Blue Cross Blue Shield of Ohio Insurance Coverage for Drug & Alcohol Rehab Programs Near Me

Does BCBS o­f Ohio Insurance Cover Inpatient Alcohol and Drug Rehab Centers?

For many, figuring out the financial component of seeking addiction treatment can be stressful. Fortunately, if you have a health insurance plan, such as one offered by Blue Cross Blue Shield (BCBS) of Ohio, you may be able to use the health coverage you already pay for to cover some or all the costs associated with rehab treatment, including those received at Inpatient Alcohol and Drug Rehab Centers in Ohio.

Because there is not 1 type of plan offered by BCBS of OH, you’ll want to verify your personal benefits and coverage before seeking treatment whenever possible. Your plan may be subject to provider networks, and you may owe certain out-of-pocket costs such as a deductible, copay, and coinsurance before your plan kicks in to cover costs.

Most rehab facilities can help you check your coverage; you’ll just need to call the center directly and provide information on your insurance plan. You could also call the number on the back of your insurance card to speak to a BCBS of OH representative to learn more about your plan.

Finally, you can work with the American Addiction Centers (AAC) trained professionals to learn more about addiction treatment and your health insurance. Reach out to AAC through different channels, such as phone or online chat. For instant information about your plan, please enter your information into the benefits form.

How to Find BCBS of Ohio Covered Inpatient Drug Treatment Centers in OH?

Depending on your health plan, you may need to ensure that you attend a drug or alcohol treatment center that falls within your BCBS of Ohio’s plan network, regardless of whether it is an inpatient or outpatient treatment facility. While this may sound daunting, it’s relatively simple to do. Plus, there are resources available to you that will help you find covered inpatient and outpatient drug treatment centers in Ohio.

AAC is an industry leader in addiction treatment services and education. The trained admissions navigators and staff manning the confidential helpline are here to help you learn more about addiction, treatment options, and insurance. You can call the helpline today to speak to a person who can check your benefits right while you’re on the phone.

AAC can also help you find out whether your insurance is accepted at any of the AAC treatment facilities across the country, and, if not, find a nearby treatment center that’s covered by your BCBS of Ohio plan.

What Is BCBS of Ohio?

BCBS of Ohio is part of the Blue Cross Blue Shield Association network of plans.¹ Specifically, there are 34 independent and locally operated Blue Cross Blue Shield companies that administer plans to all 50 states, Washington D.C., and Puerto Rico.¹

In Ohio, the BCBS of Ohio company is formally known as Anthem Blue Cross and Blue Shield Ohio.¹ BCBS of Ohio has been operating since 1984, when Medical Mutual of Cleveland, Inc. and Blue Cross of Northern Ohio merged, making it the state’s oldest and largest insurer.²

BCBS of Ohio provides coverage to more than 3.4 million members.^{3, “Select Ohio”} Additionally, Anthem BCBS of Ohio’s network includes 192 hospitals and 36,825 primary care physicians and specialists in network. ^{3, “Select Ohio”} Comparatively, across the nation, all licensed BCBS plans provide insurance to 111 million Americans in the country, or about 1 in 3 total, and facilitate a network of 1.7 million doctors.⁴

How Much Does BCBS of Ohio Cover (Addiction Treatment)?

Anthem BCBS of Ohio serves many different customers in various markets. Specifically, they provide plans in the Marketplace individual and family plan market, Medicaid, Medicare, small business plans, and employer-sponsored plans.^{5 “Our plans”} Due to the number of different plans in different markets, there are many different levels of coverage that may be provided across the board.

As such, you’ll need to review your benefits and coverage to learn more about what is and isn’t covered under your specific plan. What is covered by your Anthem BCBS of OH plan may not be covered under someone else’s plan. Regardless of plan coverage, your provider may recommend 1 of the following 4 addiction treatment plans:

• Inpatient or residential rehab. With inpatient or residential rehab programs, a patient will live at the treatment facility for the duration of their care. Here, they’ll receive round-the-clock care in a medically supervised setting, which is important for services such as detox and withdrawal management, which can become a medical emergency if not appropriately administered.^{6, Pg 8, “What types of treatment programs are available?” Para 2,}
• Outpatient rehab or therapy. With outpatient programs, patients go to an appointment or session a few times a week or month to receive their counseling or therapy. No overnight stay or live-in care is associated with outpatient rehab.^{6, Pg 10, Para 2}
• Intensive outpatient programs. With IOPs, patients typically must attend a minimum number of hours of treatment per week (usually 9 hours per week). No overnight stay or live-in care is associated with IOPs.^{6, Pg 10, Para 3}
• Partial hospitalization programs. With PHPs, which are commonly referred to as day programs, patients attend 4-8 hours of treatment per day, multiple days per week. No overnight stay is associated with PHPs.^{6, Pg 10, Para 1}

