Are you or a family member struggling with drug, alcohol, or substance abuse? Have you explored rehab programs but are worried about being able to afford it? This is the reality for millions of Americans. It is estimated that over 23 million people in the United States are currently struggling with addiction or substance abuse of some kind. Of those struggling with it, only 11% are receiving any treatment. Many of those people avoid it due to not understanding the financial options they may have. 

Signs You May Need Rehab

Addiction and substance abuse take different forms in every individual. However, there are several common signs you should watch out for in yourself or a family member:

  • Hiding substance use from family or friends
  • Feeling shame or guilt over your use of substances
  • Feeling pressure to use substances or drink for social reasons
  • Behaving in a risky manner such as driving while intoxicated
  • Being unable to meet work or school commitments
  • Having legal issues as a consequence of substance use.
  • Harming relationships with family or friends due to substance use.

Do Blue Cross Blue Shield of Montana Plans Cover Drug Rehab?

If you are seeking treatment for substance abuse or addiction and are a member of Blue Cross Blue Shield of Montana, you may be eligible for some or all of your rehab cost to be covered by your insurance. Substance abuse treatment is considered a component of the behavioral health benefits offered by the insurance plan. Depending on which policy a client has, substance abuse treatment from industry professionals may require zero or low out of pocket fees.

The History of Blue Cross Blue Shield of Montana

Throughout the decades, Blue Cross Blue Shield of Montana has focused on providing quality health care coverage to residents of Montana.

BCBS of Montana works extensively with nonprofit organizations throughout the state to invest in the expansion of health care access and improved outcomes for communities across the state. 

For more information on coverage, contact Blue Cross Blue Shield of Montana Today. 

Why do We Need Rehab Coverage?

With over 23 million Americans struggling with addiction or substance abuse, it is clear that this is a nationwide problem. For years, addiction was considered a consequence of poor moral decisions or character flaws. However, after years of research and development in the behavioral health fields, there is strong evidence that addiction should be considered a chronic disease like diabetes, Alzheimer’s, or cardiovascular disease. 

Similar to ADHD, substance abuse or addiction is a result of dysfunction in the frontal cortex of the brain, altering how incentives and rewards are processed in the brain, leading to the individual consuming substances without sufficient regulation. These substances further damage the brain’s ability to regulate behavior, creating a feedback loop of worsening addiction and behavior. 

Due to the difficulty of managing this disease without support, professional treatment at a rehab facility is the best way to undo the damage and relearn how to live a happy and sober life. 

Given that level of difficulty, patients must block out time solely dedicated to recovery. Patients that try to deal with the burden rehab while also worrying about the financial burden of it are more likely to relapse or quit the program prematurely. By covering some or all of the cost of rehab, patients can focus more fully on recovery. 

How does Blue Cross Blue Shield of Montana Rehab Coverage Work?

Since rehab programs fall within the behavioral health benefits part of the policy, all policies must be complied with when submitting a claim or seeking help at a rehab facility. Preauthorization is typically required before beginning detox or inpatient care. The best way to ensure that you aren’t stuck with uncovered medical expenses is to contact your carrier ahead of time and follow the process they give you for getting proper preauthorization. 

In many cases, you may need documentation or referral to an addiction treatment facility from a physician, so speaking with your general practitioner about your options can help start the process of getting help.

What is detox?

Detoxification is the process of retraining one’s brain and body to function without the consumption of drugs or alcohol. This part of rehab is crucial to rid the body of its dependence on substances. This is a component that virtually all rehab programs will require, typically at the very beginning of the program. Depending on the substances or seriousness of addiction, detox may take days or even weeks to complete and can be very physically and mentally taxing on patients. 

During detox, many patients will find themselves experiencing withdrawal symptoms such as nausea, anxiety, fever, delusions, paranoia, shakes, seizures, and more. The benefit of pursuing detox at an inpatient treatment facility is that medically supervised detox is the safest way to make it through the process. Health care professionals can ensure the patient’s safety while also providing treatment or medication to help ease the unpleasant detox symptoms.

What are the Differences Between Inpatient and Outpatient Treatment?

Each rehab program is unique. Sometimes coverage varies between inpatient and outpatient services. It is vital to decide which program is best for each patient with the assistance of their physician. While there is considerable overlap between the two treatments, there are substantial differences: 

Outpatient:

  • Treatment is generally longer than inpatient treatments, sometimes continuing indefinitely
  • Clients live at home and so can maintain their work or school commitments.
  • This level of treatment is generally recommended for clients that have completed detox and learned the skills necessary to self-regulate their substance consumption.
  • Typically clients will attend weekly meetings, whether those are skills workshops, group therapy, or individual therapy. 
  • Clients are held accountable for relapses or irresponsible behavior during this time.

Inpatient:

  • Treatment is typically shorter than outpatient, lasting between 30 and 90 days. Rarely, programs will help extend to 120 days or six months.
  • Clients are under 24-hour medical supervision with access to a care team at all times.
  • The cost of food and sleeping accommodations are included in the price.
  • Clients will need to take time off of work or school due to the full-time commitment required by inpatient treatment programs.
  • Daily individual or group therapy sessions are held for patients.
  • Due to being on-campus, patients are removed from any environment that may trigger abuse or any access to substances.

By knowing which type of treatment is right for you, you can better plan and coordinate any out-of-pocket expenses that end up being necessary. 

Get the help you Deserve Today

If you or a loved family member are struggling with substance abuse or addiction, but you are concerned with the cost of receiving treatment, contact Blue Cross Blue Shield of Montana to see what coverage options you have available.