Mental Health/Substance Abuse Treatment and Blue Cross Frequently Asked Questions (FAQ)
Q: Do Treatment Centers Need To Be In-Network With BCBS?
A: Some BCBS plans, known as HMOs (Health Maintenance Organizations), will require the rehab center to be in-network to provide any coverage. PPOs (Preferred Provider Organizations) plans favor the patient and give you more flexibility to choose where you want to go for mental health treatment
Q: Which Rehab Centers Accept Blue Cross Blue Shield Insurance?
A: Most private mental health and substance abuse treatment centers, like Sylvia Brafman, accept Blue Cross Blue Shield insurance plans for mental health and/or addiction treatment, but it’s always best to start with verification of benefits from the rehab center to be sure.
Q: Does Blue Cross Blue Shield Cover The Cost Of Addiction and/or Mental Health Treatment?
A: Blue Cross Blue Shield is required by federal law to offer coverage for both addiction and mental health treatment on all of its health insurance plans. How much of the cost they will cover depends on your plan’s deductibles and copays. The type of treatment you require and the length of stay are also determining factors in how much they will cover the total bill.
Q: Does Blue Cross Blue Shield Cover The Cost Of Partial Hospitalization Programs?
A: Yes, BCBS plans offer coverage for PHP treatment. Treatment at the PHP level of care is also less expensive per day than residential or inpatient treatment which may reduce your overall cost for treatment while still allowing you to get a full day (6 hours) of treatment 5 times a week if/when there isn’t a clinical need for inpatient treatment and overnight stays.
Q: Does Blue Cross Blue Shield Cover The Cost Of Intensive Outpatient Programs?
A: BCBS plans also offer coverage for IOP treatment. Treatment at the IOP level of care is also less expensive per day than PHP treatment which may reduce your overall cost for treatment, however, it also entails much fewer total hours of treatment each week so it isn’t usually the right place to begin treatment for most people. However, IOP is an excellent follow-up after completing PHP treatment.
Q: Does Blue Cross Blue Shield Cover The Cost Of Medication Assisted Treatment (MAT) like Suboxone?
A: Suboxone – a medication used in opioid treatment – is frequently used in medication-assisted treatment (MAT) programs. Because Suboxone is a prescription drug, it will fall under the pharmacy benefits of your insurance plans. Your copay for Suboxone or any other MAT medication would be determined by your pharmacy co-pay in your prescription drug plan.