does BCBS cover therapy

Does Blue Cross Blue Shield Cover Therapy?

42% of Americans have seen a therapist at some point in their life.

A further 36% are open to it.

That’s great news in terms of people taking ownership of their mental health, but does your insurance cover it?

In this article, we’ll go over the commonly asked question, “Does Blue Cross Blue Shield cover therapy?”

We’ll also go over some of the options available if you or a loved one covered by your Blue Cross Blue Shield insurance needs to receive more intensive care such as inpatient treatment.

Read on to find out more about how you can stay mentally well with your insurance plan.

What Is a Therapist, and How Are They Trained?

Therapy is typically defined by sessions in which you visit a qualified therapist to discuss your issues. Most often, therapists have trained by first studying in psychology in college.

In order to be a trained psychologist in the United States, they will need to have attended a graduate program as well. Many go on to pursue a doctorate in psychology, or even counseling.

Depending on the state, they will likely do an internship or need a certain number of clinical hours in order to qualify as a licensed therapist. Many will practice in graduate schools by counseling undergraduate and graduate students as part of their own studies.

Once they become qualified to practice, they can join a practice or choose to open their own. Some may also choose to work with patients who are inpatients in hospitals. Some may decide they want to work with inpatient and outpatient clients and mix and match their schedules to coincide with these things.

Some will participate in a practice while they earn their doctorate in psychology.

Some therapists decide to choose a specialty. For example, they may decide to work with patients with addiction issues or patients recovering from trauma. They may also limit their practice to certain age ranges. For instance, some may have more of an interest in working with adults, while others may only work with children.

What Is Therapy?

Therapy often conjures up an image of lying on a couch while you tell an old man sitting in a chair your problems. He might scribble down a few notes about you during your session.

However, there are many different types of therapy. Most often when people refer to therapy, they refer to counseling. In this format, you often sit with your therapist and discuss problems you’re dealing with, and the therapist provides you with coping skills.

Each therapist has a different approach. One therapist may choose to focus on your past while another may choose to focus on the present. One therapist may choose to focus on coping skills, while others may choose to focus on your inner dialogue.

Every therapist is unique, and thus, every relationship you have with your therapist will be unique.

Therapy is often one-on-one, with just you and the therapist involved. There is an expectation of client-therapist confidentiality, meaning they cannot “tell” on you for anything you’ve said to them. There are certain caveats, though, in which they must. This includes instances of abuse or disclosing that you have committed a serious crime.

You may also have couples therapy, where you and your romantic partner discuss issues you may have in your relationship. You can work on improving them together or may work toward finding a solution for the both of you.

Another type of therapy is family therapy. This is where your immediate family comes together to discuss the family dynamic. Sometimes, this can be in relation to one family member’s issues or addiction. Sometimes, it is just to improve upon the way the family unit functions.

Family therapy can be done with your parents, siblings, children, or grandparents. It all depends on whom you interact with most on a daily basis, and which relationships affect you the most.

The aim of therapy is always to relieve psychological symptoms and to help you, or the family unit, cope, and function in a healthier manner.

What Is the Difference Between a Psychologist and Psychiatrist?

A therapist is typically a psychologist, though a psychiatrist may act as a therapist in some ways. However, the major difference is that a psychiatrist prescribes medication to help you relieve symptoms. This medication can be for short-term or long-term use.

A psychologist does not provide medication. However, they often work closely with psychiatrists and can refer you to someone in their practice if they feel you might benefit from medication. They can also, with your permission, discuss your case with your psychiatrist to help you find the best medication available.

Does Blue Cross Blue Shield Cover Therapy?

Now that you know what a therapist is and does, we’re at the heart of the question. Does BCBS cover therapy?

The answer is yes but not to an unlimited extent. The therapist you wish to see needs to accept Blue Cross Blue Shield insurance. There may be reasons why the therapist of your preference does not accept BCBS insurance, so if this is the case, speak to your therapist of choice about alternatives.

You can find a list of therapists that accept Blue Cross Blue Shield across the United States and Canada here. If your therapist of choice will not accept BCBS, speak to him or her about possibly working on a sliding scale. Some therapists are willing to work with their clients, especially those they have ongoing relationships with.

Each Blue Cross Blue Shield plan is a little bit different. This means that each will cover a certain amount of therapy, or will have you pay different amounts of co-pay. Some plans, for example, may only cover a limited amount of visits.

