Modified: 15th Oct 2019

With millions of people requiring substance abuse help each year, the chances are high that either you or someone you love has gone through this. Unfortunately, the majority of these people never receive help. Often, this is due to the prohibitive costs associated with rehab. If you have health insurance under Wellmark Blue Cross Blue Shield of South Dakota, take heart. They are here to help you recover from your addiction.

7 Signs You Need Rehab

Admitting you have a problem is often the first step to fixing it. At first, you may tell yourself that you aren’t drinking that much. You may deny that it is causing any problems in your life. However, if you exhibit any of the following signs, you need to seek out help.

  • Struggling in school or at work due to your substance use. When drugs or alcohol start to infiltrate your everyday life, you are probably using too much.
  • Hiding the amount of drugs or alcohol you are taking. Plenty of people have a beer after work or a glass of wine before bed. If you find that you aren’t admitting how much you are drinking in a day, this could be a sign that your subconscious is telling you it’s too much.
  • Feeling embarrassed about your substance use. Again, your subconscious is probably telling you something isn’t right.
  • Feeling that you have to continue using drugs or drinking to feel loved. Addiction can stem from feelings of unworthiness. If you think that no one loves you, and this is why you are using, it is a sign you need help.
  • Driving while under the influence. Even one instance of driving while under the influence of any mind-altering substance is a red flag that you need help.
  • Losing touch with those around you. Addictions start to overpower your every waking thought. If you realize that you are losing touch with friends and family because your substance use comes first, it’s a sign that you may have gone too far.
  • Legal troubles. If your substance use has led to legal problems, such as arrests, you need rehab.

If you see one or more of these signs in yourself or a loved one, contact your Wellmark BCBS provider to inquire about rehab.

Why is Rehab Coverage so Important?

Drug overdose deaths are rising in South Dakota. In 2013, 6.9 people per 100,000 died in South Dakota as a result of a drug overdose. By 2017, this number had risen to 8.5. These numbers continue to rise as the opioid epidemic rages all over America.

Another side effect of drug use is the effects it has on a fetus. A baby can be born with Neonatal Opioid Withdrawal Symptoms (NOWS) when the mother is using opioids. The incidences of these births have also been on the rise, including in South Dakota. The cost of caring for these babies can be astronomical, as the babies are often born early and require a lot of medical care.

Many addicts don’t seek out rehab because they can’t afford it. Addiction ravages every part of a person’s life, and financial stress is often a huge part of addiction. If more insurance companies would follow in Wellmark’s footsteps and offer comprehensive rehab services, we could drastically reduce the number of opioid-related deaths in our state, as well as the incidence of babies born with NOWS.

When talking about rehabilitation for a drug or alcohol addict, detox refers to the process your body goes through when you are no longer ingesting the drugs or alcohol. If you have been placed in jail, you will go through a sudden detox, and the withdrawal symptoms can be severe. Some rehab facilities ease the detox process with medications and other treatments. Symptoms of withdrawal can include fevers, nausea, sweating, and even seizures. It’s important to be closely monitored by a healthcare professional during detox. Addicts who try to detox on their own often end up relapsing or ending up in the hospital.

Do You Need Inpatient or Outpatient Treatment?

Your doctors will determine whether you need inpatient or outpatient treatment. Severe cases will require inpatient treatment. If outpatient treatment is not working, inpatient will be recommended. Many factors go into deciding whether an addict will be treated as an inpatient or outpatient.

An outpatient is someone who can continue to live at home and go to work or school. They may be required to wear a monitoring bracelet if they have broken the law due to their addiction. They will attend meetings and doctor’s appointments. If the home is not a trigger or there are not enablers there, this can be a good option for some addicts who want to maintain their life while receiving treatment.

Inpatient treatment is what we typically think of when we hear the word rehab. It is when a person is removed from their home and placed in a hospital or other facility while they work through the steps of addiction recovery. It is more restrictive than outpatient treatment, and it’s more expensive. It is also instrumental, so it is an excellent choice for those who have tried outpatient treatment but not succeeded.

The History of Wellmark Blue Cross Blue Shield of South Dakota

The Blue Cross Blue Shield corporations were formed in the 1920s. Wellmark came to be in Des Moines, Iowa, in 1939. It was initially called Hospital Service Incorporated of Iowa. In the same year, Associated Hospital Services Incorporated formed in Sioux City. These corporations were later renamed Blue Cross of Iowa and Blue Cross of Western Iowa. They served both Iowa and South Dakota. In 1945, the Iowa Medical Service was formed, which would later be known as Blue Shield of Iowa. The variations of the Blue Cross Blue Shield memberships joined together in 1989. In 1999, they adopted the name Wellmark.

Does Wellmark BCBS of South Dakota Cover the Costs of Drug Rehab?

In South Dakota, your insurance coverage can vary based on where you live. All of the Wellmark plans include coverage for drug and alcohol rehab. However, the amounts covered and whether or not you have to pay a copay can vary. For instance, if you are on the Enhanced Blue 500 plan, you will have to pay a 20% coinsurance for outpatient treatments, as well as a $30 copay. Inpatient treatments also require a 20% coinsurance payment. These costs go up if you choose a provider that is out of network. With an HSA plan, the entire cost of rehab is covered, with no coinsurance or copays, as long as you choose a network provider.

How Does Wellmark BCBS of South Dakota Work?

Wellmark’s plans can vary depending on where you live. Regardless of the plan, precertification is necessary. Most facilities will help you to get this done, but they are not required to. You may have to pay a penalty of up to $500 if you do not get precertified. If you have any questions about precertification, make sure to call Wellmark before signing into rehab.

Get Help Today

Don’t let financial worries get in the way of receiving treatment that can truly change your life. The friendly representatives of Wellmark Blue Cross Blue Shield are ready and waiting to answer any questions you have about your insurance coverage, coinsurance, and copays. Give us a call today so we can assist you in your journey to sobriety.