Highmark BCBS Insurance for Rehab Services at Crest View Recovery Center

A major obstacle to getting help with substance use disorder is the lack of access to quality treatment. About 30% of people aged 12 and older who believe they need substance use disorder (SUD) treatment feel that they cannot afford it. Fortunately, insurance companies such as Highmark Blue Cross Blue Shield strive to remedy this dilemma by providing broad coverage for SUD.

Highmark BCBS members are welcome at Crest View Recovery Center. Let us help you navigate through your policy to determine the best course of treatment for you. Call or contact us today for capable, caring assistance.

In the past, insurance companies either refused or limited coverage for substance abuse rehab programs. Consequently, many people in need could not obtain affordable services. The Affordable Care Act, passed in 2010, requires insurance companies to cover mental health and substance abuse therapy just as they would for any other medical condition.

About Highmark Blue Cross Blue Shield

Highmark Blue Cross Blue Shield is a nonprofit healthcare insurance company with headquarters in Pittsburgh, Pennsylvania. It is an independent licensee of Blue Cross Blue Shield and was founded as Blue Cross of Western Pennsylvania during the Great Depression of the 1930s. Highmark Blue Cross Blue Shield emerged in 2015 after consolidating with other Blue Cross and Blue Shield entities.

Highmark BCBS provides more than 500,000 members with health, short-term health, and dental insurance. The company covers individuals in Pennsylvania, Delaware, and West Virginia. Highmark also offers online self-management programs that deal with many health issues including behavioral health, stress management, and tobacco cessation.

As SUDs are increasing throughout the nation, Blue Cross Blue Shield has expanded its resources in pinpointing and securing help for people with addictions. One example is the insurer’s prescription pain medication safety program which focuses on SUD prevention. The online platform OneHealth is available 24/7 to members with support, tools, and education to overcome substance abuse.

Do I Need Alcohol or Drug Rehab?

If you experience or notice the following signs, rehab may be what you or your loved one need as quickly as possible:

• Inability to stop drinking or using drugs, even if you want to.
• Shame about drinking or using drugs.
• Risky behavior such as driving under the influence of drugs or alcohol.
• Drinking excessively or using drugs to feel confident or loved.
• Problems at work, in relationships, or with the law related to drinking or drug use.

A professional inpatient or outpatient substance abuse program is an effective way to recover from addiction.

Will Highmark Cover Addiction Rehab Treatment?

Public and private insurers such as Blue Cross Blue Shield recognize substance use disorder as an urgent public health concern. As a Blue Cross Blue Shield licensee, Highmark provides coverage that entails inpatient and outpatient services as well as detox for substance abuse rehab. The insurer understands that each individual has a unique personality and substance use history and thus requires different approaches to recovery treatment.

Highmark strives to help all members access the services best suited for them. The insurer covers these treatments for substance abuse:

• Detoxification programs
• Inpatient and outpatient treatment
• Medication-assisted treatment
• Aftercare programs

Highmark strives to streamline the rehab treatment payment process and handles SUD as a chronic medical condition such as diabetes or cardiovascular disease. They typically honor a physician’s recommendation for the best protocol. Highmark may also cover experimental treatments for addiction that have been pre-approved by a doctor.

At Crest View Recovery Center, Highmark members can receive a variety of therapy options and individualized treatment plans that control costs while giving real hope for genuine recovery. We offer multiple tiers of care to help you break free of addictions to substances including:

• Alcohol
• Opioid
• Marijuana
• Heroin
• Xanax
• Adderall
• Benzo
• Fentanyl
• Cocaine
• Meth
• Codeine
• MDMA
• Morphine

The addiction specialists at CVRC implement a range of therapy approaches for individuals and their families. We host gender-based groups and process groups in an open, nonjudgmental environment. Our wilderness therapy program takes participants to the mountains to experience the kind of soul-healing serenity that only nature can provide.

Does Highmark BCBS Pay for Dual Diagnosis?

People with mental illness or addiction are highly vulnerable to developing a co-occurring condition. In 2017, over 8 million adults had mental illness and SUD concurrently. Some of Highmark’s plans provide coverage for individuals diagnosed with a co-occurring mental disorder that contributes to SUD. Your plan determines what provisions you are entitled to for dual diagnosis treatment.

