Blue Cross Blue Shield of South Carolina Coverage for Drug Rehab

Blue Cross Blue Shield of South Carolina has been providing health coverage to state residents for over 75 years. They are the only South Carolina owned and operated health insurance carrier and have large provider networks that give members a variety of choices for doctors and health facilities.

Covering more than one million South Carolinans, they provide health insurance plans for every part of the market: individual and family plans, employer plans for large and small companies, and plans for those who qualify for Medicare or Medicaid.

Does BCBS of South Carolina Cover Drug and Alcohol Rehab?

Most Blue Cross Blue Shield of South Carolina health insurance plans cover substance abuse treatment. It can also help cover co-occurring treatments. This is because the Affordable Care Act (ACA) requires most insurance providers to cover 10 essential health benefits, which include mental health and addiction treatment.

The amount of coverage depends on your specific plan, the treatment you choose, and whether the drug or alcohol rehab is in network or out of network. That’s why it’s essential to verify your coverage details before you begin treatment—you don’t want to be surprised by bills or other issues when you need to focus on recovery.

To learn more about your coverage and any out of pocket expenses, call the number on the back of your insurance card to speak with a Blue Cross Blue Shield of South Carolina representative.

What Are Blue Cross Blue Shield of South Carolina Plans?

BCBS of South Carolina offers a broad range of plans. You might have an individual or family plan from the state Insurance Marketplace or through your employer. The most popular plan is BlueEssentialsSM. In the Insurance Marketplace you can choose this plan at a Bronze, Silver, or Gold level. The Bronze plan has the lowest monthly premium but covers less of the cost of care while the Gold plan has a higher premium but covers more of the cost of care. The silver plan provides a balance of cost and coverage.

They also offer plans for those who qualify for Medicare. That includes Part D prescription plans and Medicare supplement plans if you have Original Medicare and Medicare Advantage plans that replace Original Medicare but have extra benefits. However with most Advantage plans you will need to get care within the provider network.

Finally, BCBS of South Carolina has Medicaid plans for lower income individuals and families. Healthy Blue is the company’s Medicaid plan in South Carolina. Coverage includes benefits such as gift cards to help with transportation, education assistance for adults, free or inexpensive youth club memberships, and new parent assistance.

Does Blue Cross Blue Shield of South Carolina Have Special Plan Benefits?

BCBS of South Carolina provides additional benefits for members to help them stay healthy and pursue positive habits. There are discounts on vision services, hearing aids, and other health and wellness services.

There are also SC BLUE Centers where you can meet with an insurance agent for one on one help with your insurance coverage. Finally, you can use the My Health Toolkit app to check your benefits and find in network providers and more. The app also has wellness information to help you make healthy choices.

What Inpatient Addiction Treatment Does BCBS of South Carolina Cover?

BCBS of South Carolina typically covers medically necessary care. However, what is considered medically necessary varies between patients. You should create a treatment plan with your doctor that details the care you need before seeking inpatient addiction treatment. You should also check your policy first to see if preauthorization is needed.

Your policy may cover services like medical detox services and inpatient or residential care. These types of treatment offer additional support to people seeking support for addiction recovery. Treatment centers can provide medication-assisted treatment (MAT) during the detox phase, as well as a structured, supportive environment during your treatment.

During inpatient treatment, you typically stay at a facility for 30 days, though this may be extended up to 90 days if needed. People who go through longer programs have a higher recovery rate and benefit from professional and peer support to help them stay focused on their well-being.

What Outpatient Rehab Does BCBS of South Carolina Cover?

Your BCBS of South Carolina plan may cover a partial hospitalization program (PHP), intensive outpatient program (IOP), and general outpatient treatment.

With a PHP, you usually spend about six hours per day over three to seven days a week receiving care at a facility until you complete the program. An IOP is less intensive than a PHP — you typically spend nine hours divided over three days per week getting treatment at a facility.

Regarding general outpatient treatment, the approach is more tailored to your specific needs. You can go through general outpatient treatment while still going to work, school, or doing other activities. Many people can schedule their sessions around their personal and professional lives, and you may have more options for where you get care.

Each option gives you professional support as you get treatment and recover. They can also increase the likelihood of long-term recovery. Some treatment centers also offer aftercare to support your recovery. That can include an alumni program, a 12-step program, sponsor support, additional counseling, and more.

Does BCBS of South Carolina Cover Methadone & Suboxone (MAT)?

Medication-assisted treatment (MAT) can be used along with other treatments, like behavioral therapies. MAT uses medications like methadone and suboxone to help treat opioid and alcohol use by helping you manage cravings and avoid relapse.

Methadone and suboxone both work to reduce cravings and withdrawal symptoms. They block the “opioid effect” that creates a high associated with short-acting opioids like heroin. Using approved medication can help you stick to your detox and treatment plan long-term.

Does BCBS of South Carolina Cover Other Mental Healthcare?

As part of the ACA, most BCBS of South Carolina plans cover mental healthcare. However, there are some exceptions to the law, so you should always check your coverage before you receive care.

Many people living with substance use disorders have co-occurring mental health disorders. Your insurance may cover integrated care for both your mental health and substance use treatment. When you receive integrated treatment for substance use disorder and co-existing mental health needs, you are much more likely to achieve long-term success and recovery.

Does Addiction Treatment Need to Be In-Network?

Many BCBS of South Carolina plans will not cover out-of-network care, but some do. However, even with coverage, out-of-network care will cost you much more in out-of-pocket costs. An in-network provider will result in more coverage of your addiction treatment so you can get the best possible care at an affordable price. Additionally, before you seek out-of-network care, you should review your insurance plan or talk to BCBS of South Carolina to be sure you have coverage for your specific treatment.