Blue Cross Alcohol and Drug Rehabilitation Coverage

A question normally asked when treating addiction is “Will my health insurance cover it?” Let’s face it, getting addiction treatment is often out of reach for the average person. It’s enough to keep people from getting the help they really need, but it all changed when the Affordable Care Act was established. Now, insurance companies provide affordable premiums for members. Anthem Blue Cross is one such company that covers alcohol and drug rehabilitation.

Blue Cross Coverage

The amount you’ll copay will depend on your plan. In general, the following services will either be covered or partially covered by Blue Cross:

• Outpatient Detox and Addiction Treatment

• Outpatient Medication-Assisted Treatment

• Structured Intensive Outpatient Program

Some conditions require constant monitoring and counseling through inpatient care. Blue Cross has coverage on the following programs:

• Inpatient Detox and Addiction Treatment

• Partial Hospitalization Program

• Residential Addiction Treatment

Supplementary Counseling

Mental health is just as important as physical. Both inpatient and outpatient programs cover counseling, provided you have pre-authorization from Blue Cross. These counseling will vary from group to private meetings with a guidance counselor. In some cases, patients need intensive behavioral counseling to help them adjust back to society.

Inpatient vs. Outpatient

When consulting with your physician about your rehabilitation plans, you need to consider if you have any duties or responsibilities. This is where doctors can recommend certain outpatient or inpatient treatments.

Physicians can recommend outpatient care if your condition doesn’t cause immediate harm to you, or those around you. Another factor is if your daily tasks won’t undermine the treatment.

If the condition is causing harm and it’s crucial that you’re taken away from the substance, then it’s best to take on an inpatient program. Depending on your plan, and if you can provide the copay, you can avail luxury rehab centers. These centers have extra amenities such as pools, gyms and gourmet food to make the hard process, much more bearable.

Other programs are an in between the two categories. Partial Hospitalization Programs have you visit the office for treatment for 6-12 hours, then you’re allowed to go home. Some rehab clinical trials are structured as partial hospitalization.

Blue Cross General Coverage Amount

The amount they will cover and the amount you’ll copay depends on your membership ‘metal level’. The exact pricings may vary for each situation, but these are the percentages in general:

• Gold: 60% covered, 40% copay

• Silver: 70% covered, 30% copay

• Bronze: 60% covered, 20% copay

What if I Really Cannot Get Insurance?

If consulting with Blue Cross’ support can’t get you a proper compromise, there’s still hope. There are government groups that help the masses overcome addiction. Another method is to get a loan or consult a bank on financing your rehabilitation costs.

When there’s a will, there’s a way. Health should always be your number one priority because it will serve you your whole life. Many movements have made it so that healthcare is within reach so it’s up to you to grab them.

For more information on addiction and treatment, check out the playlist below.

Dr. Vikram Tarugu MD

Dr. Vikram Tarugu, M.D, is the CEO of Detox of South Florida, Inc and medical professional focused on addiction. A veteran in the medical field with over 25 years of professional experience. He is a consultant for many South Florida Rehab centers. Patients travel from allover the US to seek his help with addiction and Hepatitis C treatment.