BlueCross BlueShield Insurance
BlueCross BlueShield is a federation of 36 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people. BlueCross BlueShield is accepted in all 50 states, and offers a wide variety of health coverage options to its customers. Within these options, specific addiction treatment coverage varies greatly.
BlueCross BlueShield Addiction Resources
BlueCross BlueShield commonly covers some costs associated with:
- Medical detox
- Inpatient treatment
- Outpatient treatment
- Partial hospitalization
- Prescription medications
The company also recently created a prescription pain medication safety program, called OneHealth, which provides members and their families with 24/7 access, support, and information on painkiller risks and addiction resources.
Using BlueCrossBlue Shield for Substance Abuse Treatment
Substance abuse coverage through BlueCross BlueShield is not one-size-fits all. Many factors determine which addiction treatment services are covered by an individual’s plan, including the plan’s coverage details, location of the customer and where they are seeking treatment, and the specific type of treatment being sought.
BlueCross BlueShield has 4 tiers of care in their plan options: Bronze, Silver, Gold, and Platinum plans.
Bronze plans: Typically these have the minimum deductible for in-network providers. Out-of-network programs are generally not covered.
Silver plans: A coinsurance percentage in addition to the deductible for in-network is generally required. Usually, out-of-network is not covered.
Gold plans: These require a coinsurance percentage (usually smaller than that of silver plans), as well as the deductible. Out-of-network is generally not covered.
Platinum plans: In-network services will have either a copay per day (with a maximum amount) or a coinsurance percentage. Out-of-network is sometimes covered; however, it comes with a higher coinsurance percentage in addition to the deductible.
Steps to Take When Seeking Addiction Treatment
Generally, an individual’s first step in seeking treatment is contacting their primary care physician, who will assess and refer them to the necessary resources, including substance abuse treatment centers and providers. On the BlueCross BlueShield member website, the plan benefits and “Find A Doctor” tool can be of great use in identifying providers and treatment that will be covered by an individual’s specific plan.
An individual may also contact addiction treatment centers directly for guidance and specifics on coverage and next steps.