Blue Cross Blue Shield Insurance for Alcohol & Drug Rehab

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If you or a loved one is struggling with substance use and have Blue Cross Blue Shield insurance, you may be eligible for addiction treatment services in rehab.

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At South Coast Behavioral Health, we recognize the importance of insurance coverage for addiction and mental health treatment. The cost of rehab can be a factor limiting individuals from receiving care. We aim to help simplify insurance for our clients. As such, we are in-network with many major insurance providers. Blue Cross Blue Shield is one such insurance provider operating around the country. An estimated one-third of Americans are covered under BCBS, largely due to its widely-used Federal Employee Network. BCBS is a comprehensive insurance provider with plans that cover addiction rehab and the levels of care in treatment. Let’s dive into using Blue Cross Blue Shield for your treatment needs. 

What Is Blue Cross Blue Shield?

Blue Cross Blue Shield is a nationwide insurance provider comprised of various independent and local companies. Blue Cross was founded in 1929 and merged with Blue Shield in the 1940s to cater to more people. Today, an estimated 115 million people are covered by BCBS. The company offers addiction and mental health treatment coverage options as part of many of its plans.

Depending on your location, the name of your provider will vary. But remember, it’s all under the umbrella of the Blue Cross Blue Shield system. Along with state-by-state coverage, BCBS provides global coverage for those permanently residing outside of the United States. Blue Shield of California is the healthcare provider for individuals residing in California. South Coast Behavioral Health accepts many of Blue Shield of California plan’s for addiction and mental health treatment 

Understanding Blue Cross Blue Shield Insurance Policies

Understanding the various programs and policies an insurance provider has can be difficult. A comprehensive insurance company like BCBS offers many plans, which also differ by name and coverage per state. Undoubtedly, this makes understanding your options more challenging. Let’s break down some of the selections available for those who want to use health insurance for addiction treatment in California.

Blue Cross Blue Shield sets up their healthcare policies in different tiers. Each tier offers distinct coverage, from bronze to gold. They range in what they provide:

Bronze: This tier offers the lower end of coverage, roughly 60%. It has the lowest monthly payment but a higher deductible.

Silver: This tier covers roughly 70% of costs, with a lower deductible but higher monthly fees.

Gold: This tier covers roughly 80% of expenses. The deductible is the second-lowest option BCBS provides, with a greater monthly insurance cost.

Platinum: This tier provides the highest level of coverage with the highest monthly costs. Out-of-pocket expenses are lower because coverage is the most comprehensive.

For people in California, here are some of the plans BCBS offers:

Blue Cross Blue Shield also provides discounts and offers on personal care, nutrition, and other services for Blue365 members. Their pharmacy services include prescription drug plans and retail and mail-order pharmacy care.

People may be covered by BCBS through their employer, as the provider has a widely-used Federal Employee Program (FEP). BCBS has an employer-sponsored Federal Employees Health Benefits (FEHB) plan for retirees. People may also be covered through a family or individual plan. Also, as mentioned, Blue Shield Blue Cross has Medicare plans for 65 and older.

What Blue Cross Blue Shield Insurance Policies Cover Addiction Treatment?

If you’re worried about whether your BCBS insurance plan covers addiction treatment, don’t fret. Under the United States’ Affordable Care Act (ACA) all insurance plans are required to include essential health benefits. Fortunately, addiction and mental health rehab treatment are considered necessary services. Therefore, the bigger question is to what degree does your specific BCBS plan cover addiction care?

Your Blue Shield of California plan should at least partially cover substance use disorder (SUD) rehab and mental health treatment. What that looks like exactly will depend on your plan. Understanding your benefits allows you to make smart decisions about what your recovery journey will look like. There are ways to receive addiction help without it being a financial burden on you or your family. We would love to help you explore your options by researching your benefits for you.

Blue Cross Blue Shield Referral for Rehab

Some plans through BCBS may require you to have a referral from your treatment provider to receive coverage. Whether your benefits require a referral, make sure you’re arranging treatment with an established recovery center. You want to ensure you enter a facility that prioritizes your treatment needs and focuses on your holistic wellness. It’s important to receive care through a knowledgeable and established treatment provider.

