Signs You May Need Rehab

Deciding to seek drug and alcohol addiction treatment is significant. There are always signs that you may need drug rehab if you are hiding your substance use from friends, spouses, and extended family members. If you are also spending your waking days and nights seeking and consuming alcohol to overconsumption, you may likely need drug rehab. 

Many people have been conditioned to see drug and alcohol as rewarding, which makes it difficult for them to assess when they are drinking too much or consuming too many drugs. The brain interprets drugs and alcohol as satisfying. The rewards centers of the brain are activated when drugs and alcohol enter the system. Prolonged use of drugs and alcohol lead to tolerance.

If you have been trying to quit drug and alcohol substance use for some time, but you have been unsuccessful, this may be a sign that you need drug rehab. Abstaining from drugs and alcohol takes specialized addiction treatment at a rehab center where you can be monitored and supervised medically to ensure that you complete the process and safely. 

You may also need drug rehabilitation if you have a substance use disorder that is comorbid with a mental illness condition. Patients often present with either substance use disorder as primary or the mental illness condition as primary. Diagnosis for the co-occurring disease or condition is subject to the guidelines of the Diagnostic and Statistical Manual of Mental Disorders (2013). 

The following are standard signs that you may need drug rehab: 

  • Consumption leading to clinical impairment
  • Consuming drugs and alcohol daily 
  • Experiencing intense cravings 
  • Tolerance 

Patients often report attempts to abstain from drugs and alcohol, but due to triggers and daily stressors, they have trouble maintaining sobriety. Prolonged use of drugs and alcohol leads to risky behavior and legal problems. 

If you need a drug or alcohol rehabilitation program, contact Blue Cross Blue Shield of Illinois to determine your drug rehab needs. Coverage depends on your addiction treatment plan and available coverage. 

For more information on your coverage and plans or access to resources, contact Blue Cross Blue Shield of Illinois.

Do Blue Cross Blue Shield of Illinois Plans Cover Drug & Alcohol Rehab?

Blue Cross Blue Shield of Illinois health plans provide drug and alcohol coverage. BCBS Illinois offers individual and family programs, in-network providers, guest membership for plan members living outside of Illinois for 90 days, and possible coverage for medical travel. 

BCBS Illinois offers comprehensive and health plan coverage to 8.1 million members, and it is the largest and sophisticated healthcare system in Illinois.

Plan members seeking drug and alcohol rehabilitation must obtain a physician referral from their primary care physician. Visits to non-network providers may require payment of out of pocket expenses. 

Once you obtain the physician referral for the drug rehab treatment, you can then set an appointment with an addiction treatment program. During your first appointment, the therapist will conduct an assessment, talk to you about your substance use, gather facts about your behavioral patterns, and determine whether you will need detox, inpatient treatment, or outpatient treatment. The therapist is subject to counseling guidelines, and drug rehab preferred practices. 

During the first appointment, the therapist may consider a dual diagnosis based on an assessment of your behavioral patterns. 

For more information on your coverage and plans or access to resources, contact Blue Cross Blue Shield of Illinois.

The History of Blue Cross Blue Shield of Illinois

Blue Cross Blue Shield of Illinois boasts 8.1 million members in Illinois. BCBS Illinois serves Downtown Chicago, Rockford, Quincy, Danville, Naperville, Springfield, Downers Grove, Marion, and Jacksonville. BCBS, Illinois has been an innovative leader in the healthcare industry. BCBS Illinois fosters exceptional healthcare and stands with its members in sickness and in health. BCBS Illinois is NCQA-accredited. 

For more information on your coverage and plans or access to resources, contact Blue Cross Blue Shield of Illinois.

Why Do We Need Rehab Coverage?

Efforts to reduce opioid prescriptions among healthcare providers have taken a new shape. Providers are reducing their prescriptions, and healthcare programs are offering comparable coverage for drug and alcohol addiction. 

In addition, recent statistics on adult men, adult women, and adolescents and youth reveal that men tend to binge drink more than women (one in four), women tend to receive a diagnosis of an alcohol use disorder more than men, and adolescents are more likely to binge drink (three in 10 young men) and pursue prescription drugs such as Ritalin and Adderall. 

Patients receiving a dual diagnosis must receive treatment for an underlying condition, especially if the underlying condition is a substance use disorder. For example, a person who has a mental illness condition may have an underlying substance use disorder. The reverse is true. The person with a substance use disorder may have an undiagnosed mental illness condition.

