Rehab Centers That Accept BCBS Insurance In Texas
Medically reviewed byIsaac Alexis, M.D., AAMA, AMP-BC
March 6, 2019
Dependency on alcohol or drugs is a common problem for millions of Texans. When you deciding to get treatment, it is important to know if insurance will help pay for your services. There are laws in place that mandate coverage for substance use disorder treatment, including detox, rehab centers, inpatient, and outpatient therapy. Blue Cross and Blue Shield of Texas offers many different plans that have this coverage.
Legal Requirements for Substance Use Treatment
The Affordable Care Act requires that insurance companies, particularly for insurance plans available on the insurance marketplace, provide coverage for essential health concerns. Substance use disorders fall under this definition, which means that insurance companies have to cover substance abuse services like outpatient therapy, detox, and rehab. Your insurance also cannot place restrictions on your access to these services beyond what they require for standard medical services.
For example, if your insurance only requires you to pay 20 percent of your costs for inpatient treatment for heart disease or diabetes, it cannot force you to pay more for inpatient treatment at preferred, in-network rehab centers. There are exceptions to this rule, but the law provides for a far greater degree of equity than people might have had years ago.
Blue Cross Blue Shield of Texas offers three types of health care plans for individuals, families, and businesses: Bronze, Silver, and Gold. The Bronze plan requires the lowest premiums, but the coverage is only 60 percent for most services. People with the Bronze plan must pay 40 percent for out-of-pocket costs. The Silver plan splits the insurance/patient out-of-pocket burden to 70/30. The Gold plan, with the highest premiums, covers 80 percent of services, with 20 percent paid by patients.
Each plan level has two types that affect the services that are available to you and your expected expenses. They are called Blue Advantage and Blue Advantage Plus. Blue Advantage Plus may cost more for you in premiums, but it also offers some out-of-network benefits. Although BCBS allows you to select from a wide range of providers in its network, you may need the Blue Advantage Plus program if you wish to see a doctor outside the network for substance abuse treatment.
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Under the ACA, preventive services must be covered without a co-insurance payment. BCBS of Texas notes that this includes certain substance-use concerns, such as smoking or alcohol use. However, you can only receive these services without a co-insurance payment if you see a doctor within your health plan network. Some BCBS insurance plans are not required to offer this service, so you should examine the terms of your specific plan.
Inpatient And Outpatient Treatment
The size of your local health plan network varies depending on your plan and your location within the state. For example, the 24/7 Nurseline allows you to talk to a registered nurse about your need for detox, rehab, outpatient therapy, or other services. Everyone has a different experience and unique needs in treatment. As such, it is important to ask your care provider for a recommendation to services in your area that will work best for you.
Mental health is finally losing the stigma that made it so much harder for people to get treatment for substance abuse problems. To learn more about Blue Cross and Blue Shield of Texas and how it can help you in your quest for sobriety, please contact us at RehabCenter.net.