Blue Cross Blue Shield Rehab: Treatment Covered by BCBS | Recovery.org (2024)

You may be wondering, ‘does Blue Cross Blue Shield cover addiction treatment?’ Yes, Blue Cross Blue Shield (BCBS) covers at least some of the costs of rehab, but coverage will vary depending on your plan.

You may also wonder what are some drug treatment centers that accept Blue Cross Blue Shield insurance? Perhaps you are wondering whether Blue Cross Blue Shield covers alcohol detox. While coverage may vary depending on your plan, BCBS plans typically cover some level of treatment for drug or alcohol addiction. You may be responsible for copayments or partial reimbursem*nt of services rendered, so contact your state’s BCBS representative to learn about specific rehabilitation coverage and costs. The cost of rehab will also depend on factors such as program length.

At American Addiction Centers (AAC), we’re dedicated to guiding you on your path to sobriety, step by step. We’re eager to assist you in verifying your Blue Cross Blue Shield coverage for rehab, so you can understand your benefits. Please contact one of our admissions navigators at or send us a text, and we’ll help you confirm your treatment options.

Since BCBS offers plans on the Health Insurance Marketplace as part of the Affordable Care Act (ACA), many plans cover mental health and substance abuse services, which are considered an essential health benefit (EHB) per the ACA.² However, coverage for certain types of treatment programs may vary depending on the plan you have and on factors like geographic location.

There are varying levels of care for addiction treatment, which can include medical detox, inpatient addiction treatment and outpatient addiction treatment programs. Coverage for these different levels of care may depend on your plan, the state you live in and the facility you choose.

While BCBS drug and alcohol rehabilitation plans can vary based on which state you are in, most plans are broken into 3 metal tiers: bronze, silver and gold. The general breakdown for each plan is as follows:³

• Bronze plans have lower premiums, but higher out-of-pocket costs. BCBS pays about 60% of the costs of your medical care once your deductible is met.
• Silver plans have higher premiums, but out-of-pocket costs are less than with a bronze plan. BCBS pays about 70% of your medical care after your deductible is met.
• Gold plans have the highest premiums and lowest out-of-pocket costs. BCBS pays about 80% of your medical care once your deductible is met.

Deductibles may vary for each plan. Make sure to contact the BCBS representatives for your state as their plan offerings may be different from those above.

In most cases, Blue Cross Blue Shield insurance provides coverage for addiction treatment and mental health services. Just be sure you choose a facility that is within the BCBS network or that your plan allows you to use out-of-network facilities. At AAC, we can help you understand the ins and outs of using your coverage for treatment. Reach out to us today at or get a text to verify your insurance and begin the process of finding the recovery center that’s the right fit for your needs

Using Medicaid and Medicare

BCBS participates in Medicaid, which is a state and federally funded health insurance plan to help people with low-incomes access necessary health insurance.^4,5 There are both mandatory benefits required by federal law and optional benefits, which vary by state.⁴

Medicare is a federal insurance program for people aged 65 and older and those under 65 with certain disabilities or medical conditions.⁵ Medicare has 4 parts (A, B, C and D), each intended to meet certain needs.⁵

Private insurance companies like Blue Cross Blue Shield offer coverage to pay for rehab that goes beyond Medicare parts A and B to include benefits you may not otherwise have with Original Medicare.⁵ Examples of insurance coverage that a BCBS Medicare plan provides are hearing aids, vision and dental care and long-term care.⁵

Federal Employee Program

Blue Cross Blue Shield offers a Federal Employee Program (FEP) for federal workers, retirees and uniformed service members. Under the FEP, you can choose among 3 plans: standard, basic and FEP Blue Focus.⁶

With the FEP standard option, you can use in-network or out-of-network providers and, depending on your plan, you can expect to pay a copay for inpatient mental health or substance abuse services.⁶ It is the most expensive plan of the 3, and pre-certification is required for inpatient hospital services at Blue Cross Blue Shield drug rehab facilities.

The FEP Basic option requires that you use in-network providers for services to be covered.⁵ Pre-certification is also required for inpatient mental health and drug addiction treatment services at Blue Cross Blue Shield rehab centers and you can expect to pay a copay.

The FEP Blue Focus Plan is the least expensive option. However, services and providers must be in-network.While this plan has no copays for inpatient mental health or substance abuse services, you are required to pay a percentage of services rendered.

Checking your insurance coverage can be done online or over the phone by calling the number on the back of your BCBS insurance card. You can contact American Addiction Centers (AAC) for free at . Seeking treatment for an addiction can feel overwhelming, but understanding your insurance benefits can help minimize the stress around getting help for substance misuse.

Whether you want to learn more about paying for rehab without health insurance or you’re interested in finding out how to use health insurance coverage for rehab, our team is here to assist you. At AAC, we support you through every step of your journey to sobriety, including helping you make the most of your Blue Cross Blue Shield insurance coverage for rehab.

We know that navigating questions like, “Does Blue Cross Blue Shield cover rehab?” can be challenging. Contact the AAC team today at to learn more about our services and verify your Blue Cross Blue Shield coverage for alcohol and drug treatment.

Additional Insurance Providers With Addiction Coverage

• Aetna
• Humana
• Kaiser Permanente
• Cigna
• Ambetter
• UnitedHealthcare
• Blue Cross Blue Shield

Related Resources

• Inpatient vs. Outpatient Treatment
• Faith-Based Rehab Centers
• Holistic Rehab Centers
• Couples’ Rehab Centers
• Seniors’ Rehab Centers
• Co-Occurring Disorder Rehab Centers
• Luxury Rehab Centers
• Private Rehab Centers
• State-Funded Rehab Centers
• Drug Abuse Hotline Numbers

1. Blue Cross Blue Shield. (n.d.). The Blue Cross Blue Shield system.
2. 2. HealthCare.gov. (n.d). Mental health & substance abuse coverage.
3. 3. Blue Cross Blue Shield Blue Care Network of Michigan. (n.d.) What’s the difference between bronze, silver and gold plans?
4. 4. Centers for Medicare and Medicaid Services. (n.d.). Mandatory and optional Medicaid benefits.
5. 5. Blue Cross Blue Shield Medicare. (n.d). Medicare Coverage Options.
6. Blue Cross Blue Shield Federal Employee Program. (n.d.). 2020 basic options benefit chart.
7. Blue Cross Blue Shield Federal Employee Program. (n.d.). 2020 FEP blue focus benefits chart.