Blue Cross Blue Shield Insurance Coverage for Alcohol Rehab and Detox Centers

Edited by: Editorial Staff
Last updated on April 27, 2022

Can You Go to Nationwide Alcohol Rehab With Blue Cross Blue Shield?

Alcohol use disorder (AUD) and binge drinking are huge issues in the entire U.S. In fact, alcohol consumption is the cause of death for about 13.5% of people aged 20 to 39. This is a clear indication that many people require alcohol abuse treatment, even though not many of them proceed to get it.1,2

Additionally, only 2% of individuals in need of substance use disorder (SUD) treatment, which includes treatment for AUD, go to rehab. About 11% of people who never went to get treatment listed lack of funds as the main reason behind their decision not to proceed with it.3

Out of those who manage to finance their treatment, most use some form of insurance. The largest percentage (21%) use Medicaid and other state-funded options. A little more than 10% proceed to use private insurance. This includes Blue Cross Blue Shield insurance coverage.3

Blue Cross Blue Shield (BCBS) has provided coverage for healthcare since 1929. This healthcare provider has over 110 million members nationwide, and they work with 1.7 million doctors, nurses, and other healthcare professionals that can provide their members with medical care. This also includes AUD treatment.4 

Does Blue Cross Blue Shield Cover Alcohol and Drug Rehab?

The Mental Health Parity and Addiction Equity Act (MHPAEA) that was voted in 2008 states that all health insurance providers, including Blue Cross Blue Shield, have to provide their members with exactly the same level of coverage for mental health and substance abuse as they would for medical emergencies and procedures.5

One of the ways in which BCBS offers nationwide coverage for treatment is through its renowned Substance Use Resource Center. This is one of the ways how every struggling individual can get help for their or their loved one’s AUD.6

All forms of treatment need to be individualized. AUD is a complicated disorder and successful treatment depends on many factors. As such, if you go to one of the nationwide Blue Cross Blue Shield addiction treatment centers, you might be able to get:7

Are There Some Parts of Addiction Treatment That Blue Cross Blue Shield Won’t Cover?

Blue Cross Blue Shield alcohol and drug treatment programs are extensive and the insurance will cover any medically-necessary part of AUD treatment. However, this means that there are some parts of the treatment BCBS won’t cover.8

No matter your healthcare plan, chances are you’ll be eligible for copayments, deductibles, and coinsurance. Additionally, you’ll probably have to pay for most non-medical costs. This includes amenities you lack a referral for, recreation programs, holistic care, food delivery, as well as most other forms of alternative therapies.8

What Are the Costs Associated With Alcohol Rehab?

There are many factors and circumstances that can affect the expenses related to your treatment for alcohol addiction. Some of these are:8,9

You’ll discuss most of these details during the initial assessment when you enter a treatment facility. This will be the moment when you’ll speak with a professional team that will look at your situation and think of a proper treatment plan that can fit your available payment options.8

What Are the Costs Associated With Inpatient Alcohol Rehab?

People struggling with long-term, severe forms of AUD will usually go to inpatient alcohol rehab facilities. This type of rehab allows people to spend time in a supervised setting, where they’ll have 24/7 medical care.7

Inpatient alcohol treatment can last for a very long time. In fact, some programs are known to last 6 months or even more. As the costs are calculated on a daily basis, this type of treatment can become very expensive. Therefore, you should consult with Blue Cross Blue Shield insurance provider to see what aspects of inpatient treatment your healthcare plan can cover.7

What Are the Costs Associated With Outpatient Alcohol Rehab?

Outpatient therapy for alcohol abuse is usually not as expensive as other forms of rehab. Outpatient programs don’t provide as extensive care, accommodation, or similar services, it can be more affordable. 7

While most Blue Cross Blue Shield substance abuse providers offer outpatient alcohol rehab programs, you should still contact your insurance provider to check out the details of your coverage.7 

What Are the Costs Associated With Alcohol Partial Hospitalization Programs (PHP)?

Partial hospitalization programs are the middle ground between outpatient and inpatient treatment. They usually require patients to stay in the facility for around 8 hours, but the rest of the time they can live at home or any other place they’ve chosen.7

As PHP doesn’t require any form of accommodation, it’s more affordable than inpatient treatment. However, as it provides patients with more extensive care than outpatient programs, it’s usually more expensive.7

What Are the Costs Associated With Medication-Assisted Treatment (MAT)?

One of the effective methods of treating alcohol addiction in some individuals is by using FDA-approved medications combined with other forms of treatment. This is known as medication-assisted treatment (MAT). Most of the time, MAT is combined with behavioral therapy and provides a ‘whole-patient’ approach to treatment.6

The cost of MAT can vary greatly and it’s challenging to predict. There are many types of medications, and they can be used in several different ways, with any existing treatment. Fortunately, a number of substance abuse treatment facilities accept Blue Cross Blue Shield, and some plans may even cover the cost of MAT. This is something you should check with your provider.6 

What Is the Cost of Alcohol Addiction?

