Blue Cross Blue Shield of Ohio Insurance Coverage for Drug & Alcohol Rehab Near Me

Does BCBS of Ohio Insurance Cover Inpatient Alcohol and Drug Rehab Centers?

If you or a loved one in Ohio is seeking addiction treatment, you may be wondering whether health insurance helps to cover the cost of treatment, including inpatient alcohol and drug rehab centers. Almost all plans in the United States, including BCBS of Ohio Medicare plans, provide some level of coverage for mental and behavioral health services, including rehab.¹ However, coverage varies based on the plan you have and where you seek care. That’s why it’s important to check coverage before seeking care when possible.

Most rehab centers in Ohio can check your coverage based on the insurance information you provide to them. You can also call the number on the back of your insurance card for more information about your specific plan. Finally, you can reach out to American Addiction Centers through different channels like call, chat, and an online benefits verification form to learn more about your plan’s details.

How to Find BCBS of Ohio Covered Inpatient Drug Treatment Centers in OH?

There are 979 rehab centers in the state of Ohio, and 80 of those are hospital or inpatient facilities.² Even though all these facilities are located within Ohio’s state boundaries, it is not guaranteed that they all are covered under your BCBS of Ohio plan.

To find a covered inpatient drug treatment center in Ohio, you can work with American Addiction Centers (AAC). AAC can help verify your insurance coverage for you. By calling our helpline, you can speak to a real person who can check your benefits right while you’re on the phone.

What Is BCBS of Ohio?

Anthem BCBS of Ohio is the tradename of Community Insurance Company.³ BCBS of Ohio is a nonprofit mutual insurance company and an independent licensee of Blue Cross and Blue Shield Association.⁴ BCBS of Ohio is 1 of 35 independent and locally operated companies that facilitate BCBS plans.⁵ Together, all BCBS licensed plans provide 111 million people in America—or 1 in 3 Americans—with health insurance. Moreover, BCBS licensed plans have a network of 1.7 million doctors.⁶

BCBS of Ohio first became known as BCBS of Ohio in 1984, when Blue Cross of Northern Ohio and Medical Mutual of Cleveland, Inc. merged.⁴ BCBS of Ohio is the state’s oldest and largest insurer.⁴ Depending on the BCBS of Ohio Medicare plan you have, you may have coverage at 1 of the 979 rehab centers in Ohio.² Call the number on the back of your insurance card to check coverage details.

How Much Does BCBS of Ohio Cover (Addiction Treatment)?

How much your BCBS of Ohio plan covers in terms of addiction treatment may vary based on the plan you have and where you seek care. Your BCBS of Ohio health insurance plan may cover some or all the cost of the following:

• Inpatient or residential rehab. In an inpatient or residential rehab program, patients stay at a facility for a period, which could be short- or long-term, and receive round-the-clock medical supervision and assistance.^{7, Pg 8, “What types of treatment programs are available?” Para 2}
• Outpatient rehab or therapy. In an outpatient rehab program, patients attend treatment 1 or 2 times a week, where they typically receive counseling or therapy but don’t have to stay overnight.^{7, Pg 10, Para 2}
• Intensive outpatient programs. In an intensive outpatient program (IOP), patients attend treatment for a minimum number of hours or sessions per week, providing more care than in a typical outpatient program.^{7, Pg 10, Para 3}
• Partial hospitalization programs. In a PHP, patients travel to a facility where they’ll spend 4–8 hours every day getting the care they need, which could include counseling and therapy or even medication-assisted treatment.^{7, Pg 10, Para 1}

Does Blue Cross Blue Shield of Ohio Cover Partial Hospitalization Programs?

Your BCBS of OH health insurance plan may include coverage for PHPs. Coverage may be full or partial and may be subject to network providers and other cost-sharing requirements like copays or deductibles. Call the number on the back of your insurance card to ask a plan representative whether your plan includes coverage for PHPs.

Does Blue Cross Blue Shield of Ohio Provides Coverage for Mental Health Facilities?

Under the Affordable Care Act (ACA), almost every health plan in the United States is required to cover mental health services and mental health facilities.¹ This means that your Blue Cross Blue Shield of Ohio is federally required to provide coverage in some capacity for addiction treatment services. For those who may need stand-alone heroin rehab or co-occurring disorder treatment, these services typically fall under this coverage mandate.

