Rehab Centers That Accept BCBS Insurance In South Dakota
South Dakota residents have access to Blue Cross Blue Shield plans through Wellmark. Employers can also provide group plans for Blue Cross Blue Shield customized for the company, so the cost and benefits may change. That’s why if you are facing drug or alcohol treatment, then Blue Cross/Blue Shield is a good choice for an insurance provider.
What To Consider When Choosing An Insurance Plan
Blue Cross Blue Shield offers three plans to most residents of South Dakota – one Gold and two Silver level programs. All of them are PPO plans or preferred provider. This means you can stay in network to receive a lower copayment. If you go receive treatment outside the network, the company will still pay at least a portion of the cost.
The metal level determines your contribution for overall care. At the Silver level, you contribute 30 percent your overall health care services and only 20 for a gold level policy.
The amount they pay towards substance abuse treatment depends on the plan, whether you stay in network or not and if you precertify. There may also be exceptions and limitations on what BCBS will pay. For this reason, it is critical that you review the plan fully prior to purchasing.
The deductible is another vital consideration, but for South Dakota residents opting for Blue Cross Blue Shield, this is less of a concern. In this state, Blue Cross Blue Shield bases their payment strictly on percentages, so you do not have to meet the deductible for them to cover some of the cost of rehab.
What Does BCBS Pay For Drug Rehab?
As with most providers, the amount Wellmark Blue Cross Blue Shield pays towards substance abuse treatment depends on a number of factors such as the treatment type, the plan you purchase, and whether or not you receive treatment inside the network. In South Dakota, it may also depend on where you live.
The company may not offer the exact same coverage in each area of the state, but all the plans should be similar. Before receiving a quote, you will be asked to provide your zip code, so you see the right plan for your area.
In most regions of the state, you have the choice between:
- EnhancedBlue 500
- MyBlue HSA 2000
- MyBlue HSA 3350
The numbers tell you the deductible necessary for each plan. If you are considering rehab coverage from Blue Cross Blue Shield, then look closely at each program to see which best suits your situation.
The EnhancedBlue 500 plan requires a 20 percent coinsurance payment for outpatient rehab services along with a $30 copay for office visits. For inpatient services, it is a flat 20 percent coinsurance payment. The coinsurance goes up to 40 percent for both inpatient and outpatient treatments received outside the network.
The two MyBlue HSA plans pay for inpatient and outpatient treatment in full with no required copayment. Blue Cross and Blue Shield will cover the entire cost of drug rehab as long as you stay in-network. This includes the cost of in-hospital detox. If you opt for out-of-network care, it increases to a 30 percent coinsurance payment.
Precertification is necessary with these plans. Without it, you may pay a penalty of up to $500. Most facilities will take care of precertification for you, but it is your responsibility. The facility will not pay the penalty if you do not precertify.
All the plans offer comprehensive coverage and can help put you on the road to sobriety. To learn more, please contact us at RehabCenter.net. We can help walk you through this difficult process.