BCBS may also only cover therapy it deems “medically necessary.” For example, you may need to have a certain diagnosis code for insurance to actually cover your therapy.

In the case of an addiction, your therapist may fill out your insurance forms giving you the code of an alcoholic. However, at a certain point in your recovery, you will no longer meet the criteria for an alcoholic. Therefore, BCBS may decide that they no longer need to pay for your therapy.

This is a common issue many people run into when seeking treatment, so it is important to be aware of this when starting therapy.

This conundrum can be frustrating, especially because most therapists don’t believe there is a point at which someone is “cured.” Most people, instead, could use a form of therapy and support in their life, so pulling it so quickly due to insurance can cause a lot of frustration.

Does Blue Cross Blue Shield Cover Inpatient Stays for Addiction?

Typically, yes. However, this will depend on which coverage plan you have. For some people, they will get almost their entire stay in a rehab facility covered, while others will get very little.

Patients who use the Bronze plan typically have insurance pay around 60% of the costs of an inpatient stay. While that may seem like a lot, inpatient stays can cost up to $100,000 per month for the most expensive inpatient rehabs. In some cases, in order to participate in the program, you must commit to an entire month or longer.

For some people, this could leave them with a bill of $40,000 or more. This doesn’t count travel or accommodation that they may need to make arrangements for in order to receive the inpatient treatment.

If you have the Platinum plan, this will cover around 90% of your inpatient stay. However, again, this doesn’t make things perfect. This plan means the highest cost per month, something that many people can’t afford. This is why many people, instead, opt for plans with lower per month payments, even if it means higher out-of-pocket costs.

With a Platinum plan, the cost of a rehab stay can also still be out of reach. If you stay in a rehab facility for 30 days to the tune of $100,000, you may still receive a $10,000 bill. For many, this is simply not possible, especially if they have spent much of their money on their habit.

Does Blue Cross Blue Shield Cover Inpatient Eating Disorder Treatment?

Yes, it does. However, the issues you run into are the same as the ones you would for an inpatient addiction treatment. Depending on where you choose to receive treatment, a month’s stay can cost between $30,000 and $100,000. Continuing treatment may also continue to rack up the bills.

However, you can still work with Blue Cross Blue Shield to try and negotiate a price and allow you or your loved one to stay in treatment as long as possible.

Why Are Inpatient Programs So Expensive?

There are many reasons why inpatient programs are so expensive. Mostly, it is because they are comprehensive. Some inpatient programs may also treat dual diagnosis, in which they help individuals not only overcome an eating disorder or addiction but can help those struggling with both. Or, they can help individuals struggling with more than one psychological disorder.

In an inpatient program, your entire day is devoted to helping you overcome your addiction or issues. You will spend the day in therapy, group therapy, or in other classes such as art therapy or light exercise.

During an inpatient program, you may receive medical detox to help wean you off of your drug of choice without causing too much harm to your body or mind. Many people use continuously in order to avoid this aspect of recovery. However, medically assisted recovery is much more comfortable.

You will not only have access to your own therapist, but depending on the facility, you’ll also speak to a nutritionist and other experts. You will help craft a plan that will help you succeed in conquering your addiction.

You will also be monitored around the clock to ensure that you do not participate in dangerous behaviors. You also have resources available if you do feel in danger, and there is always someone to speak to if need be.

Does Blue Cross Blue Shield Cover Ongoing Care?

Once you’re released from the inpatient facility, you may do intensive outpatient programs to help keep you on the path to recovery. These programs can be all day, 5 days a week, but you typically will live at home, or in a home for those recovering nearby. This allows you more freedom while continuing in your recovery.

Blue Cross Blue Shield will often pay for these programs as well, but only up to a certain extent and depending on your specific plan. It is important that you speak with the insurance company directly to find out what they will and will not cover in terms of these types of programs.

I Have Blue Cross Blue Shield, But It Isn’t Enough to Cover All of My Expenses

This is a problem many insurance holders run into. While they may get many of their total costs covered, they don’t get enough to ensure a complete and proper recovery.

Many eating disorder or addiction centers will offer scholarships and other programs that allow people who could not otherwise access their program to get the help they need. This helps relieve a big chunk of the financial burden for many.

Speak to the program you’re interested in entering today to find out if they have any similar ways to help out prospective patients.