A co-occurring disorder is when someone experiences both a mental illness and a substance use disorder at the same time.⁸ This is a common occurrence, as those with a mental illness are twice as likely to develop a substance use disorder at some point in their life, and vice versa.⁹

In 2020, 17 million adults in the United States were diagnosed with a co-occurring disorder.⁸ Because the two conditions are often interconnected, an integrated treatment approach, where each condition is treated at the same time, is often recommended.^{8, “What should I do?}

Does BCBS of Ohio Cover Alcohol and Drug Detox Programs in OH?

The ACA mandates almost all U.S. health plans cover substance use disorder treatment, which may include alcohol and drug detox programs in OH.¹ Coverage may vary based on the plan you have. Additionally, plans may require that you receive care at an in-network alcohol and drug detox center to use your BCBS of Ohio plan.

Does Blue Cross Blue Shield of Ohio Cover Alcohol Addiction Treatment?

Under the ACA, health plans, including BCBS of OH, must provide coverage in some capacity for mental and behavioral health services.¹ This mandate includes coverage for substance use disorder treatment, which may include alcohol addiction treatment.¹ To be sure what’s covered under your BCBS of OH plan, call the AAC helpline or the number on the back of your insurance card.

How Long Does BCBS of Ohio Insurance Cover Alcohol and Drug Rehab Programs?

How long your BCBS of Ohio insurance plan will cover alcohol and drug rehab programs varies based on the plan that you have. There are a few types of Medicare plans that you may be able to carry through BCBS of Ohio, and each policy has its own tiers of coverage.

The length of treatment time covered by your plan may vary. It’s best to check your coverage details prior to seeking care to help keep your health care costs low and avoid surprise medical bills. To do this, you can look up your information on your insurance card. Then, you can call the number on the back of the card and speak to someone who can help you learn more about your plan.

Despite treatment coverage, remaining in treatment for the appropriate amount of time as set forth by your provider is incredibly important. What’s more, longer treatment times are generally considered to be more effective. Research shows that treatment programs should last at least 3 months.^{10, bullet 5} This is because, after this amount of time, it’s been shown to reduce or stop drug use and improve overall outcomes.^{10, bullet 5}

What if My BCBS of Ohio Policy Does Not Cover an Inpatient Drug Rehab Program?

If your BCBS of Ohio policy doesn’t cover an inpatient drug rehab program or other types of addiction treatment, don’t worry. Depending on the rehab center you choose, there may be payment options like financing or scholarships available. Be sure to ask about these ways to help offset the costs of getting care. Getting the treatment you need right now is critical rather than pushing it down the road.

BCBS of Ohio In-Network vs. Out-of-Network Inpatient Rehab Centers

While there may not be a difference in the quality of care between in-network and out-of-network inpatient drug rehab centers, there’s typically a difference in cost and whether you can use your insurance. An in-network provider is one that is contracted with your BCBS of Ohio plan.¹¹ This means that they accept BCBS of Ohio’s pre-negotiated payment rates.¹¹

If a provider isn’t contracted with BCBS of Ohio, they are an out-of-network provider.¹¹ Seeing an out-of-network provider may not be covered under your plan unless it’s an emergency or you obtain a prior authorization.¹¹

Rehabs That Take Blue Cross Blue Shield of Ohio Insurance 

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 tele-health.
• 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 tele-health.
• Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and tele-health, all in a luxurious setting with high-end amenities.
• Laguna Treatment Center: Located in Orange County, California, Laguna is a chemical dependency recovery hospital that focuses on treating people who are medically compromised and need 24/7 oversight. Provided care includes detox services, residential treatment, dual-diagnosis treatment inpatient treatment, and intensive outpatient services.
• 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 tele-health, all with individualized treatment programs.
• Sunrise House Treatment Center: Located in Lafayette Township, New Jersey, Sunrise House provides 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 rehabs near me 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.

Does Blue Cross Blue Shield of Ohio Cover Out-Of-State Drug Rehab Centers?

Whether your BCBS of Ohio mental health coverage extends to out-of-state drug rehab centers will depend on your specific health plan. You may need to submit a preauthorization request or call the number on the back of your insurance card to learn more. Coverage may depend on whether there is an in-network provider located outside of your state.