Using your BCBS benefits
Does Blue Cross Blue Shield Pay for Treatment?
Most Blue Cross Blue Shield plans include coverage for addiction treatment — but you will need to scrutinize your benefits package and complete a few paperwork steps before you enroll.
About this coverage
Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) is one of the largest health insurance companies selling products in the United States. Because it is so large, it has contracts with a wide range of doctors, hospitals, and treatment providers — which helps when you are shopping for addiction care.
Every BCBS outpost is locally owned and operated, so it is almost impossible to make blanket statements about how plans work and what is or is not covered. Under some plans you can get care with little friction; under others you need preauthorization first and face penalties for going outside the network. Verifying your specific benefits is the only way to know.
Ambrosia Behavioral Health operates its programs in South Florida. Before admission, our team contacts BCBS on your behalf to confirm what your plan covers, whether preauthorization is required, and what your out-of-pocket costs would be.
BCBS coverage options
Insurance companies form relationships with doctors, hospitals, and other providers, and agree to hold down prices for care delivered inside that network. Addiction treatment itself can happen in several settings, and BCBS plans may apply differently to each:
- Inpatient treatment facilities
- Hospitals
- Outpatient treatment providers
- Therapists
- Doctors
How BCBS plans cover addiction treatment
Most Blue Cross Blue Shield plans include coverage for addiction treatment, but each locally operated BCBS company makes its own choices about what to cover and what rules apply before members can use their benefits. Some plans reimburse care readily; others require preauthorization or limit you to providers holding a BCBS contract.
What no company can do — BCBS included — is eliminate coverage for addiction care entirely. Federal law requires insurers to provide the same level of coverage for mental health services, including substance use treatment, that they provide for other medical care.
What your BCBS ID card tells you
Your identification card carries most of what you need to understand your benefits and where to access them:
Customer service number
On the back of the card — the direct line to the BCBS company that administers your plan.
Identification number
The digits BCBS representatives use to find your plan in their system.
Plan type
HMO or PPO — these products come with different rules about networks, referrals, and costs.
Copayment details
What you pay for common appointment types. Not exhaustive, but a useful starting picture.
Questions to ask before you enroll
Call the customer service number, provide your identification number, and ask about your coverage for addiction care — or have our admissions team do it with you. Either way, get answers to:
- Does your doctor need to write an authorization before you get help?
- How much will you pay for the care you are getting — and are some treatment options cheaper than others?
- Are you required to use organizations with a BCBS contract, and which ones can you use?
- How long can you stay in a program — are there limits?
Ready to talk with admissions?
Admissions is available 24/7 to answer questions about mental health and substance use treatment options.