I’m Ready to Explore My Options

So, now that you’ve received the answer to the question, “Does Blue Cross Blue Shield cover therapy?”, it’s time to start making some decisions.

First, speak to Blue Cross Blue Shield directly about the program you’re interested in, or the therapist you would like to visit.

If you’re ready to start your journey to recovery today, you can contact us to explore your options with Blue Cross Blue Shield. We’re waiting to help you start a new life.

Insurance Coverage for Rehab Treatment

A common worry for substance abusers seeking addiction treatment services for themselves or their loved one is whether or not insurance will cover the costs of their drug or alcohol addiction treatment. Due to the complexities of health insurance, the answer is always a variable, but most health insurance providers have some level of rehab coverage in their plans.

Successful addiction recovery often depends on consistent, specialized, guided rehab treatment, so it’s a very reasonable thing for addiction sufferers to worry about. Unfortunately, it depends entirely on your insurance provider and coverage plan. You may be eligible for partial coverage or full coverage for drug addiction and alcoholism treatment but only for certain types of treatment programs.

We can help you make sense of your insurance plan that way you know what to expect when seeking rehab treatment, plus we can help match you with a rehab center that’s in your insurance network.


Step 1: Review Your Insurance Coverage for Drug and Alcohol Treatment

Contacting your insurance company directly is often a good place to start, that way you can get information directly from the source. Before you call, make sure you have a list of questions prepared so you know what information you need answers to. The nuances of insurance coverage can be confusing and overwhelming, so the list will also help keep you keep your thoughts focused while you take down notes about your policy details.

Here are some sample questions that should give you a starting point for finding out more about your coverage.

  • Does my insurance cover every phase of drug or alcohol rehab (detox, inpatient and aftercare)? If not, what phases are covered and for what durations?
  • Will my policy cover any of the medications prescribed to me during drug and alcohol rehab?
  • Does my policy cover the different types of counseling programs and therapies that are often included in substance abuse rehab treatment programs?
  • What will my copay and/or deductible be if I choose to seek treatment for addiction?
  • What rehab treatment programs are covered by my current policy?
  • Does my policy require me to seek rehab treatment within a provider network? (If so, it may be a good idea to get a list of treatment centers that are commonly covered, if possible.)


What Types Of Drug And Alcohol Treatment Are Covered With Insurance?

While the answer is once again greatly dependent on your insurance policy and health insurance company, most plans cover some of the basic treatment programs. Detoxification is the most likely to be covered by your insurance, in part because detox and withdrawal symptoms can be fatal if the process isn’t monitored closely by trained medical professionals. Inpatient and outpatient treatment coverage is more varied, although the typical durations covered are 30, 60, and 90 days. Sometimes these treatments are only partially covered by insurance, rather than fully covered.

Insurance Policies: HMOs vs PPOs

Do you have an HMO or PPO health insurance policy? Understanding the differences between the two will help give you a better idea of whether an addiction treatment center will accept your insurance.


An HMO gives you access to certain healthcare providers and hospitals within the insurance network. Networks are made up of healthcare providers that have agreed to lower their rates for HMO plan members as part of an agreement with the insurance company. Unlike PPO plans, care under an HMO plan is covered only if you see a provider within that HMO’s network. There are few opportunities to see non-network providers, which can limit treatment options at times. There are also typically more restrictions on policy coverage than other plans, such as allowing only a certain number of visits to facilities, limiting tests, or recurring treatments.


A PPO plan provide more flexibility when decided where to receive healthcare services, compared to an HMO. These programs also feature a network of providers, but there are fewer restrictions in regards to seeking treatment outside of your network. In addition, your PPO insurance will still covery a non-network provider, although it may be at a lower rate than if you received treatment in network.

Work with an Insurance Coverage Professional

Navigating complex insurance policies on your own can be really difficult. You may find that speaking to your insurer directly leaves you with more questions than answers, even if you try to prepare as much as you can. In these situations, you and your family may be better off reaching out for extra support rather than making a decision with limited, possibly conflicting information.

Our team of addiction professionals offer over a decade of experience with addiction treatment and finding rehab options, such as inpatient or outpatient treatment programs, for substance abusers all over the country. We’re happy to help people find the treatment they need to regain control over their lives and we’ve worked with a variety of providers, including:

Our service specialists are well versed in helping families find the best treatment options for their loved ones and guiding individuals seeking addiction recovery into effective rehab programs without breaking the bank.


