Does BCBS of Massachusetts Insurance Cover Inpatient Alcohol and Drug Rehab Centers?
If you have a Blue Cross Blue Shield of Massachusetts health plan, you may be wondering what benefits your plan may provide. If you or a loved one with a BCBS of MA plan is also struggling with addiction or needs inpatient alcohol and drug rehab, you may want to know whether these services are covered under your plan. Blue Cross Blue Shield of Massachusetts helps support those seeking care for substance use disorder.1 While you may have access to a variety of treatment methods, how those methods are covered under your plan can vary.
As such, checking your benefits and coverage before seeking care whenever possible is always recommended. You can do this by calling the number on the back of your BCBS of MA health plan card or logging in to your online member portal. You can also ask a rehab center directly to help you check your benefits to find out if your plan is accepted at their location.
Finally, you can work with American Addiction Centers (AAC), the industry leader in addiction care and services, to learn more about your plan. By calling the confidential helpline, reaching out via chat, or entering your information in the benefits verification form below, you can easily verify your benefits and learn more about the services covered under your plan.
How to Find BCBS of Massachusetts Covered Inpatient Drug Treatment Centers in MA?
Depending on the BCBS of MA plan you have, you may be limited to a network of certain providers to obtain covered health services. Finding an in-network or covered inpatient drug treatment center in Massachusetts doesn’t have to be difficult. With the help of AAC, you can learn more about your coverage and benefits and find a nearby in-network provider. To unlock this access, call the confidential helpline today and speak to a person who can check your benefits right while you’re on the phone.
Additionally, the AAC staff can work with you to determine whether your plan is accepted at any of the top-notch AAC facilities across the country, including the nearby Sunrise House Treatment Center in New Jersey. If it is not accepted, we can help locate nearby facilities in Massachusetts that are under your plan’s network of covered providers.
What Is BCBS of Massachusetts?
Blue Cross Blue Shield of Massachusetts is 1 of the 34 independent and locally operated licensees of the larger Blue Cross and Blue Shield Association.2 The health insurance company, which was founded in 1937, has been providing Massachusetts residents with access to high-quality and affordable health care for more than 80 years.3
In the 1930s, the company known as Blue Cross of Massachusetts was the first of its kind to offer insurance coverage statewide, specifically for hospital stays.4 Then, in 1941, the company known as Blue Shield of Massachusetts started providing insurance coverage for visits to the doctor’s office.4 Decades later, in 1988, the 2 companies merged and formed BCBS of Massachusetts as it’s known today.4
The BCBSA provides coverage to 1 in 3 Americans across all 50 states, the District of Columbia, and Puerto Rico.2 BCBS of Massachusetts, specifically, provides coverage to almost 3 million members.3 As a not-for-profit health plan, the Boston-based community-focused BCBS of Massachusetts seeks to provide members with high-quality service and is among the nation’s best health plans in terms of quality and member satisfaction.3
How Much Does BCBS of Massachusetts Cover (Addiction Treatment)?
Figuring out how much your BCBS of Massachusetts plan covers regarding addiction treatment should be a priority. Regardless of plan coverage and the extent of your coverage, there are a few common types of addiction treatment that may be suggested for you. Here are 4 types of addiction treatment that your provider may suggest for you, depending on your unique situation.
- Inpatient or residential rehab. With an inpatient or residential rehab program for addiction treatment, a patient will generally live at the facility for the duration of their stay, which could range from a couple of days to 30 or 90 days, to a few months. Inpatient or residential programs can provide a variety of different medically supervised care and treatment methods, including medical detox and therapy.5, Pg 8, “What types of treatment programs are available?” Para 2,
- Outpatient rehab or therapy. With an outpatient rehab program for addiction treatment, a patient will attend their scheduled sessions, which could be 1 or 2 a week or less frequently, where they receive counseling or therapy, but do not stay overnight.5, Pg 10, Para 2
- Intensive outpatient programs. With IOPs, a patient will generally be required to attend a minimum number of hours of care each week (usually 9 hours/week). Like standard outpatient therapy, no overnight stay is required.5, Pg 10, Para 3
- Partial hospitalization programs. With PHPs, a patient will generally attend 4-8 hours of treatment per day, multiple days per week. However, there is not an overnight stay required with these programs, and they are commonly known as day programs.5, Pg 10, Para 1
What is exactly covered under your BCBS of MA plan and how much it covers will depend upon a multitude of factors, including the plan that you have, the type of treatment you need, and where you seek care. Your treatment may also be subject to out-of-pocket costs, like copays, coinsurance, and plan deductibles. To find out what cost-sharing may apply and the extent of your coverage, please call the number on the back of your plan card and speak to a plan representative who can further discuss your plan’s details with you.
