blue cross blue shield coverage

How Having Blue Cross Blue Shield Coverage Can Affect Your Addiction Treatment

Last updated on July 17th, 2019 at 09:55 am

Approximately 31 million people worldwide have substance abuse disorders.

Seeking professional help can improve your chances of recovering from an addiction. In 2017, there were over 1.3 million people in various substance abuse treatment facilities.

But is addiction treatment covered by insurance?

If you have Blue Cross Blue Shield Coverage, you have access to treatment for addiction. But with such a large network and varying plans, knowing exactly how you’re covered is essential to seeking the right treatment.

Keep reading to find out more about addiction treatment and what’s available to you.

Paying for Addiction Treatment

The costs of treatment will vary between the center you choose and the therapy involved. Treatment centers can cost anywhere from thousands of dollars per day to nothing at all. Addiction treatment centers may offer financial aid, help with financing, or accept insurance.

Many people use insurance to pay for rehabilitation. Insurance plans that may cover treatment include:

  • Private insurance
  • State-financed insurance
  • Medicaid
  • Medicare
  • Military insurance

The level of coverage depends on the provider. It also depends on the individual plan.

For those without insurance, there are low-income treatment centers. There are also free centers and those that offer to finance.

Free centers tend to have long waiting lists and fewer resources. Limited funding prevents them from offering the kind of treatment available through a private center. However, if you or a loved one need help and have no way of financing, this is still a viable option.

General Costs of Addiction Treatment

Determining costs for treatment should include the cost of detox as well as medications. They’re also dependent on whether you choose an inpatient or outpatient program.


Detox can cost anywhere from $1,000 to $1,500. The cost varies based on the drug being treated. Whether detox is part of an inpatient program also affect the costs.

Some substances have dangerous side effects from withdrawal. Detoxing from drugs like heroin or alcohol require special monitoring. As a result, this type of detox costs more than detoxing from other substances.

Many inpatient rehabs offer detox as part of their program. The cost of detox is included in the cost of your stay.

Inpatient Treatment

Inpatient rehabilitation is a residential program. These intensive programs are for treating serious addictions. Inpatient programs are usually offered in 30, 60, and 90-day programs.

A 30-day program costs approximately $6,000 and 60-day programs cost around $12,000. For a 90-day program, costs can reach up to $60,000. And for reputable centers, patients may pay as much as $20,000 for 30 days of treatment.

Outpatient Treatment

Outpatient treatments operate as part-time treatment programs. Patients are able to continue work or school life while attending this type of treatment. They’re best suited for only mild to moderate substance misuse.

Because they don’t operate as a full-time facility, outpatient rehabilitation is generally less expensive than inpatient care. On average, they cost $5,000 for 90 days of treatment. However, reputable centers such as the Hazelden Betty Ford can charge as much as $10,000.


Not all addictions require medication for treatment. But for those that do, you should be prepared for the cost. The type of medications needed will affect the cost of rehab.

Most commonly, medication is required for alcohol and opiate addiction. The price tag on these medications is upwards of thousands of dollars per year. For recovering heroin addicts, methadone can cost more than $4,000.

Blue Cross Blue Shield Coverage for Addiction Treatment

If you opt for private addiction treatment, Blue Cross Blue Shield helps you cover the costs. How much they cover is based on your deductible as well as your coverage amount. Blue Cross Blue Shield can be combined with additional coverage to maximize your resources when it comes to treating your addiction.

Blue Cross Blue Shield offers a wide range of policies with benefits that cover addiction treatment. Your coverage is based on where you live as well as your individual plan.

Blue Cross Blue Shield coverage will usually help with some of the following costs:

  • Partial hospitalization
  • Acute inpatient hospitalization
  • Residential treatment
  • Residential detox
  • Outpatient treatment

How you’re covered is based on 1 of 4 plans. These are bronze, silver, gold, and platinum.

In terms of monthly costs, bronze is the least expensive and platinum is the most. But bronze plans have the highest deductibles while platinum plans carry lower deductibles and comprehensive coverage. With a platinum plan, you have the most options for addiction treatment.

What Treatment Centers Are Covered?

When you have Blue Cross Blue Shield Coverage, you have options for addiction treatment. Their wide network ensures you have the best chance at recovering you can get.

In fact, the Blue Cross Blue Shield system is made up of over 36 independent and locally operated health insurance companies across the country. Blue Cross Blue Shield coverage is valid in every state and more than 95% of hospitals work with Blue Cross Blue Shield. In terms of treatment centers, many rehabs accept Blue Cross Blue Shield.

How to Check Your Coverage

You should know what you’re covered for before you seek a rehabilitation program. Check your coverage and base your decision on both your individual situation as well as your budget.

In order to check your Blue Cross Blue Shield coverage, visit the Blue Cross Blue Shield Association website. Have your member card handy. You’ll need the 3-letter prefix before the identification number to create your account.

Alternatively, you can look for the member company your plan comes from. The website lists all 36 member companies.

You can log in through there to check coverage details such as prescription benefits or providers in your geographic location. You can use the cost estimator to help you determine what you’ll have to pay out of pocket as well.

Costs for Inpatient Treatment with Blue Cross Blue Shield Coverage

Bronze to Platinum plans provides different levels of coverage. Your coverage also depends on whether the provider is within the Blue Cross Blue Shield network or not.