Consider Drug and Alcohol Addiction Treatment Without Insurance

If your insurance plan doesn’t cover rehab treatment, don’t give up hope. There are still options available that can help you cover the cost of treatment even if your provider won’t cover the plan you need. Many treatment centers offer affordable payment plans for patients who need help but lack insurance coverage for drug and alcohol recovery treatment. Some centers even offer financial assistance in extreme situations where patients need immediate help and care.

You may have to do some searching in order to find a solution that helps you cover rehab expenses, but opportunities for getting help covering rehab treatment are certainly available. Consider working with an industry expert to help you find new ways to save money on the addiction recovery treatment you or your loved one needs. Just because your insurance provider can’t help you doesn’t mean you’re stuck paying out of pocket expenses all on your own.

Let Us Help You Find a Rehab Center Today

Don’t let confusing insurance policies stop you from asking your provider for clear answers about your coverage details. While this is easier said than done, knowing what to ask and how to ask the big questions is much easier when you have an industry expert guiding you through the process.

We’re dedicated to helping people just like you make informed decisions about alcohol or drug rehabilitation and treatment options. Out services specialists are available 24/7, so give us a call if you’re ready to learn more about your insurance policy and find a rehab center.

Finding Best Treatment Options with Your Insurance - Addiction Treatment Services

Considerations for Health Insurance for Rehab Before Addiction Strikes

Considerations for Health Insurance for Rehab Before Addiction Strikes - ATS

Addiction is a pervasive and all-consuming disease. No one plans on becoming addicted or needing to use rehabilitation or detox services, yet thousands of Americans use these services each year.

No one plans on dying unexpectedly or incurring serious injuries, yet we purchase life insurance and disability insurance for protective purposes. This is exactly what our health insurance does for detox. It helps us pay for the unforeseen, which may include addiction treatment and detox services.

Addiction Treatment Is an ‘Essential Service’

The Obama administration passed the Patient Protection and Affordable Care Act (ACA) in 2010 – also referred to as “Obamacare.” The administration established a number of so-deemed “essential” medical services under this law. When a medical service is “essential,” insurers must pay for all or at least a portion of these costs.

One of the most groundbreaking aspects of this rule was making addiction treatment services essential. Previously, insurers often refused to pay for addiction treatment, using the justification that “you made your bed, now you get to lie in it.”

Fortunately, the provisions of the Affordable Care Act recognize addiction for what it actually is – a complex medical condition that affects victims physiologically as well as psychologically. In fact, the physiological addiction caused by some substances can be so strong that attempting to stop on your own can lead to dangerous consequences. Alcohol withdrawal, for example, can lead to debilitating or life-threatening seizures.

Is Rehab Covered by Insurance?

Addiction treatment services are essential, but people might wonder if they can still get health insurance for rehab. The simple answer is that any plan, regardless of its level, will offer some assistance with addiction treatment costs. The amount that your insurance company pays will depend on your level of coverage.

The Affordable Care Act recognizes that it’s unrealistic to expect anyone, especially those struggling with addiction, to pay thousands of dollars for rehabilitation costs. When shopping for health insurance, it’s a good idea to look at the percentage of rehabilitation costs your plan may cover.

Who Should Plan for Addiction Treatment?

Everyone should plan for the unforeseen, even if it doesn’t seem in the realm of possibility. It’s essential to understand that addiction can develop unexpectedly, even in an unexpectant individual. Say, for example, that you have a surgery or medical procedure that requires narcotic painkillers. An addiction to these potent substances can develop quickly, and even lead to heroin addiction.

In our scope of practice, we often run into individuals who are “surprised” by their or their loved one’s addiction. Having peace of mind that you have access to treatment for heroin addiction helps you plan for the unanticipated.

Another aspect to consider is young adults aged 18 to 27. This age group is allowed to stay on their parents’ insurance under the Affordable Care Act, though some may elect to establish their own policies. Though no parent wants to think about children developing an addiction, this is a period of experimentation.

Teenagers and young adults often experience their first exposure to alcohol and other drugs in this time period. Even moderate alcohol use can develop into a full-blown addiction within this vulnerable age range, so learning about alcohol addiction treatment centers in the area and if your insurance will cover them is essential.