If you’re not sure what providers qualify for your coverage, you can use BCBS’ provider finder directory.

Blue Cross Blue Shield Pre-authorization for Rehab

Some plans under Blue Cross Blue Shield will require preauthorization on certain coverages. What does preauthorization (also called prior authorization or precertification) mean? Essentially, a requirement for preauthorization means your medical provider needs to sign off on your need for certain programming or services. When it comes to substance addiction treatment, your insurance plan may necessitate your doctor or therapist to permit you. For instance, your doctor may need to put in a request with your insurance for you to receive medication for your symptom management.

Just as plans differ in coverage, they can also differ in required preauthorization. Reach out to BCBS or have us reach out to you to determine how this affects you.

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Looking for quality substance abuse treatment that’s also affordable? South Coast accepts most major insurance providers. Get a free insurance benefits check now.

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Rehab Programs Covered by Blue Cross Blue Shield Insurance

Blue Cross Blue Shield provides coverage, at least partially, for rehab programs. Expensive costs surrounding addiction treatment and medication management can be a huge barrier to getting help. BCBS’s coverage for levels of care helps remove the financial burden from rehab so individuals can focus on getting better. Since BCBS is a large insurance network spanning the United States, it’s possible to receive out-of-state addiction recovery treatment. With nothing limiting how and where you get treatment, help isn’t out of reach.

Blue Cross Blue Shield Coverage for Detoxification

In general, BCBS plans cover medical detox. This common first step of treatment removes from the body substance toxins causing withdrawal symptoms and cravings. To reach a stable place of sobriety, individuals likely need to begin with detoxification.

Blue Cross Blue Shield Coverage for Residential Treatment

Blue Cross Blue Shield provides coverage for residential inpatient treatment. This intensive first level of care for addiction rehab is the first stage after detox. Clients learn the reasons for their addiction as well as management tactics to make sobriety a priority.

Some possible limitations to your BCBS inpatient benefits could be:

It’s important to know what your Blue Shield of California coverage includes so you can plan accordingly.

Blue Cross Blue Shield Coverage for Partial Hospitalization

Partial hospitalization (PHP) is a flexible care option for those battling substance abuse, mental illness, or co-occurring disorders. PHP allows clients to attend programming in-center during the day but still live at home to attend to responsibilities. Many BCBS plans have benefits for PHP built in. However, you may need to meet some requirements to be eligible for coverage for intensive treatment. For instance, you may need to explore co-pays, coverage limitations, or required preauthorization.

Blue Cross Blue Shield Coverage for Intensive Outpatient Treatment

Similarly, intensive outpatient treatment (IOP) is a flexible program plan for drug and alcohol addiction recovery. Clients enter an intensive outpatient program when they need help for SUD but also must return home in the evenings. IOP reduces the number of hours spent in session compared to PHP. Therapy, counseling, and relapse prevention planning are all core aspects of IOP. Blue Cross Blue Shield and its California branch commonly cover IOP. However, the specifics are contingent on the individual and their plan.

Blue Cross Blue Shield Coverage for Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) prescribes medication for the management of symptoms. For example, clients may battle symptoms of withdrawal, in which case an opioid antagonist like naltrexone can block cravings. Conversely, a client struggling with mental illness may be prescribed medication to help them manage the symptoms of their disorder. Blue Cross Blue Shield has plans that cover medical prescriptions, although preauthorization may be required.

Your BCBS provider may only cover FDA-approved prescription drugs. For alcohol use disorder (AUD), these are:

FDA-approved drugs for the treatment of opioid use disorder include:

Talk to your insurance provider (or have us call on your behalf) to find out how your benefits accommodate MAT.

Using Blue Cross Blue Shield for Mental Health Treatment

Mental health treatment is considered an essential service under the Affordable Care Act (ACA). As such, all insurance plans must include behavioral health treatment like therapy, inpatient treatment for mental health, and SUD care. Your Blue Shield of California plan may include mental health coverage for counseling, treatment, and medications for issues including:

Determining your benefits will let you make informed choices when it comes to rehabilitation for mental illness and substance addiction.

