Now has never been a better time to get treatment. Thanks to the Affordable Care Act (ACA), all insurance plans must cover behavioral health treatment, mental and behavioral health inpatient services and substance use disorder treatment. Each insurance plan is unique and will cover a different amount of care, but it’s reassuring to know that financial assistance is available.

If you or a loved one needs treatment for a drug or alcohol problem and you have Blue Cross insurance, know that you have options. The River Source accepts Blue Cross Blue Shield and has experience working with these plans. We always recommend starting with your individual policy and speaking directly to your insurance company to know what is covered.

Our Blue Cross Blue Shield Rehab Specialists are also available to answer questions and determine exactly what your insurance will cover at our treatment facility. Many people who call in are pleasantly surprised to see that a large portion of their treatment is covered.

What is Blue Cross Blue Shield?

The Blue Cross and Blue Shield Association has 36 health insurance companies that make up the Blue System. Coverage is available in all 50 states and Puerto Rico. It is the most common insurance, serving roughly 105 million Americans and contracting with 96 percent of hospitals and 93 percent of doctors and specialists. If you are part of a Blue Cross plan, rest assured that your insurance will help you out with medical costs.

The individual and family plans fall into one of four categories: Bronze, Silver, Gold or Platinum. Let’s learn more about these plans and how much coverage you can expect from each one.

  • Bronze plans. The Bronze plan has the lowest costs and is best for people who are generally healthy and don’t go to the doctor often. There is a low monthly payment and a high deductible. This level covers 60 percent of medical costs and the patient covers 40 percent.
  • Silver plans. The Silver level has a slightly higher monthly cost and a lower deductible. Like the Bronze plan, it’s best for people who are healthy and don’t require regular doctor visits. This level covers 70 percent of medical costs and the patient covers 30.
  • Gold plans. The Gold plan is a strong insurance policy because it covers 80 percent of medical costs and has a low deductible. Patients pay 20 percent. The Gold level is ideal for families and individuals who need a higher level of care. The trade off is higher monthly payments.
  • Platinum plans. Not all states offer a Platinum plan. If you’re lucky enough to have this insurance, you are only responsible for 10 percent of medical costs, while insurance covers 90 percent. Like the Gold level, there is a low deductible and high premiums.

Does BCBS Cover Substance Abuse Treatment?

Blue Cross Blue Shield plans do cover some treatment, but the specifics depend on your individual policy. Most plans cover medical detox services as long as they are deemed necessary, such as for those who are suffering from a benzodiazepine addiction, opiate addiction or alcohol addiction. Because withdrawal from these substances can be fatal, medical detox is considered necessary.

As for the actual meat of the addiction treatment, what is covered and by how much is up to your specific plan. If you have an HMO (Health Maintenance Organization), your care will only be covered at specific facilities. If you have a PPO (Preferred Provider Organization), you have a much larger selection of treatment centers to choose from. You can also select an out-of-network rehab center for a higher cost.

Getting the Most from Phoenix Blue Cross Treatment Centers

To get the most from your insurance, it’s important to choose a treatment center that accepts your insurance plan and has affordable rates. Addiction treatment facilities vary in price. For example, high-end luxury programs charge more because they include extra services and amenities in their care. These amenities may include higher staff-to-patient ratios, private rooms and exclusive meals. It does not necessarily mean the care is better.

Most inpatient facilities cost more than outpatient centers because there is more care being offered. Recovering addicts live at the facility, and therefore, receive meals, lodging and activities. When looking at your options, know the amount of care you will receive through your insurance. If your policy only covers up to a certain amount, an affordable rehab will get you more care at a lower cost.

The River Source is one of the preferred Phoenix Blue Cross treatment centers. Our BCBS Rehab Specialists would love the opportunity to speak with you about your policy and what will be covered. With affordable rates and cutting-edge therapies, many of our BCBS patients are able to receive comprehensive care for little out-of-pocket costs. Call us today to learn more!