Regence Insurance Coverage for Alcohol & Drug Rehab

Regence Insurance is a subsidiary of the nonprofit healthcare organization Cambia Health Solutions and a member of the Blue Cross Blue Shield network of insurance companies.

Regence offers individual and family plans through employers and state Insurance Marketplaces in in four northwestern states – Idaho, Washington, Oregon, and Utah. They also have Medicare plan options. Regence members can access wellness resources for weight loss and fitness and rewards for meeting their wellness goals.

In 2020, Regence Insurance in Oregon started a new initiative that made them the first insurance company in the nation to directly address medication safety through data sharing. They partnered with two health providers–MultiCare and Oregon Health and Science University (OHSU)–to verify patient medication history upon discharge from the hospital. This collaboration streamlined the process of medication information review and ensured greater patient safety.

Does Regence Insurance Cover Addiction Treatment?

In compliance with the 2010 Affordable Care Act (ACA) most Regence Insurance plans provide coverage for rehab. The ACA requires most insurance plans to cover 10 essential health benefits which include substance use and mental health treatment.

However there are exceptions to the law and individual plans will have different requirements and limits for the coverage they offer. That’s why it’s important to verify your insurance details before you begin treatment.

It’s also a good idea to work with your doctor to create a treatment plan which will help the insurance company determine what care is medically necessary for your needs.

What Are Regence Insurance Plans?

Regence offers both individual and family plans and Medicare plans.

Individual and family plans from Regence are available on the state Insurance Marketplaces or you may have coverage through your employer. There are two primary types of health coverage.

Preferred provider plans (PPOs) offer the most flexibility but also have the highest monthly premiums. You are able to see specialists such as psychiatrists and addiction counselors without a referral and you can get some coverage for out of network providers. However if you use a provider not in the network you will pay significantly more when it comes to deductibles and copayments. You may also need preauthorization before you begin treatment.

Health maintenance organizations (HMOs) have lower monthly plan premiums. With an HMO you have to get care within the provider network. You also need to get a referral to see a specialist and you may need preauthorization before you start rehab.

Regence Insurance also offers Medicare plans. If you have Original Medicare you can get a Part D prescription plan or Medicare supplement plan through Regence. You can also choose a Medicare Advantage (or “Medicare Part C”) PPO plan. Medicare Advantage plans provide the same services as Medicare but they usually include extra benefits as well such as prescription drug coverage. However you’ll need to use the provider network for your care or pay more for out of network coverage.

What Inpatient Addiction Treatment Does Regence Insurance Cover?

Regence Insurance covers medically necessary care so you should have a treatment plan from your doctor before you seek care from a facility. Regence Insurance may cover your inpatient care if your provider decides it is medically necessary.

Inpatient addiction treatment can include medical detox which typically takes about a week. During that time, you will go through the detox process under medical supervision while your body gets rid of the drugs and alcohol in your system. This can come with withdrawal symptoms which can be treated in an inpatient setting.

Inpatient or residential care typically lasts at least 30 days but may last up to 90. The length of time varies based on your individual needs. In these settings you have more professional support from people who know how to help you during recovery. You also get peer support from others going through a similar journey. Inpatient treatment for addiction can increase the likelihood of long term recovery and may even provide further support after your initial treatment.

What Outpatient Addiction Treatment Does Regence Insurance Offer?

Outpatient programs–partial hospitalization (PHP), intensive outpatient (IOP), and regular outpatient (OP) programs–are programs that may be available as part of Regence Insurance’s substance use and mental health coverage.

Partial hospitalization programs allow you to attend treatment during the day; you do not spend the night at a facility. These day programs typically involve sessions lasting 4 to 8 hours a day three to four days a week. Most run for 30 to 90 days.

Intensive outpatient programs often involve 9 to 20 hours of treatment per week and these hours are spread over 3 to 5 days. Typically 90 days of treatment are recommended.

In general outpatient programs you may have sessions at a clinic or rehab facility once a week. During sessions you’ll receive group counseling and education on addiction and relapse prevention. You may also be able to get individual sessions.

Does Regence Insurance Cover Methadone & Suboxone (MAT)?

Medication assisted treatment (MAT) can help with medical detox and continued treatment of substance use disorder. Methadone and suboxone are both long acting opioids that block many of the effects of short acting opioids like heroin and oxycodone.

Both medications make the detox period more comfortable and reduce withdrawal symptoms. They can also help you manage cravings during treatment so you can lay a solid foundation for recovery.

People who go through MAT may have a higher likelihood of long term recovery. However it’s essential to understand the risks of these medications and you should talk with your doctor to decide if this is the right treatment option for you.

Does Regence Insurance Cover Other Mental Healthcare?

Due to the ACA most Regence Insurance plans cover mental healthcare. However there are exceptions, so you should check your coverage before contacting treatment centers.

Often substance use disorders co occur with other mental health disorders. You may be able to use your coverage to get integrated care that addresses both of these conditions. By treating co occurring disorders along with your substance use you can give yourself a higher chance of recovery.

Can I Travel Out of State for Treatment with Regence Insurance?

Your Regence Insurance plan will determine your coverage when seeing an out of state provider. The company offers both PPO and HMO plans and many include the BlueCard program. The BlueCard program may allow you to get coverage if you need out of state care but the amount of coverage will vary.

HMO plans do not cover out of network care so it’s very unlikely that you can use them outside your state.

With a PPO plan you have more options. You generally have coverage for out of network providers but you will pay far more out of pocket than you would with an in network provider. While you have more options with a PPO plan, staying in network maximizes your insurance coverage.

How to Verify Coverage with Regence Insurance

You can verify your Regence Insurance coverage by contacting customer service at 1 (888) 675-6570. You can also log into your online insurance account or ask the treatment center you want to use if they accept your plan.

Regence Insurance has a wide variety of plans so you must provide the exact plan name when asking about your coverage. That way you ensure you get accurate information and can proceed with your treatment as soon as possible.