Does BCBS of Michigan Insurance Cover Drug Rehab?

Blue Cross Blue Shield of Michigan is an independently licensed company affiliated with the Blue Cross Blue Shield Association. Blue Cross Blue Shield is an umbrella organization that operates health insurance companies throughout the U.S. and serves more than 100 million people.

Blue Cross Blue Shield of Michigan provides health insurance to 5 million Michigan residents, including individuals, families, and companies. They have thousands of health insurance plans to choose from.

Does Blue Cross Blue Shield of Michigan Cover Addiction Treatment?

Most Blue Cross Blue Shield of Michigan plans cover mental health and substance abuse treatment, as required by the 2010 Affordable Care Act. This act requires that most long term insurance plans provide 10 essential health benefits, and both addiction treatment and mental healthcare are on the list.

However, there are exceptions to the law and insurance plans differ. As a result the options for treatment and requirements to get care can vary widely. It’s important to get the full details of your insurance plan before you commit to a rehab program.

When you verify your insurance you can find out what type of treatment is covered and for how long. You’ll also learn what out of pocket costs to expect such as deductibles and copayments so you aren’t caught off guard.

What Are Blue Cross Blue Shield of Michigan Plans?

Blue Cross Blue Shield of Michigan provides a variety of insurance plans. You can have an individual or family plan from the state Insurance Marketplace or from your employer. Or you might qualify for a Medicare or Medicaid plan from BCBS of Michigan.

Individual and family plans come in two types. A preferred provider plan (PPO) allows you to choose your own doctors and rehab treatment facilities. You don’t need a referral. But these plans generally have a higher monthly premium.

For more information about Blue Cross Blue Shield of Michigan PPO plans, you can call 1-888-563-3307, from 8 am. till 9 pm Monday through Friday.

Health maintenance organization (HMO) plans have lower monthly plan fees than PPOs but they also have higher deductibles and copayments. HMOs utilize a network of healthcare providers who are pre approved by the insurance company. You must obtain a referral from your primary doctor before you can see a specialist. Services from out of network providers are generally not covered.

For more information about Blue Cross Blue Shield of Michigan HMO plans, call the number on the back of your BCBSM ID card, anytime between 8am and 8pm, Monday through Friday.

Blue Cross Blue Shield of Michigan offers Medicare Part D prescription drug plans for Original Medicare and Medicare Supplement Plans to help cover Original Medicare costs. BCBS of Michigan also offers Medicare Advantage (or “Medicare part C”) plans. Medicare Advantage plans provide the same services as Medicare. But they often include extra benefits, such as prescription drug coverage and vision care and even dental treatment.

If you qualify for Medicaid, Blue Cross Complete might be your health plan. It serves lower income individuals and families in Michigan. Generally Medicaid plans have $0 coverage for a variety of medical needs which may include addiction treatment.

What Types of Inpatient Addiction Treatment Does BCBS of Michigan Cover?

Insurance plans generally focus on paying for medically necessary care so it’s important to work with your doctor to come up with a treatment plan. Some of the inpatient drug rehab treatment options that may be included in Blue Cross Blue Shield behavioral health plans are below.

Medical detoxification services involve treatment to make the detox process (where substances leave your system) safe and as comfortable as possible. This often includes FDA approved medications and other medical care. During detox you often receive counseling and treatment planning services as well.

Inpatient treatment takes place in a clinic or hospital. Residential care takes place in a facility outside of a hospital. Both include around-the-clock care and support provided by professional staff. Inpatient care may last for several days or weeks. Residential care typically lasts 28 to 30 days, 60 days, or 90 days. The goal of these programs is to give you a distraction free environment to focus on creating new mindsets and habits that allow you to achieve long term recovery.

What Outpatient Rehab Does BCBS of Michigan Cover?

Outpatient programs allow you to attend treatment during the day and return home at night. You might be living independently or in a sober living house with others. There are several levels of outpatient treatment.

In a partial hospitalization program, treatment typically runs for 4-8 hours a day, three or four days a week, over 30 to 90 days. This is the most intensive form of outpatient rehab and is often called a day program.

Intensive outpatient programs typically offer 9 to 20 hours of treatment per week, which are spread over 3 to 5 days. The recommended minimum duration for IOP treatment is 90 days.

In general outpatient programs, clients typically visit a clinic or rehab facility one or more times per week. Group counseling and educational sessions are provided, with individual sessions offered as needed. This is the least intensive form of care.

With telehealth services, treatment and counseling are delivered by phone or over the internet. Telehealth can be used when local treatment options are either unavailable or inconvenient. It can also be a part of aftercare support services when you finish your treatment plan.

Does BCBS of Michigan Cover Methadone & Suboxone (MAT)?

Medication Assisted Treatment (MAT) is used during medical detox and during ongoing treatment. MAT has been shown to manage cravings which allows you to stay stable and lowers the chance of relapse. This can be especially important with opioids where relapses have a high chance of resulting in overdose deaths.

The medications help normalize brain chemistry and block the euphoric effects of misusing substances. Like all treatment it’s important to understand your insurance coverage before you start. You might need a referral or preauthorization depending on your plan. You might also need to use in network providers to get coverage.

How to Verify Coverage with BCBS of Michigan

There are a number of ways to verify coverage with Blue Cross Blue Shield of Michigan. Individuals may call the number on the back of the member ID card and speak with a care representative. They can answer your questions and help you find the right providers.

Another option is to use the BCBS of Michigan website to log into your account and verify coverage. You can also find in network providers and locate educational information on the BCBS website.

Often, treatment centers will help individuals verify their insurance coverage and will help obtain prior authorization for services, if needed. If you have a treatment center in mind and want them to verify your coverage it is important to have the plan name and member ID number. There are a lot of different plans under the BCBS of Michigan umbrella.

Blue Cross Blue Shield of Michigan Insurance