Does Blue Cross Blue Shield of Massachusetts Provide Coverage for Mental Health Facilities?
Almost all health plans in the United States, including some plans issued by the BCBS of MA, are required by the Affordable Care Act to provide coverage in some capacity for 10 services that are deemed essential health benefits.6 Mental health and substance abuse treatment is considered to be 1 of the 10 listed EHBs.7 As such, health plans must provide some level of coverage for services such as behavioral health services, substance use disorder treatment (e.g., rehab), and inpatient mental and behavioral health services.7
This mandate enables those seeking treatment for a single condition, such as stand-alone heroin rehab, or multiple conditions, such as a co-occurring disorder, to get the care they need. A co-occurring disorder, which is also referred to as a dual diagnosis, is known if someone has both a mental illness and substance use disorder at the same time.8
It is said that those who have a mental illness are twice as likely to develop a substance use disorder at some time in their life, and vice versa.8 Due to the interconnected nature of the conditions, it’s recommended that treatment for both be given at the same time.8 “What should I do?” Many rehab programs provide this type of treatment, and your health plan may cover all or some of the costs associated with this type of care.
How Long Does BCBS of Massachusetts Insurance Cover Alcohol and Drug Rehab Programs?
When it comes to improving the odds of successful rehab treatment, remaining in treatment for the appropriate length of time is of the utmost importance. Every person’s path to recovery is different, and some may need more or less than the recommended amount of treatment time. However, only your provider can best speak to your situation.
Across the board, it is recommended that longer treatment times are proven to be the most effective. Specifically, treatment is recommended to last for at least 90 days to improve overall outcomes.9, bullet 5 Work with your provider to determine what is best for you.
Please note that no matter how long a provider suggests your treatment should be, it is not guaranteed that your plan will automatically cover your treatment. The length of time that your plan will cover various alcohol and drug rehab programs will depend upon the plan that you have, where you seek care, and the treatment you need.
To find out more about your plan’s coverage details, you can look up your insurance information on the back of your card or by logging into your online member portal. Remember to verify your benefits and coverage before seeking care whenever possible.
What if My BCBS of Massachusetts Policy Does Not Cover an Inpatient Drug Rehab Program?
Understanding how to pay for rehab, even when your BCBS of Massachusetts plan doesn’t fully or partially cover the costs of rehab. Depending on the rehab facility, there may be alternative payment options offered to you. For example, some facilities may provide financing for which you can apply.
Additionally, some others may offer scholarship opportunities, which could help you get care at little to no cost to you. Be sure to ask the facility whether these are available options for you so that you can get the treatment you need right now rather than pushing it down the road.
BCBS of Massachusetts In-Network vs. Out-of-Network Inpatient Drug Rehab Centers
Certain BCBS of Massachusetts plans may only provide coverage for services rendered by in-network providers. An in-network provider is 1 that works with BCBS of MA health plans to provide pre-negotiated healthcare services and lower costs to covered plan members. provide lower-cost healthcare services to its coved health insurance members.10 “In-network Provider”
Using in-network providers can help keep your healthcare costs low.10 “In-network Provider” Depending on the plan you have, you may not have coverage for services rendered by out-of-network providers. Call the number on the back of your card or call the AAC helpline today for assistance in finding a covered provider near you.
Rehabs That Take Blue Cross Blue Shield of Massachusetts Insurance
American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Blue Cross Blue Shield insurance plan, the following AAC facilities accept Blue Cross Blue Shield for drug and alcohol addiction rehab.
- AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and tele-health.
- Desert Hope Treatment Center: Located in Las Vegas, Nevada, Desert Hope provides individualized care programs as well as offering a full continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, and tele-health.
- Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and tele-health, all in a luxurious setting with high-end amenities.
- Laguna Treatment Hospital: Located in Orange County, California, Laguna is a chemical dependency recovery hospital that focuses on treating people who are medically compromised and need 24/7 oversight. Provided care includes detox services, residential treatment, dual-diagnosis treatment inpatient treatment, and intensive outpatient services.
- Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and tele-health, all with individualized treatment programs.
- Sunrise House Treatment Center: Located in Lafayette Township, New Jersey, Sunrise House provides treatment for people suffering from substance abuse from a medical and holistic standpoint. With various evidence-based therapeutic interventions, personalized care is provided through detox, residential treatment, dual-diagnosis treatment, and outpatient services.
There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Blue Cross Blue Shield insurance.