What You Need to Know About BCBS Federal Insurance and Drug Rehab

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 by or are evaluating your options with a Blue Cross Blue Shield Federal Employee Program, you may be wondering 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.

tiles spelling out health insurance, surrounded by pills.

What You Need to Know About BCBS Federal Insurance and Drug Rehab

About Blue Cross Blue Shield (BCBS)

Blue Cross Blue Shield (BCBS) is an extensive health care network and insurance company with set operations in the United States. As one of the most prominent health insurance industry leaders, BCBS’s growth since its founding in 1929 is extensive.

By the time the company was around 20 years old, it was already servicing consumer clientele numbers in the millions.

Today, Blue Cross Blue Shield and its name affiliations work to provide over 106 million people with the medical and financial services they need.

For more than 80 years now, BCBS has provided consumers within its network with stability and innovative care tactics as they continue to grow. As a federation of 35 separate insurance providers such as Blue Cross, BCBS, BCBS Federal, and more, the company continues to prove it can deliver the growth, stability, and quality services it boasts.

blue cross blue shield federal employee program logo.

Blue Cross Blue Shield Federal Insurance

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), it 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.

BCBS and Addiction Treatment Services

Millions of men, women, and children struggle with drug and alcohol use disorders. The good news is, health insurance is not just for the healthy, and addiction rehab centers exist across the country to help clients heal from substance abuse.

No two substance abuse rehab centers and insurance providers work the same, but they all share many similarities. If you or a loved one have an insurance policy with BCBS Federal, you can have some peace of mind knowing your health care network is a community of people who genuinely want to see you well.

Even still, trying to navigate the world of insurance packages, healthcare, and rehabilitation facilities may prove overwhelming.

couple sitting reviewing paperwork and looking confused.

Understanding your insurance plan can feel overwhelming, we’ll help simply Federal BCBS addiction treatment coverage.

Understanding Your Blue Cross Blue Shield Insurance

Understanding insurance is challenging. The benefits packages, terms of use, and terminology are extensive, and not every insurance company works the same.

Of course, even with all of the differences between insurance providers, some concepts behind health care coverage remain consistent. Learning the basics of these concepts can help make navigating the complex world of insurance coverage easier for you.

Types of Health Insurance Coverage

Each insurance provider provides its clientele with a series of coverage packages to select. These packages are typically:

  • HMOs – Health Maintenance Organizations
  • PPOs – Preferred Provider Organizations
  • EPOs – Exclusive Provider Organizations
  • POS – Point of Service

Each of these insurance packages provides clients with different services, benefits, and perks of use. And of course, insurance providers use many different terms to describe insurance benefits and treatment costs.

clipboard with insurance form and stethoscope.

Blue Cross Blue Shield insurance offers multiple levels of insurance coverage.

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 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 mental health tools that help individuals cope with the everyday stresses of life. The program is personalized and not only offers access to articles, activities, videos, uplifting-quotes, and member stories but also includes tools to track sleep, stress, and goals.

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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.

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 plan levels.

hands taking pills out of medication holder.

Federal BCBS insurance does cover substance abuse treatment and medication management.

BCBS Federal Coverage Plans and Levels

BCBS Federal insurance offers three plans so that individuals can choose what fits their needs best.

Standard Option

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

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

FEP Bue Focus the most economical plan for those needing basic health care services. It includes:

  • In-Network Care
  • Preferred Drug Coverage

For additional information and a more detailed breakdown visit the BCBS FEP site.

group therapy with arms around each other.

Addiction Treatment Services

When it comes to substance abuse treatment BCBS Federal insurance has you covered. All three insurance plan levels offer coverage for drug or alcohol addiction 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.

In general, the BCBS federal insurance rehab services that are covered include:

If you require drug or alcohol rehab Blue Cross Blue Shield Federal insurance will cover a significant portion of your expenses, making recovery a reality! If you’re ready to begin your recovery journey, call the admissions team at St. Johns Recovery Place and they’ll help confirm your insurance coverage and assist with any specific questions.

older man sitting on bed looking sad.

Receive treatment for substance use disorder with the help of BlueCross BlueShield Federal Employee Program.

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. They may give you the option to visit 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.

person looking at laptop and writing notes on a sheet of paper.

Treatment centers may accept an insurance provider, but not necessarily be “in-network”.

Rehabs That Accept BCBS Federal Insurance

Another important distinction to make is the difference between “Accepting” an insurance provider 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.

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 browse rehab centers that accept BCBS Federal insurance by doing a simple 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 daunting. 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.

hands holding fanned out hundred dollar bills.

Payment options are available for both residential treatment and outpatient rehab.

If you have BCBS Federal insurance alcohol rehab and drug rehab are 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 substance abuse rehab will cost you your monthly premium, plus any copays, deductibles, and/or 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 full 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 based on your income level, and others that offer financing or payment plans.

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Drug addiction treatment is possible with BCBS FEP!

SJRP Drug and Alcohol Rehab Center is In-Network with Federal BCBS Insurance

At SJRP, we understand the frustration and anxiety of finding an insurance plan that will cover everything you need, and we know how nerve-wracking it can be to get yourself enrolled in a rehab facility. For these reasons and more, we want to be here to support you through every step of the recovery process.

As a holistic addiction treatment facility with connections to BCBS Federal insurance and other Blue Cross affiliates, we work diligently to support the needs of our communities and the needs of our clients as individuals.

Offering inpatient and outpatient treatment, dual diagnosis treatment, individualized treatment programs, and numerous recovery services, SJRP is a treatment provider that truly stands out in the substance addiction treatment industry.

If you’re struggling with alcohol or drug abuse, we are committed to helping you get the recovery treatment you deserve. Call our office today and speak to an admissions team member to verify your insurance, discuss payment concerns, and get started on your journey to recovery! Call 833-397-3422.

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Struggling with alcohol abuse or drug abuse? Call SJRP today to get the help you deserve!

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