first step in getting the help you need. BCBS of North Carolina offers multiple solutions to check your benefits and understand your coverage:

• Blue Connect. Log into your Blue Connect member online portal to explore the specifics of your plan. Additionally, you can contact a representative via email or live chat to discuss your BCBS North Carolina coverage for rehab.⁸
• Blue Connect app. Download the mobile app to check your benefits from your phone.⁸
• Contact member services. Call the number on the back of your insurance card to speak with a representative who can explain your benefits and treatment coverage.⁹

Because BCBS North Carolina coverage for addiction treatment depends on your specific plan, understanding expenses is crucial. Potential out-of-pocket costs may include co-pays, deductibles, and other costs.² With an in-network provider, you can avoid unexpected expenses.²

BCBS of North Carolina may partially or fully cover co-occurring disorder treatment.² Co-occurring disorders, or dual diagnoses are common among those struggling with addiction.⁵ People may experience mental health conditions, like depression, anxiety, and post-traumatic stress disorder (PTSD) along with SUD.⁵ Experts recommend treating all conditions simultaneously to promote the best outcomes.⁵

Finding the best care for you can seem challenging. Our recovery.org directory provides the tools to tailor your search based on your insurance, location, level of care, and preferences.

Seeking addiction and co-occurring disorder treatment can open the doors to a new beginning. With evidence-based treatments, like cognitive behavioral therapy, motivational interviewing, medications for addiction treatment, relapse prevention training, and more, you can build healthy coping skills to address the underlying causes of addiction.⁵ 

1. Blue Cross and Blue Shield of North Carolina. (n.d.). About us.
2. Blue Cross and Blue Shield of North Carolina. (2024). Summary of benefits and coverage: What this plan covers & what you pay for covered services.
3. Healthcare.gov. (n.d.). Affordable Care Act (ACA).
4. Healthcare.gov. (n.d.). Health benefits & coverage.
5. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (third edition).
6. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and substance abuse treatment.
7. American Society of Addiction Medicine. (2024). About the ASAM criteria.
8. Blue Cross and Blue Shield of North Carolina. (n.d.). About Blue Connect.
9. Blue Cross and Blue Shield of North Carolina. (n.d.). Call us.