Blue Cross Blue Shield Coverage for Residential Treatment

Blue Cross Blue Shield may provide coverage for inpatient (residential) treatment at a rehab program that takes Blue Cross Blue Shield. With PPO coverage, you may choose an out-of-network provider for your residential care. Our Admissions Department can help you understand your coverage level and what you may need to pay. 

Blue Cross Blue Shield Coverage for Outpatient Treatment

There are several kinds of outpatient treatment that may be covered by BCBS. 

Intensive Outpatient Programs (IOP)

Intensive outpatient programs (IOP) consist of several intensive days of treatment for a few hours each day (or a few times a week). These programs may be covered by BCBS depending on your plan. 

Partial Hospitalization Programs (PHP)

With partial hospitalization programs (Day Treatment), you spend most of your days in the treatment facility, returning home at night. These are great programs for those who don’t qualify for residential or inpatient care. BCBS may cover some or all of this kind of treatment, depending on the plan you have. 

Outpatient Treatment

Outpatient treatment consists of group therapy, medication management, and other kinds of care that don’t require you to live at the facility or stay overnight. Outpatient treatment may be covered by your BCBS plan with or without prior authorization. According to BCBS, non-emergency mental health and substance use disorder services may require prior authorization. You can check your Evidence of Coverage or Certificate of Insurance to see your plan’s requirements. 

Blue Cross Blue Shield Rehab Coverage FAQs

Does Blue Cross Blue Shield insurance cover drug and alcohol rehab?

Yes. Blue Cross Blue Shield insurance does cover drug and alcohol rehab, but the exact coverage varies by plan. Solution Based Treatment takes Blue Cross Blue Shield’s PPO plans, which provide out-of-network coverage. 

How can I verify my Blue Cross Blue Shield insurance benefits?

Call Solution Based Treatment to verify your benefits quickly at (833) 999-1941 or call your Blue Shield Advisor at (866) 529-2193. You can also log into your Blue Cross of California account. 

Does Blue Cross Blue Shield cover outpatient addiction treatment?

Blue Shield of California may cover some or all outpatient addiction treatment at Blue Distinction Centers. With the PPO plan, you can choose in- or out-of-network providers for your care, as well. 

Does Blue Cross Blue Shield cover inpatient mental health?

Blue Shield of California may cover a portion of or all of your inpatient mental health care. The exact coverage will depend on your specific plan and if you see an in-network or out-of-network provider for your care. 

Do treatment centers need to be in-network?

Depending on the kind of insurance coverage you have, rehabs that take Blue Cross Blue Shield may need to be in-network. If you have a PPO plan, Rehab program Blue Cross Blue Shield insurance coverage may apply even if you go with a provider who’s out of your network. 

How much does Blue Cross Blue Shield insurance cover?

At Solution Based Treatment, we can verify benefits for you for free in an hour, so you’ll know if your insurance will cover 100% of the cost of treatment. You can also check your plan’s schedule of benefits to see your deductible, copays, and other factors that affect your overall cost. 

How do I pay for costs not covered by Blue Cross Blue Shield insurance?

When there isn’t coverage for a service or treatment you’d like to have, you will need to cover those costs on your own. You can speak with our Admissions Department about payment options such as payment plans or covering the costs with cash or by card. 

How is a Blue Cross Blue Shield HMO different from a PPO?

HMO plans allow you to choose a primary care physician to treat you, but you’ll see only the specialists or providers who are in your network. If you receive out-of-network care, you’ll have no coverage. PPOs are different because they’re more flexible. PPOs cover at least some out-of-network coverage if you’re willing to pay more for your monthly premiums. 

Can you get a single case agreement with Blue Cross Blue Shield?

Depending on your plan, you may be able to get a single case agreement with Blue Cross Blue Shield to continue your care with a provider of your choice. Speak with our Admissions Department to discuss a single case agreement or reach out to your Blue Shield Advisor at (866) 529-2193 to learn more about single case agreements.