Taking a Proactive Approach

There’s a chance you’ll never have to use your addiction therapy coverage – but it’s essential to be prepared in the event that you do. Research rehab facilities in your area that take insurance and seek a program that will provide affordable, high-quality addiction treatment services.

It’s best to plan for these contingencies while you’re switching or shopping for health insurance coverage. As a general rule, the higher your premium, the more extensive the coverage. For example, a plan with a higher premium may cover 75 percent of the cost of rehabilitation, while a lower premium may only cover 60 percent.

Your best plan will depend on your budget and other health needs. Ask your insurance company specifically about their portion of the cost, so you can determine what you’ll have to pay out of pocket. It’s much easier to plan these things out now than when a problem arises.

No one likes to think about the potential for addiction, but no one plans on developing an addiction either. By familiarizing yourself with your insurance coverage, you can make important decisions now that may be more difficult to make in the moment.

Are You Wondering How Your Insurance Can Cover You in Rehab?

Best Treatment Options for Your Specific Needs

How Will My Insurance Be Affected By Going to Rehab - ATS

Will Going to Rehab Raise My Insurance Rates?

Will Going to Rehab Raise My Insurance Rates - Addiction Treatment Services

Although it was once believed that addiction was the result of weaknesses in willpower or morality, it is now widely acknowledged that anyone can become trapped in a cycle of physical and psychological addiction. The medical community now understands that addiction should be treated with the same level of commitment, resources and respect with which they address other types of illness.

Addiction is a serious health concern that negatively impacts the lives of those who are dependent on substances. Addiction’s ripple effects also impact friends, family and co-workers.

Unfortunately, many people deny their addiction or put off treatment because they’re worried about what might happen if they go to rehab. But the longer an addiction goes on, the greater the threat to personal health and safety, and the greater the risk of major legal and career consequences.

Uncertainty about insurance coverage and how to pay for rehab is one of the issues that may delay seeking treatment for many individuals. Let’s look at how insurance coverage for addiction treatment works and address common concerns.

Will Going to Rehab Raise Your Insurance Rates?

No. Under the Affordable Care Act (ACA), insurance companies in the U.S. cannot raise rates or premiums for patients who seek treatment for one of the 10 “essential services” covered by the ACA, and substance use disorder is one of those essential services.

Under the ACA, insurance companies must cover addiction treatment the same way they cover other illnesses, and cannot charge more or deny coverage for pre-existing conditions.

However, it does not guarantee that the entire cost of treatment will be covered. What exactly is and is not covered will depend on the individual’s insurance plan.

Alcohol and Drug Rehab Insurance Coverage Under the Affordable Care Act

Insurance Coverage for Rehab Under Affordable Care Act Statistic - Addiction Treatment ServicesThe Affordable Care Act, also known as Obamacare, outlines 10 “essential services” that all insurance plans must provide coverage for.

One of those 10 essential services is:

  • Mental health and substance use disorder services (including behavioral health treatment)

The ACA also forbids insurance companies from raising premiums or denying coverage due to pre-existing conditions. This means that those who need rehab no longer need to worry about their addiction being labeled as a pre-existing condition that could affect future insurance coverage or rates.

Finally, the ACA requires that insurers charge the same rates to all patients on a given plan, regardless of factors such as age or pre-existing conditions. The level of coverage must also stay consistent regardless of the type of illness, which prevents insurers from discriminating against those with drug or alcohol addictions.

What Types of Addiction Treatment Services Are Covered by Insurance?

While the exact coverage depends on the particular insurance plan, plans generally cover the following types of addiction recovery services:

  • Inpatient/residential treatment
  • Partial hospitalization programs
  • Outpatient treatment (including Intensive Outpatient Programs)
  • One-on-one counseling
  • Group therapy
  • Recovery support services and education
  • Medication (for detox and maintaining sobriety)
  • Ongoing support groups

This is a general guide. You should check your insurance benefits statement to determine what your plan actually covers, or you can have a third-party professional review your insurance plan and break it down for you.

Will Insurance Cover the Full Cost of Addiction Treatment?

The answer to this question depends on the specifics of your insurance plan and the treatment program you choose. As with all insurance plans, there are specific limits and requirements. You may find that your plan covers all or only part of treatment.

However, the law does require that insurance companies pay at the same rates for rehab as they do for other types of medical treatment. This prevents insurance from charging more or covering less in an unfair way. How much coverage you will have will depend on your overall level of insurance benefits. Plans with more expensive premiums typically cover more than less expensive plans.