Will My Highmark Plan Cover a Long Stay in a Rehab Facility?

Someone who is addicted to both alcohol and drugs may require a more extended stay in a rehab center compared to a person who is addicted to just one substance. In these cases, a physician might recommend that they stay for at least 90 days. If more time is necessary, Highmark members need to obtain approval from their doctor before the insurer provides coverage.

How Does Highmark BCBS Cover Inpatient and Outpatient Rehab Treatment?

Highmark provides coverage that varies widely according to individual plans. While some plans provide full coverage, others pay a percentage called coinsurance. For instance, if your coinsurance is 35%, you would be responsible to pay 30% of your bill and Highmark would take care of the remaining 65%.

Inpatient Rehab

Your Highmark BCBS plan likely requires a pre-certification for inpatient care at a substance abuse rehab facility. The insurer offers four main types of plans that provide different levels of coverage and require members to meet certain costs:

• Bronze: For in-network, members must meet the minimum deductible for in-network facilities. Out-of-network programs are typically not covered. 
• Silver: For in-network, members generally pay a coinsurance percentage plus the plan’s deductible. Out-of-network programs are typically not covered. 
• Gold: For in-network, members must pay a coinsurance percentage lower than that of Silver plans in addition to the deductible. Out-of-network programs are typically not covered.
• Platinum: For in-network, members pay either a coinsurance percentage or a daily copay up to a maximum amount. Out-of-network programs may be covered, but they require a higher coinsurance percentage with the deductible.

Outpatient Rehab

How Highmark covers outpatient addiction rehab services depends on your plan, your physician, and the facility you choose. Costs under the company’s various plans include:

• Bronze: For in-network facilities, members must meet the deductible. Out-of-network services are not typically covered. 
• Silver and Gold: For in-network programs, members may have to pay a coinsurance percentage as well as the deductible. Out-of-network services are not typically covered.
• Platinum: For in-network, members pay either a coinsurance percentage or a daily copay up to a maximum amount. Out-of-network programs may be covered, but they require a higher coinsurance percentage with the deductible.

How Can I Pay for Costs that My Highmark BCBS Health Plan Won’t Cover?

Rehab costs are the primary hurdle for many individuals who need substance abuse intervention. Insurance helps reduce the financial burden significantly, but it will not eliminate every treatment expense. However, whatever you pay for recovery is only a fraction of the costs of continued addiction.

You may be able to take advantage of these and other sources of financial assistance for SUD recovery:

• Sale of assets
• Community, state, or federal government programs
• Secondary health insurance
• Rehab scholarships
• Crowdfunding
• Bank loan

Please call us at Crest View Recovery Center even if you are unsure about how to pay for treatment. Our advisors can discuss financing options that you may not have considered. We are here to help you achieve freedom from addiction.

How Do I Verify Highmark BCBS Coverage for Drug Rehab?

Exploring rehab centers, weighing costs, and combing through insurance plans can be overwhelming for a person or family battling addiction. If you need guidance with understanding your addiction rehab coverage under a Highmark policy, reach out to us at Crest View Recovery Center.

Rehab Can Help You

According to the American Society of Addiction Medicine (ASAM), addiction is a chronic but treatable medical illness. The ASAM states that prevention and treatment programs are typically as effective as those for other chronic conditions. Verify your Highmark Blue Cross Blue Shield coverage today with our team at Crest View Recovery Center.

About Crest View Recovery Center

Crest View Recovery Center is a skilled addiction treatment facility located in Asheville, NC. CVRC blends conventional rehab programs with reality therapy to create customized plans for each patient. Nestled among the highest peaks of the Blue Ridge Mountains, our community surrounds you with natural beauty and tranquility to restore and inspire change within you.

You can face the world again with the physical, mental, and spiritual strength to overcome addiction. The National Institute of Drug Abuse states that your treatment program is one of the most critical factors in your recovery. Contact Crest View Recovery Center now at (866) 986-1371 and let us help you get started with your new, addiction-free life.

 

References:

https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report 

https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHFFR2017/NSDUHFFR2017.htm#cooccur2 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308192/pdf/AJPH.2016.303558.pdf