Please note, just because these are common treatment methods that may or may not be right for you. Your health care provider can determine the best course of treatment for you. Additionally, be sure to verify that your insurance coverage extends to the treatment type before receiving treatment unless it’s a true medical emergency. Call the number on the back of your insurance card to get started.

Does Blue Cross Blue Shield of Ohio Provide Coverage for Mental Health Treatment Facilities?

Mental health facilities provide a variety of different treatments for various mental health conditions, including mental illness and substance use disorder. If you or a loved one needs treatment for a mental illness, substance use disorder treatment (e.g., stand-alone heroin rehab), or both, which is known as a co-occurring disorder, your BCBS of Ohio health plan may be federally required to provide coverage in some capacity for services rendered at these facilities.^7,8

For those who experience co-occurring disorder, it is recommended that each condition be treated separately, but at the same time, to truly address the interconnected nature of the diagnosis.^{7 “what should I do?”}

The Affordable Care Act, which is also known as the ACA, PPACA, or Obamacare, is a health care reform law that was enacted in March 2010 and brought many changes to the way health care is treated in the U.S. by health insurance companies.⁹ One of those changes was to mandate coverage for certain health care services, known as essential health benefits, including mental health and substance use treatment.¹⁰

Under the mandate, almost all U.S. health plans must cover mental and behavioral health services like inpatient mental and behavioral health services, substance use disorder treatment, and behavioral health treatment, in some capacity. How your specific plan provides coverage for such services may vary, and you may be subject to coverage by only in-network providers, copays, and deductibles. Call the number on the back of your insurance to learn more about your specific coverage.

How Long Does BCBS of Ohio Insurance Cover Alcohol and Drug Rehab Programs?

Although your BCBS of Ohio plan may be federally mandated to provide some level of coverage for alcohol and drug rehab programs, how long your specific policy covers treatment may vary. Factors that may influence how long your BCSB of Ohio health plan covers rehab treatment include the type of treatment you need, where you seek care, and the extent of your treatment.

You can look up your insurance coverage on the insurance card or by signing into your online member portal. You can also call the number on the back of your insurance card to work with a BCBS of Ohio representative who can further explain your insurance coverage to you.

Regardless of how long your BCBS of Ohio insurance covers alcohol and drug rehab programs, it’s important to heed the advice of your provider. Sometimes, you’ll be recommended to remain in treatment for longer than your insurance may cover treatment.

While every person’s situation is unique, and some people need more or less treatment than others, experts recommend remaining in treatment for at least 90 days to improve overall outcomes. ^{11, bullet 5} Work with your provider to determine the most appropriate treatment program and length of that program.

What if My BCBS of Ohio Policy Does Not Cover an Inpatient Drug Rehab Program?

If your BCBS of Ohio policy does not cover an inpatient drug rehab program or any other types of rehab treatment, you may personally be responsible for covering the costs. However, there may be payment options offered by your rehab facility to help you pay for rehab. Examples of options that may be available to you include scholarship options and financing opportunities. Remember, getting the treatment you need right now is critical; do not push off getting treatment.

BCBS of Ohio In-Network vs. Out-of-Network Inpatient Drug Rehab Centers

Knowing the difference between whether an inpatient drug rehab center is in-network or out-of-network with your BCBS of Ohio plan may help you save on your healthcare costs. At in-network facilities, you can generally use your health insurance to help pay for the costs associated with treatment, as the provider is contracted with your BCBS of OH plan to provide coverage at a lower, pre-negotiated rate.¹²

Providers that are outside of your plan’s network may not be covered under your plan unless it’s a true emergency.¹² This means that you may have to pay the full cost of care if your insurance doesn’t help cover costs associated with out-of-network providers. To find a covered facility near you, call the AAC helpline or use Anthem BCBS of Ohio’s online Find a Doctor tool.

Rehabs That Take Blue Cross Blue Shield 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.