Because knowing what type of treatment is needed and how insurance covers this treatment can be confusing to people who are new to this topic, we highly recommend talking with an expert in this area. You can certainly call your insurance company to ask about coverage and rehab options. Just keep in mind that they may steer you towards providers that are in their network and the most affordable for them, not necessarily the best for you.

However, our insurance experts at Addiction Treatment Services can provide you with an objective analysis of your coverage and help you narrow down your treatment center choices based on your unique circumstances and needs.

How Can I Afford Out-of-Pocket Rehab Costs?

If you find that your insurance will only cover part of the cost of treatment, then the next step is to figure out how to pay the balance. Check with the rehab facility you’ve selected to see:

  • If they will allow you to pay in monthly installments;
  • If they can refer you to lenders who specialize in this type of financing; or
  • If they offer discounts for up-front cash payments.

Again, speaking to an expert in the area of rehab financing can save you a lot of time in this process. Addiction Treatment Services can help you with this as well.

When Is the Best Time to Get Addiction Treatment?

Now is the best time to get serious about going to rehab, for two reasons:

  • The longer addiction goes on, the more it harms the life of the addicted individual.
  • The Affordable Care Act may be changed in the future in ways that remove the consumer protections that are currently in place.

Before the Affordable Care Act, treatment for substance abuse and addiction was not always covered by insurance. Now, the ACA guarantees at least partial coverage to those who need it, and ensures that insurance companies treat addiction patients fairly. But if changes to the law occur, then it may once again become harder to get insurance coverage to help pay for addiction treatment.

There is no better time than the present to seek out the professional help needed to take back control from addiction. Right now, this is being made easier by the United States government through the Affordable Care Act. Take advantage of this opportunity to turn your life around for the better – without having to pay the full cost yourself.

Insurance and Intervention Help for Families

While insurance will cover some portion of treatment for addiction and substance abuse, navigating insurance coverage and claims can be very difficult without the help of a professional.

Addiction Treatment Services can help you with insurance verification, advise you on how to get the most out of the coverage you have, and then help you find a rehab program that is 1) covered by your plan and 2) a good fit for the type of treatment you need.

We can also advise families on how to stage an intervention for drug addiction so that their family member can understand the importance of going to treatment right away. With addiction, any delay in undergoing treatment can be deadly, so bringing in professional help speeds up the process.

Learn How We Help Individuals and Families Understand Addiction Insurance Coverage

Explore Our Insurance Services

Does Insurance Cover Drug and Alcohol Detox Treatment - Addiction Treatment Services

Does Insurance Cover Drug and Alcohol Detox?

Drug And Alcohol Detox Insurance Options - Addiction Treatment Services

Figuring out if your insurance covers drug and alcohol detox policy can be extremely difficult.  You may not have the experience in health care policy to understand that giant booklet they handed you during benefit enrollment, but that’s OK. We do have experience in working with insurance companies and can tell you what you need to know about getting your detox services covered.

Detox Services as a Medical Necessity

While the law requires that substance abuse treatment services, including detox, must be covered by your health insurance, the extent of your coverage may vary. For example, insurance providers have a right to only pay for medical services that are deemed necessary. Proving a treatment program is necessary can be easier said than done, in some cases. You must be able to prove that you need detox services by providing a doctor’s note.

Here comes the next sticking point in negotiations. There are two kinds of detox services: inpatient and outpatient. While both are viable options, inpatient services are generally supervised more closely and have fewer instances of relapse. For that reason, inpatient rehab treatment is also more expensive. Your insurance company may only pay for an outpatient detox unless you can prove that an inpatient care center is medically necessary.

Determining Medical Necessity

Confused About Insurance Options - Contact Addiction Treatment Services

Insurance companies look at a few different factors to determine medical necessity for inpatient drug and alcohol detox. First and foremost, insurance providers evaluate the severity of your withdrawal symptoms. For example, withdrawal from alcohol, especially when you’ve been drinking heavily over a period of years, can be deadly. In this case, medically supervised detox is vital.

Next, providers will assess the intensity of services you’re requesting, as well as your projected length of stay. Finally, they’ll consider your unique personal circumstances. Do you have coexisting conditions such as depression, anxiety, or another mental disorder? Do you have a family history of substance abuse?

