Does Blue Shield of California Cover Opioid Treatment? ‌‌| Rehab Coverage

Can You Go to Opioid Rehab Centers With Blue Shield of California?

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In 2018, about 45% of deaths by overdose involved opioids, resulting in a death toll of over 2,400. Prescription opioids remained the biggest issue, as they contributed to almost 1,100 deaths.1

Fortunately, thanks to the Mental Health Parity and Addiction Equity Act, all insurance providers have to ensure their members have the same coverage level for substance use disorder (SUD) treatment and mental health as they would for any other medical condition and service.2

A large number of people from California use Blue Shield to cover treatment at opioid rehab centers. This private healthcare provider might cover the costs of your treatment depending on several factors. In general, about 10% of people who check into substance abuse treatment facilities in California have Blue Shield insurance.3

Blue Shield Opioid rehab coverage in California

What Does Blue Shield of California Cover for Opioid and Drug Rehab?

Depending on your healthcare plan, Blue Shield of California might cover these parts of addiction treatment:4

What Part of Opioid Rehab Isn’t Covered By Blue Shield of California Healthcare Plans?

For opioid treatment to be covered by Blue Shield insurance providers, it has to be medically-necessary. Therefore, all non-medical amenities, such as recreational programs and food delivery, aren’t usually covered by most healthcare plans. This may also include same-day admittance into professional treatment, holistic care services and alternative therapy, couples’ therapy for partners struggling with addiction who want to get treatment together, and most private treatment services.2

How Much Opioid Rehab Costs

Unfortunately, high costs of opioid treatment are one of the main reasons why many people don’t seek treatment.3 The exact costs of treatment depend on the severity of your opioid addiction, what length of treatment is necessary, what treatment includes, and how intense the included services should be. A professional team working at rehab centers should be able to give you an overview of the costs upon admission into the facility. 5,6

Fortunately, Blue Shield substance abuse coverage may help you cover most of these costs, so don’t hesitate to contact their dedicated helpline for exact information.

How Much Inpatient Opioid Rehab Costs

Inpatient treatment for opioid addiction is, in general, the most expensive type of rehab. The main factor that affects the cost of inpatient treatment is its length. You might need to go to one of the following:7

The more severe your SUD is, the longer the treatment, and higher the costs.8 At the same time, the cost of inpatient treatment will depend on additional services, treatment intensity, and the treatment center itself.7

How Much Outpatient Opioid Rehab Costs

Outpatient opioid rehab doesn’t provide as extensive services as inpatient treatment. The main reason behind this is that it doesn’t include accommodation costs, as the person only comes to the facility for therapy and counseling. Most Blue Shield insurance plans for drug treatment programs in California will cover (partially or in full) the costs of outpatient treatment centers, helping you with your expensies.7

How Much PHP Costs

Partial hospitalization programs (PHPs) are something between outpatient and inpatient care. They typically require a person to spend around 8 hours in therapy and the rest of the time at home. As this treatment program can vary greatly depending on each patient’s needs, the precise cost will depend on the intensity of the required services and their frequency.7

How Much MAT Costs

Medication-assisted treatment (MAT) includes the use of medications such as buprenorphine, naltrexone, and methadone to help people struggling with opioid abuse, especially with withdrawal symptoms.5

As the cost of these medications can vary, and considering that not everyone will need the same medications, the expenses will depend on the exact treatment required. Make sure to check with local rehabilitation centers you’re considering to get more information about your coverage under Blue Shield California and the exact cost of treatment.5

Is Opioid Rehab More Expensive Than Opioid Addiction?

Treatment costs can be a major deterrent for many struggling individuals who’re not able to afford treatment. However, opioid addiction brings its own set of expenses if left untreated.5

A person abusing opioids is at risk of an overdose, which can even be fatal, and the treatment for such a medical emergency can be costly. Opioid addiction can also cause other health-related issues that can require additional treatment.5

Additionally, individuals dealing with opioid addiction are at a higher risk of experiencing injuries, such as traffic accidents, and getting in legal trouble. At the same time, addiction can lead to a decrease in work productivity, which puts struggling individuals at risk of getting fired in addition to losing income.5

In 2013 alone, residents of the U.S. spent 78 billion dollars on prescription opioid abuse and overdose treatment. Only 3.6% of these costs were spent on opioid treatment. Therefore, the cost of treatment is just a minor fraction of the costs of opioid addiction.5

How Long Does the Blue Shield of California Insurance Substance Abuse Coverage Last?

While your Blue Shield California insurance coverage is likely to cover your opioid treatment, the exact length of coverage will vary. The length of treatment usually varies depending on the severity of your SUD. Some people may need to use medications even after they’re done with their inpatient treatment. Additionally, it’s important to listen to professionals and stay in treatment for as long as necessary. Longer treatment length is connected with higher recovery rates.8

Of course, any length of treatment is better than not getting treatment. In general, a treatment program should last at least 3 months to significantly increase the chance of staying sober.8

To find out how long you’ll be covered, your best option is to contact Blue Shield of California and ask them about the details of your insurance coverage. You can do this by calling the number on the back of your card. Some treatment plans might have a limited length of coverage, while others might not have any limit at all.2

Should You Go to Inpatient or Outpatient Rehab Centers In-Network With Blue Shielf of California?