Drug rehab coverage is available for patients with a substance use disorder and a mental illness condition under the 2008 Mental Health Parity and Addiction Equity Act which requires insurance companies to provide comparable coverage for substance use and mental illness conditions similarly to coverage for medical and surgical procedures. Provisions of the 2010 Affordable Care Act consider mental illness as no longer a pre-existing condition. 

Drug rehab coverage is also essential for resolving the opioid crisis. The National Institute on Drug Abuse (NIDA) reports that in 2017, there were 2,202 overdose deaths, at a rate of 17.2 deaths per 100,000 persons. Among this number, there were 623 deaths involving prescription opioids (NIDA, 2019). Illinois healthcare providers wrote 51.1 opioid prescriptions in 2017 (NIDA, 2019). The U.S. rate for opioid prescriptions is 58.7 prescriptions (NIDA, 2019). The 51.1 prices increased to 75 percent, resulting in 4.8 deaths per 100,000 people (NIDA, 2019). 

Blue Cross Blue Shield of Illinois will help you locate an in-network drug rehabilitation provider. 

For more information on your coverage and plans or access to resources, contact Blue Cross Blue Shield of Illinois.

How Does Blue Cross Blue Shield of Illinois Rehab Coverage Work?

You must seek and obtain pre-authorization to receive coverage through Blue Cross Blue Shield of Illinois. Plan members are required to seek authorization before speaking with a drug and alcohol addiction and treatment program. They must also follow the guidelines of the health plan to receive coverage, including visits to an in-network provider within the state. Out of pocket expenses will apply for appointments to non-network providers and unauthorized addiction treatment. 

For more information on your coverage and plans or access to resources, contact Blue Cross Blue Shield of Illinois.

What is Detox?

Detox requires the body to remove chemicals, toxins, and other substances physically before inpatient treatment. Patients are admitted to a medical detoxification program where they undergo detox for a minimum of seven days. They are monitored by a clinician and a licensed medical professional. 

Patients exhibiting severe withdrawal symptoms may receive prescription medication to alleviate and lessen those symptoms. Prolonged use of drug and alcohol substances may require detox for longer than seven days. The therapist and drug test will determine how long detox may be necessary. 

For more information on your coverage and plans or access to resources, contact Blue Cross Blue Shield of Illinois.

What are the Differences Between Inpatient and Outpatient Treatment?

Inpatient treatment is part of the addiction recovery process. It would be a step down from medical detox if the patient needed detoxification. Inpatient treatment and outpatient treatment may be necessary for severe or less severe substance use. 

Patients presenting with prolonged substance use leading to clinical impairment and long-term tolerance may benefit from inpatient residential treatment. Patients who have undergone detox, inpatient residential treatment, but also need additional tools to navigate their addiction recovery may benefit from outpatient treatment. 

Inpatient treatment requires patients to live on-site, attend counseling and group therapy, participate in structured activities, and complete program requirements before moving to outpatient treatment, if necessary.

Outpatient treatment does not require patients to live on-site. Patients must visit the center daily for structured activities, therapy, and other program requirements. Patients can maintain a job, attend school, and return home each night. 

Blue Cross Blue Shield of Illinois offers the following treatment options:

Inpatient Treatment

  • Minimum of 30 days of residential treatment 
  • Medical detox
  • Individual and group therapy 
  • Room and board 
  • Participation in structured drug rehab programming
  • Visits with a licensed counselor

Contact Blue Cross Blue Shield of Illinois for more information about coverage and out of pocket expenses. 

Outpatient Treatment

  • Daily visits to a drug and alcohol rehab counselor 
  • Home returns, work, school attendance 
  • Individual and group therapy 
  • Drug rehab counseling
  • Addiction recovery and aftercare support

For more information on your coverage and plans or access to resources, contact Blue Cross Blue Shield of Illinois.

Get the Help You Deserve Today

If you or a loved one needs drug and alcohol rehabilitation treatment, contact Blue Cross Blue Shield of Illinois to discover your healthcare options. 

Resources

BCBS Illinois Company Info

BCBS Illinois Who We Are

BlueCross BlueShield of Illinois FAQs

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition. Washington, D.C.: American Psychiatric Publishing.

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 Disease Control and Prevention. (n.d.). Fact sheets—excessive alcohol use and risks to men’s health. It is retrieved from https://www.cdc.gov/alcohol/fact-sheets/mens-health.htm.

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

National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol use disorder. It is retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders.

National Institute on Drug Abuse. (2019, March). Illinois opioid summary. It is retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/illinois-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.