Independence Blue Cross Pennsylvania for Drug & Alcohol Rehab

Independence Health Group is a licensee of Blue Cross Blue Shield. As a result, it’s better known as Independence Blue Cross. The company has operated in Philadelphia, Pennsylvania, for over 85 years and has almost three million members. You may have Independence Blue Cross coverage through your employer, through the insurance Marketplace, or through a Medicare Advantage plan.

Does Independence Blue Cross Cover Rehab Treatment?

If you struggle with alcohol or substance misuse, getting treatment is the best way to break free. Will your insurance plan help you cover the cost?

In many cases, it will. The Affordable Care Act (ACA) requires all long term individual and small group plans to cover specific essential health benefits, which include mental health and addiction treatment. That includes any insurance plans related to government programs like Medicaid or Medicare, any plan available on the state Marketplace, and plans offered by employers with 50 or fewer employees.

Large group plans, like those offered by employers with over 51 employees, have the option to cover those benefits as well, but it’s not required.

It’s important to know the details of your specific plan before you commit to a treatment program. You can contact Independence Health directly to find out what your coverage specifics are and to get a list of substance use providers that are in the plan’s network.

If your plan covers substance use treatment, it will focus on the types of treatment your doctor recommends for your situation. There are many types of treatment including medical detox, residential rehab, and outpatient treatment. You may also be referred to medication assisted treatment if you struggle with alcohol or opioid misuse.

What Types of Plans Does Independence Blue Cross Offer?

Independence Health offers lots of types of plans, including individual and family plans in the Marketplace and Medicare Advantage and Medicare prescription plans. They also have insurance plans that employers can offer to their workers. If you qualify for Medicaid, you might have Independence Health coverage through Keystone First.

Blue Cross Blue Shield is known for having a strong provider network, and Independence Health has contracts with more than 49,000 providers and 180 hospitals. It’s important to understand if you have to use doctors in the network. Some plans have out of network coverage, but many don’t. Even if you can use an out of network provider it will be more expensive, so keep that in mind.

Many Independence Health insurance plans will have additional benefits. Keep an eye out for wellness programs like fitness classes and online programs. You may also have tools available in your online account that will help you understand out of pocket costs such as deductibles and copayments when you get care. Knowing your expected costs can help you feel comfortable going to rehab and breaking free from addiction once and for all.

Does Independence Blue Cross Cover Other Mental Healthcare?

Most Independence Blue Cross plans cover mental healthcare due to the requirements of the ACA, which considers mental health and substance use disorder services to be essential health benefits. However there are exceptions to the law and the extent of coverage varies based on the plan, so you need to check your plan’s coverage details.

If you have a co occurring mental health diagnosis alongside addiction your Independence Blue Cross plan may have coverage that provides integrated care for both diagnoses.

Independence Blue Cross has a special Behavioral Health team you can contact to find out more about the services covered by your plan. You can call (800) 688 1911 to reach the team.

What Inpatient Addiction Treatment Does Independence Blue Cross Cover?

Independence Blue Cross partners with Shatterproof which is an independent national non profit substance use disorder advocacy organization. They have a finder tool that covers 14 states to help you find an appropriate treatment center that accepts Independence Blue Cross.

However insurance coverage focuses on care that is considered medically necessary so it’s important to work with your doctor to get a detailed treatment plan from your doctor. This allows you to find out if you need to seek inpatient treatment and will provide evidence for insurance preauthorization.

Inpatient care is essential if you need medical detox so you have the support you need to keep you safe as your body clears itself of drugs and alcohol. Many patients transition to inpatient residential care after medical detox so they can continue getting intensive care and lay a solid foundation for long term recovery.

What Outpatient Rehab Does Independence Blue Cross Cover?

Independence Blue Cross plans may cover different levels of outpatient rehab depending on your needs and the medical necessity of the care. Outpatient treatment enables you to receive addiction treatment through individual and group therapy as well as virtual care.

Outpatient rehab is often done in stages after leaving inpatient care. The most intensive outpatient treatment is a partial hospitalization program (PHP) where you spend several hours a day for five to seven days a week at a treatment center.

Intensive outpatient programs (IOP) are a step down from PHP and you attend outside therapy sessions for nine to 19 hours per week. As you progress in your recovery you will eventually move to general outpatient treatment where you attend counseling sessions just once or twice a week.

Does Independence Blue Cross Cover Methadone & Suboxone (MAT)?

Many Independence Blue Cross plans cover methadone and Suboxone as well as Vivitrol as part of medication assisted treatment (MAT) programs. You’ll want to get your plan details so you understand if you need a referral or preauthorization before you begin treatment.

MAT is used to treat opioid use disorders and alcohol use disorders. It can help reduce cravings and ease withdrawal symptoms to help you stay stable during treatment. This helps prevent relapse while you lay a strong foundation for recovery.

The insurer offers a large network of facilities where you can receive MAT. You’ll want to check with your specific plan to see which of these facilities are in network for you.

Does Addiction Treatment Need to Be in Network?

To get the most out of your Independence Blue Cross insurance plan it helps if you use in network addiction treatment providers. Many Independence Blue Cross plans will not cover out of network care. Even if your plan does cover out of network providers it will cost you more because there are higher deductibles and copayments for out of network providers.

You can find an extensive list of Independence Blue Cross in network providers online or by calling 1 800 ASK BLUE.