Blue Cross Blue Shield of Texas: Rehabs & Detox Centers in TX That Take BCBS
BCBS Of Texas Insurance Coverage for Drug and Alcohol Rehab Centers
Substance abuse affects millions of people across the United States.1 Unfortunately, Texas makes no exception, with over 1,400 opioid-related fatalities reported on an annual basis in 2018, according to The National Institute on Drug Abuse.2,3 Approximately 2.4 million Texans above 12 years of age use marijuana. In addition, 8% of citizens of Texas under 12 years of age have abused some type of illicit substance.1 As a result, there is an increasing demand for substance abuse disorder (SUD) treatment.2
However, treatment is not financially accessible to everyone. In fact, the individuals that never enroll in rehab cite a lack of affordable options as the primary reason for not seeking professional treatment.3 As a result, only 2% of people who struggle with SUD receive the necessary treatment.2,4
If you’re holding a BlueCross/BlueShield policy and wondering if it will cover your addiction treatment or therapy in Texas, the best way to find out is to contact your preferred rehab center and check if you’re eligible. You can also call the number on your insurance card to learn more about your specific plan. American Addiction Centers is another great resource to reach out to if you have questions about addiction treatment and coverage. You can reach them via phone, live chat, or online form.6,7
What is BlueCross/BlueShield of Texas?
Founded in 1929, Blue Cross/Blue Shield (BCBS) insurance provides healthcare coverage to members across the United States. BCBS offers wide coverage for a variety of medical assistance, including substance abuse treatment.4
BlueCross/BlueShield of Texas (BCBSTX) is one of the largest healthcare insurers in the state. BCBSTX serves over five million members in Texas and is in-network with over 400 inpatient and outpatient facilities.6 These facilities are served by a number of primary care physicians, specialists, and other healthcare professionals. Keep in mind that the benefits you’ll receive will largely depend on the type of insurance plan you have.8
Does BCBS of Texas Cover Different Types of Drug and Alcohol Addiction Treatment?
BCBS of Texas offers a variety of health plans that cover essential health benefits, including behavioral health services, substance abuse, and mental health disorder treatment. Treatment must be appropriate, medically necessary, evidence-based, and FDA-approved in order to be covered.5
BCBS of Texas typically covers evaluation and screenings to determine the severity of a substance abuse disorder, medically supervised withdrawal through detoxification, inpatient or residential treatment, flexible outpatient programs, behavioral therapies, and treatment for co-occurring disorders. Whether it covers in-house interventions is a good question for your facility.7
Most BCBS of Texas plans offers full or partial coverage of costs of the following types of addiction treatment:6
- Long-term intensive treatment in the context of inpatient rehabilitation
- Residential rehabilitation for individuals in need of constant medical supervision
- Outpatient rehabilitation for individuals that completed an impatient program or those that display milder symptoms of SUD
- Partial hospitalization programs (PHP), which can include behavioral therapy, individual and group counseling, focused work with couples that struggle with addiction, contingency management, and mental health counseling.5
- Intensive outpatient programs (IOP), where individuals attend treatment center sessions and meetings several days a week for a couple of hours.5
There are many versions of the IOP programs: some include male-only groups for overcoming alcohol and drug addiction and by the same token, groups of women that are battling SUD. There are also programs for veterans struggling with the combination of SUD and PTSD.5
Does BCBS of Texas Insurance Cover Inpatient Mental Health Treatment Facilities?
The presence of mental health issues coupled with SUD is common. A study conducted by the National Institute on Drug Abuse found that around 9 million adults struggle to overcome both physical and psychological consequences of their addictions; this link has been shown as one key factor preventing successful recovery.2,10 Tackling both the co-occurring condition and the SUD is therefore essential.10
The Affordable Care Act has made it mandatory for insurance providers to cover at least some part of the costs of treatment when you have both co-occurring disorders or are undergoing addiction rehab.6 This means that most Blue Cross/Blue Shield substance abuse treatment facilities also provide a degree of coverage for mental health services.7,6
Is Addiction Treatment Therapy Covered by BCBS of Texas?
