Signs You May Need Rehab

It is challenging to seek drug rehab treatment when you are overwhelmed with substance addiction. It is equally challenging to consider addiction treatment when you may think that you do not have a substance addiction problem. 

One of the signs that you may need drug rehab is denial. You can exhibit denial by not confiding in your friends or close family members. 

If you hide your drug and alcohol use, this is typically a sign that you might need drug rehab. 

If you consume drugs and alcohol to the point of social and mental impairment, this is a sign that you might need drug rehab. 

If you find yourself daily seeking and obtaining drugs or alcohol to the point that it affects your daily life and responsibilities, this is a sign that you might need drug rehab. 

Any prolonged use of drugs and alcohol will increase your tolerance and make it difficult to abstain from drugs and alcohol. A drug and alcohol rehabilitation center offer the structured programming you will need to address your addiction and move forward into addiction recovery. 

Lastly, you may have an underlying mental illness condition that makes it also difficult for you to overcome substance addiction. If you have an alcohol use disorder, for example, you may also have an underlying mental illness condition such as bipolar disorder or antisocial personality disorder. 

Dual diagnoses are subject to criteria under the Diagnostic and Statistical Manual of Mental Disorders (2013). The therapist you speak with will help you understand dual-diagnosis. 

Health plans cover drug and alcohol rehabilitation. The following are standard signs that you may need drug rehab: 

  • Mental, social, and workplace impairment due to overconsumption
  • Daily seeking drugs and alcohol 
  • Intense cravings and withdrawal symptoms
  • Prolonged use and tolerance

Always consider triggers as signs that you might need drug rehab. Daily stressors affect and contribute to behavioral patterns just as much as drugs and alcohol consumption. Without addiction treatment, it might be difficult for you to abstain from drugs and alcohol, and it might lead to other troubles later. 

If you need a drug or alcohol rehabilitation program, contact Wellmark Blue Cross Blue Shield Iowa to determine your drug rehab needs. Coverage will always depend on your addiction treatment and health plan.

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

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

Wellmark Blue Cross Blue Shield Iowa health plans provide essential health benefits and drug and alcohol coverage. Wellmark BCBS Iowa covers mental health and substance use disorder, including behavioral health. Wellmark BCBS Iowa includes the following behavioral health solutions:

  • Counseling
  • Psychotherapy
  • Behavioral health treatments
  • Prescription drugs

Wellmark BCBS Iowa coverage and benefits vary by plan and market. Wellmark does not deny coverage for pre-existing conditions, which are no longer a factor in the quality of care. 

Wellmark BCBS Iowa does not cover the following:

  • Acupuncture
  • Experimental treatment
  • Long-term care
  • Non-emergency medical travel care outside of U.S.
  • Services that are determined not to be medically necessary

Wellmark Blue Cross Blue Shield Iowa provide the medically necessary coverage for drug and alcohol rehabilitation. Obtaining pre-authorization for drug rehab is considered medically necessary. You must obtain prior authorization with your primary care physician before visiting a drug and alcohol rehabilitation center. There is no guarantee that Wellmark BCBS Iowa will cover all drug rehab costs. 

Once you obtain pre-certification before attending the drug rehab center, you are able then to set an appointment. The initial meeting is about gathering facts concerning your substance addiction. At the assessment level, the therapist will determine what type of drug and alcohol addiction treatment you need. The therapist will decide if you need detox, inpatient treatment, and outpatient treatment. The therapist will also determine any dual diagnosis if you present with a substance use disorder and an underlying mental illness condition. 

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

The History of Blue Cross Blue Shield of Iowa

Wellmark Blue Cross Blue Shield Iowa improves the lives and well-being of its members. At seventy-five years old, Wellmark BCBS Iowa provides high quality, accessible, and affordable health plans. Wellmark BCBS serves the Iowa and South Dakota regions. Wellmark BCBS is NCQA-accredited.

Wellmark began out of a desire to provide healthcare for Dallas teachers in 1929. The Blue Cross (physical) is conceived at this time. In 1939, Wellmark was birthed, and it is incorporated into various trademarks, including Blue Cross of Iowa. In 1945, Iowa Medical Service forms, which is later known as Blue Shield of Iowa. 

Wellmark endured through multiple changes in business formation, becoming a mutual insurance company in 1991, partnering with Healthzones to introduce the Blue Zones project in 2011, and celebrating their 75th anniversary in 2014. 