  • Platinum
    • In-network. Copay per day or coinsurance percentage.
    • Out-of-network. Sometimes covered but with a higher coinsurance percentage and deductible.
  • Gold
    • In-network. Deductible plus coinsurance percentage.
    • Out-of-network. Not usually covered.
  • Silver
    • In-network. Coinsurance percentage and plan’s deductible for in-network.
    • Out-of-network. Not usually covered.
  • Bronze
    • In-network. Minimum deductible for in-network.
    • Out-of-network. Not usually covered.

The type of coverage provided will also vary depending on whether they use a physicians office, hospital, or a treatment facility.

There are also standard and basic benefit options for inpatient treatment. The standard option is as much as $35 for unlimited days. The basic option involves a copayment up to $875 for unlimited days.

Federal Employee Program

Blue Cross Blue Shield provides a government-wide benefits service plan to federal employees. Known as the Federal Employee Program (FEP), it consists of a basic option plan and a standard option plan.

Under the basic option, members are required to use in-network providers. The standard option allows you to choose whether you’d like to see a preferred or non-preferred provider.

Under the FEP, policyholders have access to outpatient treatment services. With the standard option, approximately 15% of the plan allowance is covered. The basic option requires copayment per day.

How to Navigate Your Policy

Understanding your insurance policy is difficult. Finding treatment centers that accept your insurance, fit your budget, and provide a high degree of care takes time that you don’t have when you’re struggling with addiction.

There are professional services to help you through this process. An addiction treatment service provider partners you with an addiction insurance expert.

They know the intricacies of coverage from state to state. They assess your policy and financial situation to help find the best possible care at the best cost for you.

Addiction treatment service providers have access to vast resources. This includes a reputable directory of organizations and state agencies that provide treatment. They also know insurance coverage information inside and out.

The process generally used by addiction treatment services is as follows:

  1. Expertly trained and experienced professionals review your Blue Cross Blue Shield coverage insurance plan in detail. They’ll determine whether you’re covered for addiction treatment under your plan.
  2. If you’re covered by your health insurance, an addiction treatment services team will work with you to determine what kind of treatment you need. They’ll then calculate how much of your treatment is covered. These specialists can also tell you how much you’ll pay out of pocket.
  3. You can expect a treatment service to direct you to the right treatment center for your policy. A good service will base their recommendations on past experience with specific treatment centers.

By knowing what you’re expected to pay, you can better prepare for recovery and your life outside of treatment. Preparing for the costs of your health in the long-term will contribute to your success after rehabilitation.

The Treatment Process

When you’re serious about getting sober, rehab is the safest way to get sober. It gives you many of the tools you need to begin living life sober. If you’re preparing to go into rehabilitation, you should know what to expect.

There are many different kinds of treatment and different treatments have different success rates. Individuals require unique care that depends on their substance of choice and mental health. Personal preference also plays a role in determining the right facility and treatment program.

In general terms, inpatient facilities follow a similar process from admissions to care. We’ve detailed this process so you can properly prepare for treatment.


The process of admitting a patient to a treatment facility is easy and quick. Professionals working at these centers know how to be comforting when someone is being admitted for treatment. All it takes to get through admissions is for a patient or a loved one to contact the facility and enroll in treatment.


After being enrolled, the patient has to enter treatment. At this stage, they’ll go through an administrative process. This usually includes a search of their items to ensure they’re not bringing in drugs, weapons, or other items that aren’t permitted.


In order to get to know the specific needs of every patient, they will be examined by the medical and clinical staff at the facility.

The medical team will determine what substance requires treatment and for how long treatment should last. They’ll also look into any mental health history. This could affect the treatment program that’s developed for them.

This assessment allows the treatment facility to individualize the recovery plan for the patient. It gives the staff an idea of the patients’ behavior and personality. Knowing these items before recovery begins maximizes the chances of success.

Throughout the program, assessments will continue to take place. This allows the clinical team to measure the success of the patient and make recommendations for life following treatment.


Detox is a necessary part of rehabilitation. It’s the process through which you rid your body of the substance you’re addicted to. For some substances, this can be a painful and even dangerous process.

In an inpatient facility, dangerous detoxifications are monitored by trained medical staff. They can prescribe the appropriate medications and make detox more comfortable.

Inpatient Care

Once the body is rid of harmful substances, the patient can begin on a clean slate. Completely sober, they’ll begin their inpatient treatment.

There are many addiction treatment programs available. Some of these include:

  • Cognitive behavioral therapy
  • Individual therapy
  • Family and friend therapy
  • Peer therapy
  • Biofeedback
  • Trauma resolution
  • Yoga and meditation
  • Self-love therapy
  • Nature therapy
  • Prayer meetings
  • Music and art therapy

Inpatient care implies that the patient takes residency at the treatment facility. Their days are full of different treatments, therapies, and services all aimed at helping them cope with living sober.

Are You Ready to Seek Help?

Millions of Americans struggle with addiction and substance abuse issues. It’s not easy to ask for help but there is help available. For those without insurance, there are solutions.

If you have Blue Cross Blue Shield coverage, you have access to a large network of addiction treatment facilities. But understanding how you’re covered and what treatment option is best for your budget is complicated.

At Addiction Treatment Services, we can help you understand all of those details and get you the help you need. Contact us for more information.

Article Reviewed by Dr. Keerthy Sunder, MD, DFAPA

Dr. Keerthy Sunder, MD, DFAPADr. Keerthy Sunder, MD is an accomplished and internationally recognized expert in the field of addiction. He has earned diplomates from the American Board of Psychiatry and Neurology, the American Board of Addiction Medicine, and the Royal College of Obstetricians and Gynecologists.