Members of BCBS of Texas can count on coverage for a wide array of addiction treatment therapies, under the condition that it is recommended by a physician or another certified medical professional. Nevertheless, before you begin the course of treatment, it’s advisable to call the number on the back of your card. This way, you will get better insight into your benefits and know what percentage of the costs will be covered.7
Your health coverage through BCBS will depend on your plan. You may wonder if it will cover detoxification, medication-assisted treatment, and behavioral therapy.7
Alcohol and Drug Detoxification
Many BlueCross/BlueShield plans offer detoxification services as part of the addiction treatment process.6 This is because detoxification is a crucial first step in the recovery journey. By getting rid of the traces of neurotoxins that result from the use of substances, you can successfully prevent the inconveniences of withdrawal and begin your road to sobriety.9
Most addiction treatment providers that are part of the BlueCross/BlueShield network offer detoxification services as a regular part of their program. Therefore, any plan that includes coverage for addiction treatment is likely to also cover drug and alcohol detox treatment.7
Methadone Assisted Treatment (MAT)
MAT is an approach to treatment that combines the use of medications with behavioral therapies and counseling.5 Methadone is one of the medications commonly used in this type of treatment. This approach can be successful because it helps patients heal not only on a physical but also on a psychological level.9
Suboxone is a combination of buprenorphine and naloxone that helps to reduce withdrawal symptoms and drug cravings.10 It is a partial opioid agonist, meaning that it occupies the same receptors in the brain as other opioids but doesn’t produce the same level of euphoria. This can help people wean off of opioids while avoiding unpleasant withdrawal symptoms.11,12
If you’re struggling with opioid addiction and are considering MAT, it’s important to check with your BCBS insurance provider to see if they cover Suboxone treatment. Most providers will cover this at least partially, but you need to be completely sure.10
Keep in mind that in order to achieve meaningful and lasting results, detox usually doesn’t suffice. Behavioral therapy is a type of treatment that is often used to address both substance abuse and mental health disorders. This type of therapy is usually covered by BCBS of Texas and in-network facilities at least in part.7
It is important to check with your specific insurance plan to determine what types of treatment are covered. Most BCBS of Texas plans will cover some level of behavioral treatment for co-occurring disorders.6,7
How Long Does BCBS of Texas Insurance Cover Different Inpatient Rehab Programs?
Addiction is a chronic disorder that is quite challenging to treat. Relapse is common, and it can happen long after the individual has last used the substance. To lower the chances of relapse, it is recommended that a person stays in alcohol or drug rehab for a period of time suggested by the physician and based on the individual’s situation upon admission.9,11
The length of treatment varies depending on the person. Although there are some effective short-term approaches, in most cases, it is recommended for patients to stay in rehab for 3 months or longer. This seems to be the shortest effective period for most patients.11 The longer the treatment lasts, the better the chances are for a complete and lasting recovery.9
For more information about your specific coverage, call your local facility to check your BCBS policy so you can know how long your plan will cover the stay at an addiction treatment center.4,5
How to Tell the Difference Between In-Network and Out-of-Network Inpatient Rehab Centers?
Some drug treatment centers are in the Blue Cross/Blue Shield of Texas network, while others are not.8
- In-network providers provide a variety of healthcare plans and additional benefits, thanks to contracts with BCBS Insurance of Texas. They’re also referred to as network providers or participating providers.8
- Out-of-network providers denote companies and facilities that don’t contractually participate with BCBS of Texas. By the same token, there are no special advantages or plans you can count on.7
The most significant differences between out-of-network and in-network BCBS of Texas rehabilitation centers are easily noticeable. These differences pertain primarily to the extent of coverage and the types of services covered. For instance, the approved amount of payment may be accepted by in-network Blue Cross/Blue Shield alcohol rehabs in Texas, but not by out-of-network providers. This means that you’ll probably have to pay a part of the cost out of your pocket if your insurance doesn’t cover it fully.9
You may easily determine whether the rehab center in your vicinity is out-of-network or in-network, just call the number on the reverse side of the card and check your BCBS of Texas coverage.
How Can We Find BCBS of Texas-Covered Inpatient Drug and Alcohol Treatment Centers In Texas?
The first step is to reach out to the AAC helpline. There, you will speak with a knowledgeable representative who can help verify your insurance coverage and benefits. From there, they will connect you with one of their leading treatment centers in Texas, such as Green House.8
Green House is known for providing top-notch quality care and programs that are tailored to each individual’s needs. If you are looking for a well-equipped and luxurious place to get quality care, you can find the best type of service at Greenhouse Treatment Center.
