What Is the Federal BCBS Coverage for Alcohol Rehab?

Blue Cross Blue Shield consists of 35 insurance providers accepted at numerous addiction treatment centers nationwide. Federal Employee Program (FEP) or The Service Benefit Plan provide health coverage to nearly 6 million US federal employees. By choosing the Preferred provider from the BCBS network, patients get access to a broad range of hospitals, doctors, and other specialists.¹ Companies affiliated with BCBS work with nearly 90% of hospitals and doctors in the US.²

Coverage for drug or alcohol addiction rehab varies from state to state and depends on your employment status and insurance type. As Federal BCBS has a wide array of drug treatment providers in-network, patients aren’t limited to treatments available solely in their location.²

Because they work with a wide array of providers, patients who have Federal BCBS insurance plans shouldn’t have any trouble finding an appropriate treatment center. However, some plans don’t have precertification requirements to get treatment at your chosen facility. Therefore, it would be a good idea to search for an in-network provider to avoid paying any extra costs that your insurance doesn’t cover.^{3, 4}

What Is the Federal BCBS Coverage for Alcohol Rehab ?

Every healthcare insurance provider is required by the Mental Health Parity and Addiction Equity Act to cover a medically necessary rehab. Treatment for substance abuse and mental health are considered essential in terms of health benefits.⁵

Most Federal BCBS insurance plans will cover most alcohol abuse rehab services, so if a different plan offers a different type of insurance, you are likely to have coverage for every medically necessary service. This includes:^{6, 7}

• Evaluation and screening office visit.
• Professionally organized intervention.
• Monitored and safe detoxification.
• Inpatient addiction rehab.
• Outpatient treatment.
• Dual diagnosis therapy.
• Behavioral therapy.

The amount of coverage you receive from your Federal BCBS insurance will depend on your chosen provider. If you choose an out-of-network or non-preferred provider, you will be responsible for the treatment costs.³ You can use BCBS insurance in every state in the country, and almost all specialists and doctors accept it.⁸

What Doesn’t Federal BCBS Cover In Terms of Alcohol Treatment?

As detox treatment for alcohol abuse is personalized to meet each patient’s specific situation, it may require additional services and a different approach that your health insurance doesn’t cover. These services can include:^{3, 7}

• Food delivery.
• Holistic care service.
• Recreation program.
• Alternative therapy.
• Non-essential amenities.
• Private treatment service.

How Much Does Alcohol Treatment Cost?

Treating alcohol addiction and its cost can vary depending on numerous factors. They include the extent of the addiction, personal requirements, and potential mental or physical health problems that often go hand in hand with alcohol addiction. Here are some of the determining factors for alcohol rehab costs:⁵

• The services on offer.
• The levels of care.
• Amenities included.
• The intensity level of the rehabilitation.
• The duration of the treatment program.

The Inpatient Program Cost for Alcohol Abuse Treatment

Residential alcohol rehab is typically the level of treatment that is the most expensive, as patients live at a rehabilitation facility for a period of time – ranging from 30 days to an entire year. Each treatment facility has its own unique rules, activities, and amenities that cater to varying levels of preferences and nutrition requirements. These extras are not typically covered by a health insurance plan.⁶

Precertification is required for admission to accredited treatment facilities for short-term stays, which are mostly covered by Federal BCBS preferred rehabilitation centers. However, this is only considered medically necessary if combined with treatment for a mental health disorder.³

The Outpatient Program Cost for Alcohol Abuse Treatment

Outpatient treatment for alcohol addiction typically involves a weekly visit for a counseling session with a therapist. The visitation frequency generally will depend on the severity of the addiction. It can last anywhere from 60 days to an entire year. This treatment method may not always be successful for individuals suffering from serious addiction or who have had multiple relapses in the past.⁹

Compared to inpatient addiction treatments, outpatient therapy is typically less expensive. However, intensive outpatient programs are more costly. Take into consideration the transportation costs as well for which you’re responsible for.⁵

Partial Hospitalization Programs Cost for Alcohol Addiction Treatment

Patients who have federally supported or state health insurance are typically eligible to be covered by PHP. This might consist of occupational therapy, various forms of mental health treatments or education regarding alcohol abuse. The patient covers transportation and meals and other similar costs.⁹

PHP rehab costs will depend on a few factors, such as the comprehensiveness of the medical care needed and the length of time in treatment. Insurance companies will often cover the costs of PHP rehabilitation for patients who have undergone a thorough evaluation and been deemed eligible. To get a clear idea of what the costs may be, it is helpful to speak with your insurance provider and the staff at the facility you are considering. Behavioral therapy programs are often included in treatment plans and can help address the causes of addiction. These sessions usually last for 6-8 weeks and occur for a minimum of 20 hours per week. Intensive treatment may be necessary for those with more severe disorders.⁹

The Cost of Medication-Assisted Treatment

If your Federal BCBS substance abuse provider deems it medically necessary, they will likely cover the costs of medication-assisted rehabilitation. As substance addiction can be a chronic disorder, it’s essential to adhere to prescribed medication for extended periods of time.¹⁰

Your provider will keep you updated on how frequently you’ll have to go through reevaluation of your therapy. If it is still necessary, they will continue covering the costs. Your primary care doctor determines the duration of treatment through regular check-ins to assess your current condition. On average, MAT (Medication Assisted Treatment) costs $11 per day.¹⁰

The FDA approves three other types of medication for alcohol abuse that are commonly used.¹¹ Naltrexone is highly effective but works only when you take it regularly.^{12, 13}

The Costs of Alcohol Rehab vs. the Costs of Alcohol Addiction

The costs of untreated alcohol addiction can be much higher than the costs of treatment, in terms of both money and quality of life. Addiction can lead to serious health and legal problems, strained professional and personal relationships, and other difficulties that can have a negative impact on every aspect of your life. Getting treatment for addiction can help you avoid these costly consequences and get your life back on track.¹⁴

• The costs involving substance abuse.
• Income loss because of poor job performance.
• The cost of health problems related to alcohol.
• DUIs/DWIs and other legal issues.