Alcohol addiction is a great expense to both the US economy and individuals consuming alcohol. In fact, in 2010, alcohol abuse and binge drinking cost the economy 249 billion dollars.10

When it comes to individual losses, people with SUD are more likely to experience a loss of productivity at work, which can lead to lower income or even losing one’s job. At the same time, people who are binge drinking are at a higher risk of developing additional health problems and encountering legal expenses, as alcohol use leads to increased chances of committing a crime.10

Lastly, alcohol abuse can affect the brain’s structure and change the way it works, even causing extensive damage. This may result in more comprehensive treatment, which also comes with additional expenses. Prolonging treatment can even possibly delay getting alcohol out of your system, which can also mean more complex withdrawal symptoms. On the other hand, getting treatment early on can help prevent serious consequences.8,11

How Long Does the Blue Cross Blue Shield Alcohol Rehab Coverage Last?

When looking at the length of your Blue Cross Blue Shield in-network and out-of-network coverage, it’s best to contact the Blue Cross Blue Shield helpline or your medical professional and healthcare provider to see what’s the best option for you. 

In general, there are many indications that longer treatment options have higher success rates. While there isn’t a precise length of treatment that works for everyone, it seems that 90-day rehab programs have better outcomes in helping people stay sober. On the other hand, shorter programs, such as programs that last no more than 10 days or fairly short weekend rehab programs, may exhibit higher relapse rates.11

However, the length of coverage for your alcohol or drug treatment program will depend on your Blue Cross Blue Shield insurance plan. 

Inpatient or Outpatient Alcohol Rehab: Which One Should I Choose?

Both inpatient and outpatient alcohol rehabs have their benefits and flaws. To understand them, you need to understand the differences that set them apart. Here are a few important distinctions:7

  • Inpatient rehab centers allow you to stay in a professional environment with 24/7 healthcare providers available to offer a high quality of care. 
  • They help individuals live in a supportive ecosystem, as all members have typically gone through similar experiences. 
  • In such surroundings, you can avoid triggering situations that may cause you to relapse.
  • Opposite of that, outpatient therapy isn’t as extensive as inpatient.
  • Still, outpatient therapies help people stay in a warm, familiar environment, while still receiving professional guidance through counseling and support groups. 

Both inpatient and outpatient drug rehab centers nationwide  typically accept most insurance plans, which also includes Blue Cross Blue Shield. While it’s up to a medical professional to determine what type of treatment is right for you, inpatient treatment generally has better recovery rates.7,11

How to Apply for Blue Cross Blue Shield Insurance-Covered Rehabilitation Centers?

Whether you’d like to go to a BCBS-covered facility for secialized addiction treatment and recovery in TX or one of the available rehabs in CA, the process of using your coverage for such programs is the same nationwide. There is typically a set of protocols you need to follow for your treatment to be covered. 

All covered treatment services need to be medically necessary and FDA-approved. This means you’ll need to get a referral that you’ll deliver to your Blue Cross Blue Shield treatment provider. Without a referral, you can legally be denied coverage.12

Most of the time, your primary care provider will be the one who’ll provide you with a referral. However, another option is to call your local hotline for more information on addiction and available coverage or the Blue Cross Blue Shield hotline. You can ask them about some additional options. For example, you might be able to get the referral via phone.12

Once you get the referral, you should once again contact your insurance provider and ask them to point you in the direction of facilities that accept their coverage. This is also how you’ll get instructions for any future steps.12

Locating Nationwide Blue Cross Blue Shield Alcohol Rehabs

There is more than one way how you can find local treatment centers that provide advanced care and accept Blue Cross Blue Shield insurance coverage. 

  • Your first option is to call the Blue Cross Blue Shield helpline and get informed about rehab centers that provide the care you need. Many people are afraid to call hotlines as they fear their private information being leaked, but the laws require all hotlines to be confidential.13
  • Next, you can call your local substance abuse hotline. This is a good place not just to find Blue Cross Blue Shield rehab centers, but also to get informed about the different treatment programs and the process of getting admitted into a treatment facility. 
  • Finally, you can contact American Addiction Centers (AAC), as they have a confidential hotline for alcohol addiction. This will give you an opportunity to talk to a professional dispatcher who can answer any questions you might have about alcohol abuse in general, treatment, and whether insurance will cover your treatment. In fact, this is a great place to verify your insurance and check your benefits. 

AAC has some of the leading well-equipped treatment centers, and you can also ask the dispatcher for more information on getting treatment in one of their renowned facilities.

Frequenty Asked Questions