The facility is situated in a former Neiman Marcus wellness center and renders an experience-based and client-oriented service to all patients. They believe that everyone deserves a chance at recovery, and will do everything in their power to help you get there while guaranteeing your privacy and security.12
You can get a variety of services at the Green House Facility, including:
- A medically supervised withdrawal management and detox program to help you through the process safely and comfortably.
- An intensive outpatient program (IOP) that provides structure and support while allowing you to live at home and continue working or attending school.9
- A partial hospitalization program that provides a higher level of care than IOP, but doesn’t require 24/7 supervision.
- A residential treatment program that gives you the time and space you need to focus on your recovery without distractions.
- A recovery residence where you can live with other people in remission and receive ongoing support.
Finally, this is a place where you can enjoy a holistic approach to therapy and treatment, which may help you make improvements on an emotional and spiritual level as well.9
Frequently Asked Questions
What Should I Do if my BCBS of Texas Policy Does Not Cover an Inpatient Drug Rehabilitation Program?
According to the National Survey of Substance Abuse Treatment Services from 2017, almost 37% of people in Texas who need drug rehabilitation services don’t have insurance that will cover the costs.12 However, there are still options available for those without insurance, including state-funded rehab, as well as private insurance options.9
Out of 431 rehab facilities in the state, 62.9% accept private insurance, including BCBS of Texas. In addition, 90.3% of facilities offer cash or self-payment options, and 49% have sliding fee scales.6 Finally, 47.8% of facilities provide free treatment for those who are unable to pay.6
It’s important to note that for treatment to be effective, it’s crucial to start as soon as possible. Many BCBS of Texas treatment centers offer same-day admissions to make this process easier. If you or your loved one waits to get treatment, you might sacrifice the effectiveness.8
Does BCBS of Texas Provide Rehab Coverage Nationwide?
If you’re an insurance holder of BCBS of Texas, you may be wondering if your insurance will cover rehab services outside of the state. The good news is that BCBS provides coverage for inpatient and outpatient rehab facilities nationwide. So no matter where you are in the country, you can rest assured knowing that your BCBS insurance will provide coverage for the treatment you need.8,9
It’s important to note that not all rehab centers are created equal. Some facilities may have better success rates than others, so it’s important to do your research before choosing a center. You can rely on TX substance abuse hotlines to guide you through the process.9
Does BCBS of Texas Cover Luxury Drug Rehab Centers in Texas?
Yes, BCBS of Texas will cover at least some aspects of your stay at a luxury drug rehab center.5 However, it is important to check with your individual policy to see what exactly is covered. Some policies may only cover a portion of the cost, while others may not cover any costs associated with luxury treatment. Such non-essential services might include:6
- Spa treatments
- Private rooms
- Gourmet meals
- Certain types of therapy and counseling, that go beyond addressing the primary or coexisting disorder
It is important to remember that just because a service is not covered by your insurance, it doesn’t mean that it’s not worth paying for out of pocket. Many people find that the extra amenities offered at luxury drug rehab centers help them to feel more comfortable and relaxed during their treatment, which can lead to better results. If you have the means to pay for such services, it may be worth doing so in order to improve your chances of success in recovery.9
Why Should I Select an In-Network Drug Rehab Facility Covered by BCBS of Texas?
If you’re struggling with addiction, it is important to get the help you need as soon as possible. If you have BCBS of Texas insurance, selecting an in-network provider is the optimal way to ensure that your treatment is covered. There are several reasons why you should choose an in-network drug rehab facility if you have BCBS of Texas insurance:8,12
- First, in-network providers have agreed to accept the terms of your insurance policy, which means that they will work with your insurer to provide the coverage that you need. This can save you a significant amount of money on your overall treatment costs.
- Second, in-network providers have been vetted by BCBS of Texas and have met their standards for quality care. This means that you can be confident you’re getting the high-quality treatment you deserve.
- Finally, in-network providers are typically more convenient to work with, as they are familiar with the claims process and can help ensure that your treatment is covered. This can save you a lot of time and hassle when it comes to getting the care you need.
If you’re looking for drug rehab and have BCBS of Texas insurance, selecting an in-network provider is a beneficial option. With the peace of mind of knowing your treatment is covered and the assurance of quality care, in-network providers can help you get the treatment you need to start on the road to recovery.12