Blue Cross Blue Shield (Kentucky Blue)
Blue Cross Blue Shield (BCBS), known as Kentucky Blue in Kentucky, is one of the largest health insurance companies in the US. They provide coverage for more than 100 million people every year.
Kentucky Blue plans cover drug and alcohol addiction treatment programs. But this coverage will vary depending on the specific plan you carry.
Anyone with a BCBS health insurance plan may get partial to full coverage for their substance abuse treatment costs.
For individuals entering addiction treatment, it could be helpful to learn which treatment services and drug rehab programs are covered by their insurance and whether the treatment facility they’re interested in enrolling in will accept a Blue Cross insurance benefit.
Blue Cross Blue Shield Coverage for Addiction Treatment
Each Blue Cross Blue Shield plan allows for different levels of coverage. Meaning there will be different percentages of coverage for specific treatment services.
The amount of coverage someone will receive for drug and alcohol rehab programs will also depend on the following:
- State laws and local regulations
- Where you seek treatment (hospital, rehab center)
- Type of treatment needed (inpatient, outpatient, intensive care)
It’s important to note that plans are unique to the individual, and the best way to understand your health insurance benefit is to speak to your insurance provider directly.
Blue Cross Insurance Plan Tiers
There are four different levels of Blue Cross plans. None of them is better or worse than the others. They simply offer various copays, deductible amounts, and premiums depending on your household’s needs.
The four levels of plans include:
- Bronze: These plans typically have lower monthly premiums and higher deductibles. They may also have more significant copay amounts for certain treatment services.
- Silver: This plan type generally averages the price between the Bronze and Gold plans. Making it a mid-range monthly premium and deductible decreased copay amounts from the Bronze plan but not relatively as low as the Gold offering.
- Gold: Gold plans tend to have higher monthly premiums and lower deductibles. Individuals with these plans may also have lower copayments for treatment services.
- Platinum: Out of all the tiers, Platinum plans tend to have the highest monthly premium cost and lowest deductibles. Plans will vary on copay amounts but tend to have lower out-of-pocket costs than any previous tiers.
Substance Abuse Treatment and Blue Cross Frequently Asked Questions (FAQ)
Q: Do Rehab Centers Have To Be In-Network With Blue Cross Blue Shield?
A: Some BCBS plans, known as HMOs (Health Maintenance Organizations), will require the rehab center to be in-network to provide any coverage. PPOs (Preferred Provider Organizations) plans may provide more rehab center choices but will still likely offer limited coverage for treatment that’s considered out-of-network.
Q: Which Rehab Centers Accept Blue Cross Blue Shield Insurance?
A: Most private drug and alcohol rehab centers, such as ARIA, accept Blue Cross Blue Shield insurance plans for addiction treatment.
Q: Does Blue Cross Blue Shield Cover The Cost Of Inpatient Drug And Alcohol Treatment?
A: Inpatient treatment with Blue Cross starts with a Standard Option with a copay of $35 per day for an unlimited number of days. There is also a Basic Option with a copay of $175 per day for unlimited days, up to $875 per admission for unlimited days. Keep in mind these numbers are an estimation only. Depending on their specific plan, someone may pay more or less for inpatient addiction treatment copays.
Q: Does Blue Cross Blue Shield Cover The Cost Of Partial Hospitalization Programs?
A: Outpatient care is typically covered under Blue Cross at a similar rate as inpatient rehab programs.
Q: Does Blue Cross Blue Shield Cover The Cost Of Intensive Outpatient Programs?
A: Blue Cross coverage for partial hospitalization programs (PHP) if the addiction treatment center meets the coverage requirements. Individuals will likely also have to meet their individual deductible and copay and need an in-network treatment provider.
Q: Does Blue Cross Blue Shield Cover The Cost Of Sober Living?
A: Because sober living is sometimes considered a part of outpatient treatment, Blue Cross may cover the cost of sober living homes in some circumstances. The cost of sober living will depend on your state and the insurance plan you carry.
Q: Does Blue Cross Blue Shield Cover The Cost Of Suboxone?
A: Suboxone – a medication used in opioid treatment – is frequently used in medication-assisted treatment (MAT) programs. Because Suboxone is a medication, it will fall under the pharmacy benefits of your insurance plans. Some plans may carry no copay, a small copay, or a hefty copay towards the medication.
Paying for Drug and Alcohol Addiction Treatment Costs Not Covered by Blue Cross
With all the variables of copays, coinsurance percentages, daily fees, and other costs, your health insurance plans may not cover all the costs associated with addiction treatment.
For many people, the cost of treatment is often a deciding factor when someone considers enrolling. Luckily, many programs and financial aid are in place to help those who need treatment.
Contact ARIA today to verify your insurance and learn about the additional treatment cost coverage you may qualify for.
Sources:
Blue Cross Blue Shield – Individuals & Families