The name “Wellmark” is formally adopted in 1997. In 2016, Wellmark Blue Cross Blue Shield created two new health insurance companies: Mercy Health Network and University of Iowa Health System. The two companies deliver health plans on and off the public exchange. 

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

Why Do We Need Rehab Coverage?

Rehab coverage is essential for addressing the current opioid crises, the rise and spread of synthetic marijuana, and the increasing risk and effect of prescription drugs on adolescents and youth. 

The National Institute on Drug Abuse (NIDA) has consistently reported healthcare providers over-prescribing opioids and the effect they have had on overdose deaths. 

Drug and alcohol rehabilitation addresses this problem at the individual, national, and industry levels. 

Statistics on men, women, and adolescents and youth have revealed much about the drug and alcohol behavioral patterns within these groups and how much alcohol plays a significant role. 

Rehab coverage is vital because it is also supported by legislation and statutes that govern how healthcare providers must provide comparable coverage for substance use disorders and mental illness conditions in a similar manner to medical and surgical procedures. 

The 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act both provide guidelines for health plan coverage. Mental illness is no longer a pre-existing condition. 

The National Institute on Drug Abuse (NIDA) reports that in 2017, there were 206 overdose deaths involving opioids in Iowa, at a rate of 6.9 deaths per 100,000 persons. Iowa healthcare providers wrote 56.4 opioid prescriptions for every 100 persons in 2017 (NIDA, 2019). The U.S. rate for opioid prescriptions is 58.7 prescriptions (NIDA, 2019). 

Wellmark Blue Cross Blue Shield Iowa will help you locate an in-network drug rehabilitation provider. 

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

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

You will need pre-certification, commonly referred to as prior authorization or a physician referral, before you can set an appointment with a drug rehab center. Except in an emergency, Wellmark BlueCross Blue Shield Iowa requires that you obtain pre-authorization to determine if the following are medically necessary for drug and alcohol addiction treatment:

  • Healthcare service
  • Treatment plan
  • Prescription drug
  • Durable medical equipment

Plan members are required to obtain prior authorization through their primary care provider or physician, who may be one of the following:

  • Medical Doctor
  • Nurse Practitioner
  • Clinical Nurse Specialist
  • Physician Assistant

Obtaining authorization from any one of these professionals is allowable under state guidelines.

Out of pocket expenses apply for visits to non-network providers or if you are currently enrolled in a drug rehab program seeking coverage. Contact BCBS Iowa if you are currently enrolled in a drug and alcohol rehabilitation program without authorization. 

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

What is Detox?

Medical detoxification is the process of the physical body ridding itself of drugs and alcohol substances. Patients endure a seven-day withdrawal process guided and monitored by a trained and licensed clinician. Patients must entirely abstain from drugs and alcohol. Patients may receive medication to relieve withdrawal symptoms. Severe and prolonged substance use leading to tolerance in patients may require more than seven days. The initial assessment with a therapist will determine how long detox is medically necessary. 

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

What are the Differences Between Inpatient and Outpatient Treatment?

Inpatient treatment is necessary for patients with severe substance addiction after medical detox. Patients live on-site, participate in structured programming, and attend therapy sessions. Coverage includes room and board and licensed counseling. 

Outpatient treatment does not require a residential stay. Patients can return home each night. They can work and attend school. They must participate in daily treatment and counseling sessions and participate in any structured programming. Aftercare support may be part of outpatient treatment. 

Wellmark Blue Cross Blue Shield Iowa offers the following treatment options:

Inpatient Treatment

  • Residential treatment, including room and board coverage 
  • Detox, short-term or long-term
  • Therapy and licensed counseling

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

Outpatient Treatment

  • Daily visits to the drug rehab center
  • Home returns, work, school
  • Therapy, counseling
  • Aftercare support

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

Get the Help You Deserve Today

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

Resources

Wellmark Blue Cross Blue Shield Iowa 

About Wellmark

Wellmark: Who We Are

Wellmark: Company Basics

Wellmark: Coverage and Benefits

Wellmark: Healthcare Glossary

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. 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. Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders.

National Institute on Drug Abuse. (2019, March). Iowa opioid summary. Retrieved from https://www.drugabuse.gov/opioid-summaries-by-state/iowa-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.