BCBS Federal Insurance for Addiction Treatment
Drug and alcohol addiction can wreak havoc on an individual’s family and life. Making the decision to go to rehab shouldn’t be weighed down by the stress of how to pay for it. Luckily, many people who have health insurance are eligible to have at least a portion of their addiction treatment covered.
Whether you’re currently insured or evaluating your options with a Blue Cross Blue Shield Federal Employee Program, you may wonder if drug or alcohol rehab is covered. We’ll address some of the common questions and concerns people have in regards to rehab coverage with BCBS Federal insurance.
Does BCBS Federal Cover Drug or Alcohol Rehab
The Affordable Care Act (ACA) has helped make paying for rehab significantly more affordable for many individuals suffering from addiction. ACA requires all insurances sold on the Marketplace to include mental health and substance abuse services as essential health benefits. To remain competitive and because mental health and substance use issues have become so prevalent, most private insurances offer coverage for these services as well. Additionally, ACA requires all insurances, including private insurances, which include said benefits, to treat substance use and mental health services equal to medical or surgical services.
If you need addiction treatment, BCBS Federal insurance offers coverage to its members under all their plans. BCBS understands the importance of mental health and treating addiction. They offer three levels of coverage in their Federal Employee Program, and each tier includes substance use treatment services. With BCBS Federal insurance, rehab is attainable.
About BCBS Federal Employee Program
The Blue Cross Blue Shield Service Benefit Program was started in 1960, offering health insurance to federal employees, retirees, and their families. Also known as the Federal Employee Program (FEP) covers over 5.5 million members in the U.S. and across the globe.
BCBS Federal prides itself on its 99% member retention rate, and rightfully so. From worldwide coverage to incentives and discounts, they know how to put their members’ needs first. They are considered the #1 insurance provider among the federal employee workforce.
What Does My BCBS Federal Insurance Policy Cover
Blue Cross Blue Shield FEP offers coverage for services that matter most and make life easier for members. All plans include:
- Free preventative care, including annual physicals, flu shots, nutritional counseling, and cancer screenings.
- Two free telemedicine appointments with Teladoc, which include behavioral health services.
- Worldwide coverage so you don’t have to worry if you’re working or traveling overseas.
- Wellness incentives.
- No referrals are needed for specialists.
BCBS Federal insurance is a PPO (Preferred Provider Organization) with an expansive network that includes 96% of hospitals, 95% of physicians, and over 60,000 retail pharmacies. That means you don’t have to worry about switching doctors because most likely your current doctors are accepting and in-network with BCBS Federal insurance. It also means that there are plenty of rehabs that accept BCBS federal insurance.
And because mental health has become such an important issue, starting in 2021, BCBS Federal included a self-guided mental wellness program called myStrength for all members at no additional cost. The app offers 24/7 access to tools that help individuals cope with the everyday stresses of life. The program is personalized and provides access to articles, activities, videos, uplifting quotes, and member stories and includes tools to track sleep, stress, and goals.
BCBS Federal Coverage Plans and Levels
BCBS Federal insurance offers three plans so that individuals can choose what fits their needs best:
- Standard Option
- Basic Option
- FEP Blue Focus
Standard Option has the highest monthly premium and therefore offers the most additional benefits. These include:
- In-Network AND Out-of-Network care
- Preferred AND Non-Preferred Drug Coverage
- Access to Mail Service Pharmacy
Basic Option is the middle ground plan and also the better choice if you currently have Medicare. Basic Option includes:
- In-Network Care
- Preferred AND Non-Preferred Drug Coverage
- Medicare Part B Reimbursement
FEP Blue Focus is the most economical plan for those needing essential health care services. It includes:
- In-Network Care
- Preferred Drug Coverage
For additional information and a more detailed breakdown, visit the BCBS FEP site.
Substance Use Treatment Services
When it comes to drug or alcohol treatment, BCBS Federal insurance has you covered. All three plan levels offer coverage for substance use treatment services. The amounts you pay will vary depending on your specific plan. Copays, deductibles, co-insurance, and in-network vs. out-of-network care are all contributing factors. If you’re ready to begin your recovery journey, call the admissions team at St. Johns Recovery Place, and they’ll help confirm your coverage and assist with any specific questions.
