Rehab Centers That Accept BCBS Insurance In Washington

Health Insurance And Substance Abuse Treatment

With the passage of the Affordable Care Act, the federal government deemed that certain types of health care benefits are considered “essential.” This means that insurance plans on the health care marketplace must offer coverage for essential health concerns. Under the heading of mental health, treatment for substance use disorder is defined as an essential health benefit.

As a result, plans under the jurisdiction of the ACA must not make exceptions to treatment for substance abuse without reaching parity with similar types of health care coverage. For example, if your insurance plan requires a pre-approval for admittance to an in-network rehab center, it must also require doctors to obtain pre-approval for other inpatient health concerns like joint surgery or diabetes treatment. The Blue Cross and Blue Shield insurance companies in Washington offer many plans that provide this coverage under the law.

Blue Cross And Blue Shield Plans

There are two local organizations that provide insurance coverage for the state of Washington. Certain counties in Washington are covered under Premera Blue Cross while the other counties are covered under Regence Blue Shield.

Premera Blue Cross offers three levels of plans, called HMO, HMO-POS In-Network, and HMO Plus. None of these plans requires a deductible for health care services. The first two plans feature lower premiums, higher co-insurance payments, higher out-of-pocket maximums, a 20 percent co-insurance payment for all outpatient services, and a deductible for prescription drugs. The HMO Plus plan requires higher premiums, but provides more coverage with lower co-insurance payments for all services and no deductible for prescription drugs.

Regence Blue Shield offers plans with varying premiums and coverage levels. Insurance holders can choose from plans based on a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). The HMO plans have lower premiums, but have greater restrictions on the types of services you can access without a referral. With the PPO plans, you may not need a referral to see a doctor for specialist treatment for drug or alcohol dependency.

Preventive Care For Substance Dependency

Getting basic treatment from your primary care physician is considered preventive treatment under the ACA, which means many BCBS plans cover it without requiring a co-insurance payment. However, there are limits to this kind of treatment. Regence Blue Shield defines preventive treatment for substance abuse as screening and behavior counseling intervention designed for adults age 18 and older. Your plan may or may not cover this service without a co-insurance payment, depending on whether it was grandfathered into the marketplace after the ACA.

Addiction Rehab Treatment With BCBS

Premera Blue Cross offers coverage for inpatient treatment with a co-insurance payment instead of a covered percentage. For the HMO and HMO-POS In-Network plans, that co-insurance payment is somewhat higher than the co-insurance payment for the HMO Plus plan. After the first four days of inpatient treatment, there is no co-insurance payment for remaining days.

Access to services for detox, rehab, therapy, and other treatments for substance abuse depends largely on your insurance. You may need a referral with your Blue Cross and Blue Shield insurance, and your co-insurance payments will depend on your coverage. By taking charge of your treatment, you can build a happier life free of substance use. Contact us at RehabCenter.net to learn more about how we can help you find the treatment you deserve.