Signs You May Need Rehab
The signs you may need drug and alcohol rehabilitation are based on your behavior and patterns associated with abusing drugs and consuming alcohol. Many symptoms have been diagnosed in drug and alcohol rehab patients and clients who have a substance use disorder. For example, typical signs of a person with an alcohol use disorder include the following:
- Consumption of alcohol leading to significant impairment
- Spending activities seeking, obtaining, and consuming alcohol
- Cravings and withdrawals from prolonged use
- Development of a tolerance
- Continued and persistent attempts to stop but unsuccessful
These are clinical signs that you may need drug and alcohol rehabilitation. The social signs may include activities leading to hiding your drinking, feeling ashamed about your drinking, engaging in risky behavior due to drinking, legal troubles, and having difficulty with friends and family members.
If you need drug and alcohol rehabilitation, Premera Blue Cross Blue Shield of Alaska may provide the coverage you need depending on your plan.
For more information on your coverage and plans, contact Member Services.
Do Blue Cross Blue Shield of Alaska Plans Cover Drug & Alcohol Rehab?
Blue Cross Blue Shield of Alaska covers drug and alcohol rehabilitation. If you need treatment for drug and alcohol addiction, then as a member, you may benefit from one of our behavioral health plans which may require out of pocket expenses depending on your treatment plan and coverage.
You will need to obtain pre-authorization to receive a physician referral. Once you get pre-authorization, you will need to set an appointment with a therapist. At the first appointment, the therapist will assess your substance addiction. The first session is about gathering facts about your substance addiction and what to consider for your addiction treatment.
The goal is to determine the best level of care appropriate for your addiction recovery and offer a tentative diagnosis, which may form a single diagnosis or a dual diagnosis. For example, the therapist may diagnose you with a substance use disorder. If you are considered the dual diagnosis, you may also receive treatment for your mental illness condition. Substance use disorders co-occurring with a mental illness condition may require a different treatment plan. Before you leave your first appointment, the therapist will determine the number of sessions you will need and how much coverage applies to your treatment.
Intensive outpatient treatment may be necessary for any chemical dependency on a substance. Outpatient treatment may also include partial and some residential. You will need to contact your primary care physician to direct you to the right specialist for your care.
For more information on your coverage and plans, contact Member Services.
The History of Blue Cross Blue Shield of Alaska
Premera Blue Cross Blue Shield of Alaska is an NCQA accredited health plan. Premera BCBS is focused on the two million subscribers it serves in the Pacific Northwest. Premera is the most extensive health plan in the region that provides tailored services to its customers in Washington and Alaska. Premera focuses on disease management, prevention, patient safety, and wellness. Premera is committed to controlling rising medical costs for its customers.
Since 1952, Premera Blue Cross Blue Shield have been serving its customers by providing individual and family health plans, dental plans, small group plans, large group plans, and Medicare Supplement plans. For Premera, the customer is at the center of what they do. Premera is dedicated to helping customers maintain their unique lifestyle specific to the Pacific Northwest.
Why Do We Need Rehab Coverage?
The Centers for Disease Control (CDC) reports that men binge drink (one in four) more than women and that women are dying more from alcohol overconsumption.
The National Institute on Drug Abuse (NIDA) reports that in 2017, there were 102 overdose deaths involving opioids in Alaska, a rate of 13.9 deaths per 100,000 persons. Alaska health providers wrote at a rate of 52.0 opioid prescriptions (NIDA, 2019). The U.S. rate for opioid prescriptions is 58.7 prescriptions (NIDA, 2019).
Monitoring the Future (2016) estimates that among adolescents and youth, three in 10 young men binge drink during eighth grade at 12%, during tenth grade at 27%, during twelfth grade at 38%, and during college at 43%. The report includes statistics also for illicit drug use and abuse of prescription drugs such as Adderall and Ritalin (Monitoring the Future, 2016).
Because drug and alcohol addictions are considered chronic diseases and are treatable similar to medical conditions such as heart disease and diabetes, the addiction treatment industry has undergone innovation in how healthcare providers, insurance companies, and patients navigate addiction recovery.
Addiction and chemical dependency affect the way the brain is rewarded due to substance use. The brain processes rewards, making it harder to overcome the disease and manage the symptoms of withdrawal. Drug and alcohol substances, with repeated use, create physical dependency, and also emotional and psychological dependencies.
When you enter a drug and rehabilitation center that helps you to focus on addiction recovery, you will receive the counseling, treatment, and relapse prevention tools that will help you deal with triggers and daily stressors. Insurance coverage will alleviate the cost burden and help you navigate the process thoroughly. By providing full or partial coverage, you will be able to focus on recovery and move forward out of your addiction.
For more information on your coverage and plans, contact Member Services.
How Does Blue Cross Blue Shield of Alaska Rehab Coverage Work?
Blue Cross Blue Shield of Alaska drug and alcohol rehabilitation provides coverage for pre-authorized and approved claims. Patients must receive authorization and a physician referral to receive coverage. Out of patient costs will apply for customers who do not contact the insurance provider, obtain information for how to navigate the process, and follow the procedure outlined by the health insurance carrier.
