Federal Blue Cross Blue Shield Coverage for Drug & Alcohol Rehab
Can Federal Blue Cross Blue Shield Insurance Cover Rehab?
Federal BCBS insurance may be able to cover all or at least a part of the cost of rehab for drug or alcohol addiction. Coverage depends on the details of your insurance plan as well as the level of care needed. Generally, Federal Blue Cross Blue shield may be able to partially cover inpatient or residential treatment, outpatient rehab, detoxification and medication-assisted treatment.
If you or a loved one is struggling with a substance use disorder (SUD), it is important to find out your level of rehab coverage with Federal BCBS. This can help you to determine the amount you will pay out of pocket.
What Substance Abuse Treatments Does Federal Blue Cross Blue Shield Cover?
Depending on your plan, the BCBS FEP plan may cover:2
- Inpatient Rehab – Patients will stay at the treatment facility 24/7 and receive highly structured care from addiction professionals. This type of treatment allows the patient to get some space from a potentially negative home environment so they can focus on their sobriety.
- Residential Treatment – Residential treatment provides 24-hour care but is less intensive than an inpatient rehab. Patients will still receive a high level of care and support in order to maintain recovery from a substance use disorder (SUD).
- Outpatient Rehab – Overnights stays are not required in an outpatient rehab and treatment can take place in various settings (rehab center, hospital, mental health clinic etc.). Bear in mind, the treatment intensity varies depending on the individual’s specific needs.
- Detoxification – A professional drug detox program uses medications and therapies to help manage the body’s response to quitting drugs or alcohol. The goal of detox is to ensure a patient is not physically harmed when going through the withdrawal process.
- Medication-Assisted Treatment (MAT) – MAT consists of a combined approach (medications and behavioral interventions) to treat substance use disorders (SUDs).
Does Federal Blue Cross Blue Shield Cover Mental Health & Co-Occurring Disorder Treatment?
Federal BCBS may cover co-occurring or dual diagnosis treatment, such as treatment of depression or anxiety as well as addiction treatment, under mental or behavioral health services. Depending on your level of coverage, mental health treatments may at least be partially covered.2
What is Federal Blue Cross Blue Shield Insurance?
Federal BCBS insurance is also known as the Blue Cross and Blue Shield Service Benefit Plan, or the Federal Employee Plan (FEP). The BCBS FEP program has been part of the Federal Employees Health Benefits (FEHB) since its inception in 1960 and now covers over 5.5 million federal employees, retirees, and families in the U.S. and overseas.1
The Blue Cross Blue Shield Association negotiates annually with the U.S. Office of Personnel Management (OPM) to determine benefits and premiums for the federal plan.1
BCBS FEP Plans
Federal Blue Cross Blue Shield, a Preferred Provider Organization (PPO), offers 3 benefit plans for individuals and families:2
- Standard Option (Enrollment Codes 104/105/106)
- Basic Option (Enrollment Codes 111/112/113)
- FEP Blue Focus (Enrollment Codes 131/132/133)
These plans vary in deductibles, out of pocket costs, and whether you have to see a preferred provider.
Can I Have Medicare & BCBS FEP Coverage?
Yes, you may be eligible for both Medicare and the Service Benefit Plan. Medicare works best with federal BCBS coverage when Medicare is your primary coverage, where Medicare pays for services first, and then BCBS pays their own portion after.3