There are a few differences between inpatient and outpatient rehab centers that might be crucial in determining which type of program is the best choice for you. While there are some ways you can assess yourself and see whether you need help with addiction, it’s important to leave the decision on the type of treatment to a medical professional. Still, there are some indications that inpatient treatment might have better success rates compared to outpatient.8

  • Inpatient treatment provides patients with accommodation, high-quality services, and 24/7 medical care. The entire environment is focused on recovery, and a person will be surrounded by people who’ve been through similar hardships, providing a support system.8
  • There are many benefits to outpatient treatment, as well. It allows a person to stay in a familiar environment, and it’s a good option for someone highly motivated to stay free of opioids. Also, outpatient treatment is usually a less expensive option.8

Still, it’s important to note that outpatient treatment may not be the best choice for someone who is at any risk of relapse It can be challenging to stay sober in a triggering environment that made them use in the first place.8

How to Find Blue Shield of California Insurance Drug Treatment Providers for Opioid Addiction?

If you’ve never used insurance for drug or detox treatment, either in California or nationwide, then you might feel confused about using Blue Shield for the first time. Fortunately, there is a set of rules and protocols similar for every insurance company in the U.S.9

To have Blue Shield insurance cover your rehab, treatment needs to be medically necessary and FDA-approved. Therefore, you’ll need a referral before you can schedule your treatment.9

To get a referral and start your treatment, you’ll need to have a consultation with a medical professional or your primary care professional. Certain insurance providers might allow you to schedule a referral meeting via phone. However, if you want to get information about all possible options, you’ll need to call the Blue Shield California helpline or a local hotline for people struggling with opioid addiction.9

Then, you should work with a professional to determine what the best opioid treatment option for you is, and what drug treatment programs are covered by Blue Shield California insurance.9

Locating Blue Shield California-Covered Substance Abuse Treatment Facilities

Whether you’re looking to help a family member struggling with opioid addiction or you’re looking to get sober yourself, you’ll need to find a treatment facility that accepts payment options available for you.

Whether you’re looking for women-only treatment settings or flexible executive programs for top-level professionals who cannot leave their jobs to go to rehab, the process of finding the right facility covered by Blue Shield of California insurance is usually the same.

  1. You can call the Blue Shield of California helpline and ask them about rehab centers that will accept their coverage. This is a good moment to get details about treatment cost and insurance coverage and see whether there are some in-network or out-of-network addiction treatment facilities that will accept your coverage.
  2. You can call a local substance abuse hotline and give them as much information about your struggle as you can. A trained dispatcher will instruct you on what your next step should be. This is also a good place to ask about any specific programs, such as local faith-based rehabs for Christians or short, weekend drug rehabs near you. Finally, you can ask a dispatcher to give you more information about addition treatment and the rehab process.
  3. You can also talk to your doctor and explain your situation to them. This is also a good moment to get a referral.
  4. You might want to contact American Addiction Centers (AAC), one of the leading authorities in addiction treatment, and get in touch with some of their renowned facilities. While on the phone, you can ask a professionally trained dispatcher to verify your insurance and check your benefits. AAC operates numerous advanced facilities, including Laguna Treatment Hospital.

Laguna Treatment Hospital

Laguna Treatment Hospital, a professional treatment facility in California, offers opioid addiction treatment and accepts Blue Shield insurance. This facility offers high-quality services, such as medical detox, treatment of co-occurring disorders, intensive outpatient therapy, and inpatient treatment. This facility is in contact with all major insurance carriers, including Blue Shield, and accepts people from all parts of California, Northern and Southern, as well as from all parts of the U.S.

Also, besides Laguna Treatment Hospital, American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Blue Cross Blue Shield insurance plan, the following AAC facilities accept Blue Cross Blue Shield for drug and alcohol addiction rehab.

  • AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and telehealth.
  • Desert Hope Treatment Center: Located in Las Vegas, Nevada, Desert Hope provides individualized care programs as well as offering a full continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, and telehealth.
  • Greenhouse Treatment Center: Located in Grand Prairie, Texas, the Greenhouse facility offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and telehealth, all in a luxurious setting with high-end amenities.
  • Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and telehealth, all with individualized treatment programs.
  • Sunrise House Treatment Center: Located in Lafayette Township, New Jersey, Sunrise House provides advanced treatment for people suffering from substance abuse from a medical and holistic standpoint. With various evidence-based therapeutic interventions, personalized care is provided through detox, residential treatment, dual-diagnosis treatment, and outpatient services.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are diverse rehab facilities near your area that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Blue Cross Blue Shield insurance.

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