For more information on your coverage and plans, contact Member Services.
What is Detox?
Detoxification is the process of the body ridding itself of toxins and chemicals. The medical detoxification process is supervised and monitored by a licensed physician. The detox process is typically seven days where the patient must abstain from drugs and alcohol or any other type of chemical and stimulant. The detox process is the precursor to inpatient residential treatment. A detox may take more than seven days, depending on the patient’s tolerance for substances and the patient’s willingness to abstain from substance use.
During detox, the patient will endure multiple withdrawal symptoms that might require prescription medication. For example, patients withdrawing from opioids may need prescription medicine to lessen the severity of the symptoms. Patients may also need other substances such as tobacco, cannabis, and stimulants to reduce the symptoms associated with opioid withdrawal (APA, DSM, 2013).
The detox process includes withdrawal symptoms such as nausea, anxiety, seizures, and fever. The prescription medication would be necessary to address fever or viral infections due to the detoxification process – also, patients undergoing the withdrawal process experience nutritional deficiencies. Putting back what is taken out as part of the detox process helps the patient navigate the detox process and complete medical detoxification.
For more information on your coverage and plans, contact Member Services.
What are the Differences Between Inpatient and Outpatient Treatment?
Inpatient and outpatient treatment options differ in behavioral health plans. The standard coverage includes inpatient residential and various outpatient treatment options.
Inpatient treatment may be conducted in a hospital, a state psychiatric hospital, or a separate drug and alcohol treatment center. Admissions under any environment require pre-authorization and physician referral.
A residential treatment center is a live-in center for patients to receive addiction treatment for substance use and counseling for a mental illness condition. Pre-authorization is required.
Addiction treatment in a partial hospitalization facility is less intensive, but it is structured. Patients attend outpatient care for four or six hours per day while they are transitioning from inpatient treatment. Partial hospitalization is more intensive than the treatment you may receive through a therapist.
Intensive outpatient treatment is also a structured program and provides intense levels of care. This treatment option ensures that you can still work, attend school, and be responsible in your personal life. Intensive outpatient treatment helps you to address your addiction and any diagnosed co-occurring mental illness condition.
Outpatient treatment options are scheduled appointments. Patients attend a center for once or twice per week. Outpatient treatment is ideal for patients who do not need intensive forms of treatment but who are motivated to maintain their addiction recovery.
Blue Cross Blue Shield of AK provides drug and rehabilitation coverage unique to the customer’s addiction treatment plan. Treatment options vary, and there are differences:
Inpatient Treatment
- Treatment may last 30, 60, or 90 days.
- Clients receive medical detox 24 hours per day.
- Insurance covers the costs of accommodation and food.
- Clients are expected to attend daily therapy sessions.
- Clients learn to deal with triggers and daily stressors.
- Clients are expected to live at the rehabilitation center.
Contact BCBS AK for more information about coverage and out of pocket expenses.
Outpatient Treatment
- Clients receive treatment that lasts longer than inpatient treatment.
- Clients are expected to attend therapy sessions and weekly meetings.
- Clients can return home each night. Clients can work, attend school, or any other commitment.
- Clients must be accountable for their actions. They learn how to address responsibilities through individual and group therapy.
Contact a BCBS representative for more information about out of pocket expenses.
Get the Help You Deserve Today
If you or a loved one needs drug and alcohol rehabilitation treatment, contact Blue Cross Blue Shield of Alaska to discover your healthcare options.
Premera Blue Cross Blue Shield AK Resources
Summary of Benefits and Coverage
Other Resources
Beronio, K., Po, R., Skopec, L., & Glied, S. (2013, February 20). Affordable care act expands mental health and substance use disorder benefits and federal parity protections for 62 million Americans. Retrieved from https://aspe.hhs.gov/report/affordable-care-act-expands-mental-health-and-substance-use-disorder-benefits-and-federal-parity-protections-62-million-americans
Centers for Medicare & Medicaid Services. (n.d.). The mental health parity and addiction equity act (MHPAEA). The Center for Consumer Information & Insurance Oversight. Retrieved from https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/mhpaea_factsheet.html
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition. Washington, D.C.: American Psychiatric Publishing.
Centers for Disease Control and Prevention. (n.d.). Fact sheets-excessive alcohol use and risks to men’s health. Retrieved from https://www.cdc.gov/alcohol/fact-sheets/mens-health.htm.
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol use disorder. Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders.
National Institute on Drug Abuse. (2019, March). Alaska opioid summary. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/alaska-opioid-summary.
Schulenberg, J.E., Johnston, L. D., O’Malley, P., Bachman, J. G., Miech, R. A., & Patrick, M. E. (2016). College students and adults ages 19-55. Monitoring the Future, National Survey Results on Drug Use, 1975-2016. Retrieved from http://www.monitoringthefuture.org/pubs/monographs/mtf-vol2_2016.pdf.
