BlueCross BlueShield

bluecross blueshield

What is Blue Cross Blue Shield?

Blue Cross Blue Shield is one of the United State’s top insurance companies. About 1 out of 3 Americans are covered by Blue Cross Blue Shield in some way. Blue Cross Blue Shield is a large organization of several insurance companies and organizations. This means that although your insurance might not explicitly say that it is Blue Cross Blue Shield, you might still qualify for insurance at a clinic that takes a Blue Cross Blue Shield subsidiary or Blue Cross Blue Shield itself.

Who Do I Call to Get Information About My Blue Cross Blue Shield Plan?

Many addiction clinics are willing to talk to your insurance company on your behalf, in this case, Blue Cross Blue Shield. Addiction clinics like Sana Lake know what questions to ask when they talk to your insurance company. There are many ins and outs of insurance and there are many people who do not fully understand their policy, even though insurance companies are required to write their policies in “common language”. Common language means that they are not supposed to use technical terms and that policy wording that would not understandable to the average person.

Why are Insurance Policies Hard to Read?

However, with the dizzying length of many police’s fine print and specialized scenarios that either are or are not covered, specialized language does inevitably come up. Sometimes people choose their insurance based on affordability and do not read much beyond that. There are other times that the insurance is provided by the person suffering from addiction’s employer. When that is the case the insurance that the person’s employer chooses might not have a lot of coverage for addiction recovery.

What does the Affordable Care Act Say about Drug and/or Alcohol Rehabilitation Treatment?

Luckily, barring a few exceptions, all insurance coverage is required by the Affordable Care Act of 2010 to provide at least partial mental health coverage. Addiction is considered a mental health condition. There is also the possibility that no health care insurance might offer some help to people who need to pay for their addiction recovery process. While it is unlikely, it is important to explore all options. One example is that the driver’s insurance might pay for some alcohol rehabilitation in some states in the hope of preventing future drunk driving incidents. All states have different requirements and most plans are different in their particulars.

What Should I Ask My Insurance Company about my Drug and/or Alcohol Rehab?

Here are some questions to ask your insurance company while you are looking for your ideal addiction recovery clinic:

  • Are there certain addictions that this policy does not cover rehabilitation for?

For example, some plans might cover alcohol addiction recovery, but not heroin addiction recovery

  • Does this policy cover all parts of the clinical rehabilitation process?

There are several steps in the addiction recovery process during formal treatment. Some policies will cover things like detoxification from drugs, but not residential treatment, vice versa, both, or neither

  • Does my policy cover the clinic(s) I am interested in?

Although many clinics accept blue cross blue shield insurance, some do not. The ones that do not would be considered out-of-network. Out of network clinics are, as a rule, more expensive to enroll in and generally, insurance companies pay less for treatment at out-of-network clinics if they pay at all.

  • What length of time will Blue Cross Blue Shield pay for me to be at alcohol and/or drug rehab at the clinic?

Some insurance policies will only pay for a certain number of days in each stage of the clinic’s program. Others might not cover certain parts of the process at all

Will You Pay for the Clinic’s Aftercare Program?

The last part of many addiction recovery clinic’s programs is aftercare. During aftercare, the discharged patient lives at home in their community. They go about their day to day lives for the most part while engaging in activities like seeing the clinic’s caseworkers on a regular basis, being routinely drug tested, meeting with other alumni of the clinic to strengthen the recovering person’s support network, and other activities.

Does Blue Cross Blue Shield Provide its Own Aftercare Program? 

Some insurance companies provide their own aftercare programs that can be added to the clinic’s aftercare program and last much longer. These benefits from Blue Cross Blue Shield can include, cookouts with other people in recovery to celebrate milestones in another client’s lives, celebrate your own accomplishments, therapy, group therapy, etc.

How Long Does It Take to Get into a Drug or Alcohol Rehab Clinic?

The process of enrolling someone in an insurance clinic can be done very quickly. Many insurance companies understand that addiction is a critical disorder and that people suffering from it need help quickly. Some insurance companies require their clients to be formally diagnosed with addiction by a doctor who is not affiliated with any drug and/or alcohol rehabilitation programs. Others might let you go straight to the clinic.

What Other Illnesses Coexist with Drug and Alcohol Abuse?

As addiction is a mental health care issue and an overall health care issue, people who are affected by addiction might have the opportunity to get help for conditions that are related to their addiction disorder. These conditions can include:

  • Hepatitis C
  • HIV/AIDs
  • Heart Infections and Disease
  • Skin Infections
  • Many Cancers
  • Dental Problems
  • Damage and Destruction of Nerve Cells

How Do I Get Help for My Drug and Alcohol-Related Health Conditions?

When you and/or your clinic of choice contact your insurance company they will know what to do to get you the help that you need for any other mental disorders as well as any physical conditions that you might need that stem either directly or indirectly from the drugs or from side consequences such as sharing needles.

Why Does Drug and Alcohol Treatment Sometimes Fail?

Besides physical conditions such as cancer, often people who have an addiction disorder might also have other psychiatric disorders or might develop them later because of the drugs that they are abusing. People often start abusing substances in order to cope with the psychiatric pain of untreated or improperly treated mental illness(es). Some of the most common mental disorders that people seek relief from substances are:

What is a Co-occurring Disorder?

Often people who have a mental disorder that is co-occurring with their addiction disorder will have trouble getting help for their other mental health disorder(s). Co-occurring disorders are mental health conditions like the ones above when they occur in the same individual as an addiction disorder.

Why Don’t Some People Get Help for Their Mental Health Conditions?

This is because substance abuse can hide someone’s underlying mental disorders. If a person does not get help for their underlying mental condition(s) they will soon relapse after treatment.  If someone does not have some relief from the pain of their underlying mental health condition(s) they will abuse substances to feel some relief. If they do not get help for the pain from their other disorder(s) their motivation to abuse substances in order to feel some relief will still be there after they have finished their rehabilitation clinic’s program. They will soon turn back to substances because they are still in pain.

What Does the Affordable Care Act Mean for Addiction Recovery?

Luckily, the Affordable Care Act requires virtually all companies to provide at least some mental health and addiction coverage to their clients as a standard part of their plans. This Act also stops companies from denying someone coverage for preexisting conditions and it stops companies from discontinuing your coverage when you get sick/have to go to a rehabilitation clinic.

Most Human Resources (HR) departments will be very understanding and they will be more than willing to work with you anonymously and quickly to help you enroll in your drug and/or alcohol rehabilitation clinic of your choice.

When you are ready to start your addiction recovery you can reach us by dialing (855) 745-3336. You can also contact us here.  

References:

https://www.healthcare.gov/health-care-law-protections/

 https://www.bcbs.com/

https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/addiction-health

https://www.healthcare.gov/health-care-law-protections/

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.