In general, the BCBS federal insurance rehab services that are covered include:
- Individual or group psychotherapy
- Medication management
- Psychological testing
- Intensive outpatient programs
- Office clinic and home visits
- Diagnostic testing
- Inpatient rehab
If you require drug or alcohol rehab, BCBS Federal insurance will cover a significant portion of your expenses, making a recovery a reality!
Does BCBS Federal Cover Medication Management
Medication management can be a crucial component of a comprehensive rehabilitation plan. Typically, medication-assisted treatment is used in conjunction with counseling and behavioral therapies for opioid and alcohol addiction as well as in cases of co-occurring disorders. Most insurances that cover rehab services will also cover medication management. BCBS Federal does include medication management coverage in all three of their insurance plans.
BCBS Federal In-Network vs. Out-of-Network Services
If you’ve ever had or dealt with health insurance, you’ve surely heard the words “in-network” and “out-of-network.” Simply put, insurance companies contract with doctors, hospitals, and facilities to provide medical services at a set rate. The contracted providers are now considered to be in the insurance company’s network. Insurance companies can require that you only see in-network providers, or they may give you the option to see either, but the out-of-network providers will incur higher out-of-pocket expenses such as copays and deductibles.
With BCBS Federal insurance, the Standard Option plan is the only one that offers both in-network and out-of-network coverage. Basic Option and FEP Blue Focus only offer in-network coverage. This is important to know because if you have a Basic or Blue Focus plan and select a provider that is NOT in-network, you will be responsible for 100% of the cost of care. St. Johns Recovery Place is in-network with BCBS Federal Insurance so if you require addiction treatment and have a plan with BCBS Federal, rest assured that you will not need to pay for the cost of rehab completely out of pocket.
Rehabs That Accept BCBS Federal Insurance
Another important distinction to make is the difference between “Accepting” an insurance and being “In-Network.” Drug rehab facilities may “Accept” a variety of insurances. However, this does not mean that they are “In-Network” with those insurance companies. This relates back to being an “out-of-network” provider. A treatment facility may accept your BCBS Federal Standard Option insurance, but if they are not a Preferred (in-network) provider of BCBS, then you will be stuck paying the higher out-of-network copays and deductibles.
You can find rehabs that accept BCBS Federal insurance simply by doing an internet search. However, be sure to verify with the facility as well as with your insurance company to confirm that they are indeed in-network.
St. Johns Recovery Place IS in-network with BCBS Federal.
Paying for Drug and Alcohol Rehab
Paying for drug and alcohol rehabilitation can seem like a daunting subject. Many of us have heard of lavish rehabs that cost tens of thousands of dollars (or more.) But fret not. Those rehabs exist but are not the norm. There are many low- and mid-range treatment facilities that offer the same or even better care. Many people are also not aware that they can use their health insurance to help offset some of the cost of rehab.
If you have BCBS Federal insurance, alcohol rehab, and drug rehab is covered, albeit with varying out-of-pocket expenses depending on your specific plan.
If you don’t have insurance, but you are a current or retired federal employee, and you or your family member needs drug or alcohol treatment, BCBS Federal insurance is likely your best choice. The monthly premiums can be significantly lower than those of other private insurance companies. In addition, insurance cannot refuse to cover you based on pre-existing conditions.
With BCBS Federal insurance, rehab will cost you your monthly premium, plus any copays, deductibles, and co-insurance. However, many of those expenses can be negotiated with your providers. You can often set up monthly payment plans rather than having to pay the total balance in one lump sum.
If you do not have and cannot get insurance, you can look into other alternatives such as grants, scholarships, or donations. There are also rehab facilities that work on sliding scales that depend on your income level and others that offer financing or payment plans.
At St. Johns Recovery Place, we are committed to helping you get the recovery treatment you deserve. Call our office today at 833-397-3422 and speak to an admissions team member to verify your insurance, discuss payment concerns, and get started on your journey to recovery!
- HealthCare.gov Mental health & substance abuse coverage. (Accessed 2021, July 20)
- Blue Cross Blue Shield. 2021 BENEFIT SUMMARY BOOK Blue Cross and Blue Shield Service Benefit Plan. (Accessed 2021, July 20)
- Blue Cross Blue Shield. Our Plans. (Accessed 2021, July 20)
- Blue Cross Blue Shield. Behavioral Health. (Accessed 2021, July 20)
- Blue Cross Blue Shield. myStrength Program. (Accessed 2021, July 20)