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Does Blue Cross Blue Shield Insurance Cover Drug Treatment?

Last Updated: October 25, 2019

I have insurance with Blue Cross/Blue Shield. Will it cover my drug rehab? Typically, yes. But coverage varies from state to state and plan to plan. That means some programs may cost consumers a great deal out of pocket, while others might provide robust coverage. Call the company directly, using the number on your health insurance card, to find out more about your benefits.

AAC is in network with Blue Cross Blue Shield at many facilities; treatment can be free depending on your policy and co-pay / deductible.

Note: American Addiction Centers strives to provide you with the most updated information on each carriers’ addiction insurance coverage but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels. AAC is not affiliated or endorsed by the Blue Cross and Blue Shield Association or any of its licensees.

About Blue Cross and Blue Shield

The Blue Cross and Blue Shield Association owns 36 health insurance companies, independent and locally operated, nationwide which comprise the Blue System.

Commonly referred to as “The Blues” or “BCBS,” Blue Cross and Blue Shield have over half of all federal employees enrolled in their network, as part of the Federal Employee Program.

Blue Cross Blue Shield’s individual and family plans fall into 3 or 4 categories, depending on your state: bronze plans, silver plans, gold plans, and platinum plans. Bronze plans will have the lowest costs, while platinum plans will have the highest monthly costs. Some states will not offer the platinum category. Blue Cross and Blue Shield recommends the bronze-level plan for those who do not go to the doctor often, as it will have a low monthly payment and a high deductible.

In summary, the tiered plans of Blue Cross Blue Shield are as follows:

  • Bronze: This level covers around 60% of medical costs, with a low monthly payment and a high deductible.
  • Silver: This level covers around 70% of medical costs, with a slightly higher monthly payment and lower deductible.
  • Gold: This level covers around 80% of medical costs, with a higher monthly payment and low deductible.
  • Platinum: This level covers around 90 of medical costs, with the highest monthly payment and the lowest deductible.

Health insurance through Blue Cross Blue Shield varies by state, however, so it is recommended that you check your state’s specific coverage details.

Checking Your Insurance Coverage

To see what is covered under your Blue Cross Blue Shield health insurance plan, you can either enter the 3-letter prefix before the identification number on your member card on the Blue Cross Blue Shield Association’s website, or you can find your company directly on the website’s listing of the 36 member companies by state.

Blue Cross And Blue Shield offers a Federal Employee Program (FEP) plan for federal workers and retirees in the Federal Employees Health Benefits (FEHB) program. FEP and FEHB plans offer similar benefits as other BCBS plans do with a few exceptions. You can review your benefits and learn more about the coverage you have on the FEP Blue site.

Once you’ve found your company, you can log in to check your coverage. At your local company’s website, you can find details, such as your prescription drug benefits or a list of providers in your area. As a member, you can also access the cost estimator for treatment.

Blue Cross Blue Shield insurance offers many plans specific to your state of employment. For example, employees in the state of Idaho may have a BC of Idaho plan, whereas Tennessee residents will have a BCBS of Tennessee plan. These state-specific plans still utilize the nationwide BCBS network of providers, so patients are not limited to receiving care exclusively in their home state. BC of Idaho patients in need of rehab are still able to travel to states like California or Florida to receive the care that they need.

Using Blue Cross Blue Shield for Drug Rehabilitation

In general, Blue Cross Blue Shield plans do cover treatment for addiction, at least in part, but again, specifics are based on the individual policy you possess. Most plans cover treatment for medical detox, if determined to be necessary. This would most likely be the case for those suffering from benzodiazepine addiction, alcohol addiction, and opiate addiction. Detoxing from these substances can be dangerous and should always be monitored by medical professionals.

The type of treatment center you choose, as well as the specific professionals who treat you, will be determined by your plan. If you have an HMO (Health Maintenance Organization) plan, you are only covered at HMO-contracted facilities. If you have a PPO (Preferred Provider Organization) plan, you have the option to see a wider range of providers, and you can see an out-of-network provider at a higher rate.

As with all medical issues, oftentimes, only a portion of detox or addiction treatment is covered by insurance. It’s important to speak with Blue Cross Blue Shield to determine your exact level of coverage and learn what that means in terms of the specific dollar amount you will pay out of pocket.

The options available to you under Blue Cross Blue Shield are dependent upon your situation and the coverage you have. However, the Blue Cross Blue Shield network is quite large, meaning that those who have this particular insurance will have little trouble finding a center for treatment. The fastest way to go about finding a center for treatment is by using the Blue Cross and Blue Shield Association’s website to search locally for providers near you.

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Last Updated on October 25, 2019
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About the editor
Sarah Hardey
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A Senior Web Content Editor for the American Addiction Centers. Sarah has worked with healthcare facilities across the country to create digital content for readers of all types.

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