Substance abuse treatment not only lowers societal costs but also improves productivity in the workplace and reduces interpersonal conflicts. Treatment can positively impact our healthcare system by lowering drug-related overdoses and deaths. It can also lower drug-related crime rates and improve the criminal justice system. Individuals who receive treatment for substance abuse can expect to see improvements in their overall quality of life.¹⁵

What Duration of Alcohol Rehab Does Federal BCBS Rehab Cover?

Insurance providers for substance abuse will typically cover treatment as long as it’s deemed medically necessary. It’ll depend on the patient’s circumstances and needs, addiction seriousness, and other underlying mental or physical health issues. Overall, the longer the rehabilitation, the higher the success rate, as well as a lower risk of the patient relapsing.³

The length of time you stay in rehab will depend on the specific insurance policy you have and what medically necessary treatments are required. You can get an accurate estimate of the coverage and options by contacting your health insurance provider. Have your insurance card ready when you contact the Federal BCBS helpline or go to their website to fill out a form online.³

How to Choose Between Nationwide a Federal BCBS Inpatient & Outpatient Alcohol Treatment Program

There is no one-size-fits-all answer to the question of whether Federal BCBS inpatient or outpatient alcohol and drug rehab is the best program for you. The decision should be made by addiction experts after carefully examining and assessing your individual needs, circumstances, addiction severity, and your overall health. However, everyone’s situation is different, and factors such as lifestyle, finances, and support system, can play a role in determining which type of treatment is right for you.^{7, 11}

Inpatient rehab can be a difficult solution for some people who cannot take time off work or don’t have a strong support system. Removing themselves from their current surroundings may help them go down the same route, especially if alcohol dependecy is a common occurrence in their group of friends or a partner who struggles with alcohol abuse. Inpatient rehab can provide the necessary structure and support to help those struggling with substance abuse get better.⁹

Some people will base their decision on what is covered by their insurance plan. There are a few things to keep in mind when picking a rehab program that will give you the best chance at recovery and lasting sobriety:⁹

• The quality of professional care in accredited and licensed facilities should be at a high level, regardless of the type of rehab.
• The rehab ecosystem of companionship among peers can provide motivation.
• Support groups can be found in inpatient, as well as outpatient programs.
• An inpatient program allows for personalized and patient-focused intensive treatment.
• Taking accountability for your actions and staying mindful of your goals is essential to increase your chances of staying on track.

How Is Federal BCBS Insurance Coverage Used for Substance Abuse Treatment?

If you’re looking to begin treatment at an alcohol rehab center, it’s essential to check if the facility of your choice is a Preferred provider for Federal BCBS. Additionally, consult with a BCBC representative to better understand the services they cover and for which you’ll need to pay yourself. In some cases, you may need to go through the Federal BCBS pre-certification process before checking into the substance abuse rehab facility. Here’s how the process works:³

• It’s important to consult with a specialist to determine what kind of treatment is necessary for your alcohol addiction.
• Find an adequate treatment program, preferably a BCBS Preferred provider rehab center.
• Determine what substance abuse insurance coverage is available with your insurance.
• Federal BCBS will establish your coverage in collaboration with your rehab center of choice.

How to Know Which Alcohol Treatment Programs Accept Coverage For Federal BCBS Insurance

It’s important to be honest with your doctor with regards to your alcohol abuse and your willingness to go to rehab. Your doctor can proceed to perform an evaluation and then refer you to locally-based addiction experts and treatment facilities. If you’re not yet ready to go through the entire process, there are 24-hour drug and alcohol abuse hotlines you can contact. The service is confidential and free. The representatives on these lines are trained and will provide you with valuable information about how to treat your alcohol addiction. All personal information is protected by privacy laws.¹⁶

AAC is a nationwide provider of substance abuse rehab that accepts Federal BCBS. Our admission navigators can help you understand your payment options and the benefits of your health plan. Give us a call today and have your insurance card ready. We’ll be happy to help you explore your coverage and access the full benefits of your plan.

If you have questions about addiction treatment or what your insurance covers, they can help verify and answer any inquiries you have about treatment options. This will give you the necessary information of what your coverage includes and how much additional cost you may be responsible for. You may also be able to check your insurance coverage online through your insurer’s website.AAC is here to assist you in taking the first steps toward treatment and can explain what to expect from the alcohol abuse treatment program. With AAC’s nationwide network of first-rate addiction rehab centers, finding a facility near you that offers Federal BCBS insurance coverage is easy. Plus, in case of an emergency, same-day admission is available.