Remember, your medical necessity status is fluid. In other words, you may initially qualify for treatment, only to find that your insurance company may downgrade your services over time. For example, you may qualify for inpatient treatment for a few days during detox, but see your insurance update to cover outpatient treatment once your symptoms stabilize.

Fighting an Insurance Denial

Even if you receive an initial insurance denial, you may have other options. Each insurance request has the possibility of one or more appeals. In order to fight an insurance denial, you’ll need the help of your physician and other experts in the mental health field. If you can prove that your request is based on medical necessity, you may be successful in appealing a denial.

What If I Don’t Have Insurance?

If you don’t have insurance to cover alcohol and drug detox, or your provider refuses to pay, you still have options. Many treatment centers offer their services on a sliding scale, and you may qualify for public or nonprofit funding.

Lastly, you may be able to pay for your services on an affordable payment plan. Your financial situation should never be a barrier to quality detox services and rehab treatment. Remember, we’re here to help!

Choosing a Partner to Help

Detoxing and beginning your road to recovery is something you should never have to do alone. Our team of interventionists can help you or a loved one find a quality rehab treatment center, answer your questions, address your concerns, and help you live your best life!

For more information about the services we offer and for negotiating with insurance providers, please reach out to us.

More Workers Testing Positive for Drugs

drug testDrug testing in the workplace is quite common among employers. Many people are required to submit to a pre-employment drug screen, and often random testing upon suspicion as well. According to Quest Diagnostics, there has been another increase in the number of employees who are testing positive for illicit drugs. The report shows a nearly 10 percent increase overall compared to the previous year, with greater increases among specific drugs.

There are still conflicting opinions on whether or not drug testing policies actually help reduce workplace substance abuse or discourage employees from addiction-enabling behaviors, but few can argue with the idea or the importance of protecting others from harm that can be caused by people under the influence on the job. Typical issues include accidents and injuries from carelessness or slower response time. Occupations that require the use of heavy machinery and other potentially hazardous tools should be most cautious about drugs and alcohol usage among employees.

In many cases, when an employee tests positive for illicit drugs, they are given a resource list for counseling and rehabilitation programs. They can often take a medical leave of absence to address their substance abuse issues and return to work upon successful completion of a program.

At Addiction Treatment Services, we specialize in helping people find drug and alcohol rehabs that work with their insurance policies. With contacts and resources for referrals throughout the country, we have helped many people enroll in the best quality treatment centers. Contact us today if you are an employee or employer and seeking treatment programs that accept your insurance.

Increases in Insurance Coverage for Behavioral Health Lead to Concerns of Provider Shortage

hhsacainsInsurance coverage for behavioral health increased for Americans through the passage of the Affordable Care Act, but the demand for mental health and addiction treatment services hasn’t noticeably changed yet. This could be a result of a combination of factors. The first is that some states haven’t expanded Medicaid coverage. Another is that patients aren’t aware of the benefits to which their new insurance plans give them access.

The question is: when these stop gaps are filled, will there be enough healthcare providers to treat those who seek treatment for substance abuse and mental health disorders?

The Substance Abuse and Mental Health Services Administration (SAMHSA) found tens of millions of people are in need of behavioral health treatment. Without healthcare coverage, people are more likely to postpone or skip treatment all together. Foregoing treatment for behavioral health disorders could lead to increased substance abuse, homelessness, unemployment and even suicide.

With the updated Mental Health Parity and Addiction Equity Act (2008), insurance companies are now required to provide the same coverages for substance abuse and mental illness as they would provide for medical or surgical procedures. A plan that covers behavioral health now covers many inpatient or outpatient services, emergency care and medications used to treat substance abuse. When the law was passed, one-third of those with private insurance did not have coverage for substance abuse, opening treatment opportunities for those who could previously not afford it.

According to the Department of Health and Human Services, over half of U.S. counties, all rural, do not have a practicing psychiatrist, psychologists or social workers. The agency estimates a shortage of more than 7,500 psychiatrists and other professionals trained in mental healthcare.

“There has always been a long-standing shortage,” said Bob Carolla, a spokesman for the National Alliance for Mental Health. Carolla said that expanding healthcare is good, but healthcare providers need to be prepared to handle the growing demand for it.

If you have health insurance coverage and would like a complimentary substance abuse benefits check, contact Addiction Treatment Services today to find out some effective rehabilitation options.