We Are In-Network With Aetna, Anthem, & Cigna Health Insurance Plans

South Coast Behavioral Health is proudly an in-network provider of substance abuse and dual diagnosis treatment services for BlueCross BlueShield Anthem, Aetna, and Cigna health insurance plan members.

Aetna Insurance Logo- We accept Aetna Insurance Plans

We also accept most major insurance providers

Tricare insurance
Providence Health

If you are ready to recover, please reach out to speak with one of our admission coordinators.

Should I Use Blue Cross Blue Shield Insurance for Rehab?

Substance use disorder (SUD) is a serious medical disorder that shouldn’t be overlooked. However, it also shouldn’t cause shame or embarrassment. Fortunately, substance abuse is easily treated through professional addiction rehab. If you or someone you know is battling addiction to drugs or alcohol, it’s important to act quickly. Substance abuse hurts you and those you love, but it doesn’t have to any longer.

If you’re considering using Blue Cross Blue Shield insurance to cover treatment for addiction, mental illness, or co-occurring disorders, reach out. Certainly, speaking to a provider of BCBS insurance will help you narrow in on how treatment could look. With stigma and financial burden removed from the equation, nothing is holding you back from making the change you deserve.

We encourage you to reach out to our team by calling 866-881-1184 for more information on our treatment services and locations in your area.

Verify Your Blue Cross Blue Shield Coverage Now

Verifying your insurance plan on your own can lead you down a rabbit hole of information. When wondering how to receive insurance coverage for addiction treatment, you want the process to be simple and efficient. We can help you track down the details of your plan if you reach out with some basic personal details. For example, helpful information that we’ll use to determine your coverage includes:

Finding a Blue Cross Rehab Near Me in Orange County, California

South Coast Behavioral Health is a Blue Cross Blue Shield insurance rehab provider located in Orange County, California. We are proud to offer evidence-based treatment programs for substance abuse and mental health disorders specifically tailored to meet the needs of military service members, veterans, and their families.

Our substance use disorder treatment centers are located in several cities throughout Orange County, California including:

South Coast is honored to provide specialized treatment for veterans and first responders within each of our drug and alcohol rehabs in Orange County, CA. Our Valor Program provides personalized treatment founded on trauma-informed care.

At South Coast’s Blue Cross Blue Shield approved rehab facilities, our clinicians understand the unique challenges faced by those who serve our country. Throughout our addiction treatment programming, we provide compassionate care and support throughout the recovery process.

During treatment, veterans gain access to a variety of vital addiction treatment services such as medication management, behavioral therapy, and addiction counseling.

In addition to traditional therapies, we also offer expressive arts therapy which allows clients to explore their feelings through creative outlets. This can be especially beneficial for veterans who have difficulty verbalizing their emotions.

We also provide dual diagnosis treatment for co-occurring mental health and substance abuse disorders, and medication-assisted treatment (MAT) for those struggling with addiction.

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TRICARE Insurance

Paying for Rehab with Blue Cross Blue Shield

Finding a Blue Cross Blue Shield provider in California is simple. Blue Shield of California serves all zip codes within California. You just need to find which connected company your location falls under. To do this, go online to Blue Shield of California and enter your zip code. You’ll be redirected to the provider operating under BCBS for your area.

We are proud to be in-network with Blue Cross Blue Shield and other major insurance providers. We have centers across the United States where you or your loved one can receive treatment through your plan.

South Coast Behavioral Health is here every step of the way to support you through this process with compassion and expertise. To learn more about our veterans rehab program or receive help in paying for rehab with Blue Cross Blue Shield, reach out to us at (866) 881-1184.

If you or someone you know is struggling with addiction, please don’t hesitate to reach out to us.

We are here to help because we’ve been there.

The Treatment Experience at South Coast

What Our Alumni Have to Say

This place truly saved my life. I'll be forever grateful for the opportunity to get and stay sober here... Everyone was great. This experience definitely paved the way for a real future for me and for my son. Thank you.

J.C. Alumni of SCBH
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