Will BlueCross BlueShield Cover The Cost of Rehab?

Choosing to change your life and enter rehab isn’t an easy decision, and it takes enormous courage to make that choice. Be proud, because it means that you and your loved ones can look forward to a happy future, free from the confines of addiction. While the path to recovery begins here, there are likely many questions you’re looking to answer. Everyone worries about finances, and the cost of rehab is often a cause for concern.

However, It doesn’t have to be. The Affordable Care Act dictates that every insurance plan should cover the cost of rehab to some extent. If you’re wondering, “Does BlueCross BlueShield cover alcohol rehab?” the answer is yes. The exact coverage you’re entitled to depends on several factors, including where you live and the plan you’ve been paying for.

BlueCross BlueShield recognizes the importance of treatment for drug and alcohol addiction and covers some costs of the following levels of care:

  • Inpatient hospitalization
  • Partial hospitalization
  • Detoxification
  • Outpatient treatment

Is Being In-Network Necessary?

When you’re researching how much of your cost is covered, it’s crucial to find out whether you have a PPO (Preferred Provider Organization) or HMO (Health Maintenance Organization) plan. With a PPO, you have access to more health care providers across the country, whereas, with an HMO, you’ll have to make sure your treatment center is HMO-contracted.

A PPO also lets you visit an out-of-network facility, but the amount you’re expected to pay would be higher. We’d recommend speaking to your insurance provider if you have any questions about exactly what type of plan you have.

Plan Options

Different states have different regulations and laws, so your plan will invariably depend on where you live. The way you’re covered will also be affected by the type of facility you receive treatment in — a rehab center, doctor’s office, or hospital.

A rough outline of how your insurance costs may be worked out depending on which type of plan you have follows.


As the policyholder, you’ll pay the minimum per month for this type of coverage. It carries the minimum deductible for in-network providers and usually doesn’t cover out-of-network programs.


For in-network services, you’ll pay a coinsurance percentage as well as the plan’s deductible. A silver plan doesn’t usually cover programs that are out of network.


You’ll usually pay a smaller coinsurance percentage than you would with a silver plan, as well as meeting the deductible. Most of the time, a gold plan doesn’t cover out-of-network services.


Platinum plans usually offer the policyholder a range of coinsurance percentages or co-pays for anything network. For instance, you may have a co-pay per day capped at a specific price point. In some cases, your policy may cover out-of-network centers, but the coinsurance percentage or deductible is usually higher.

Other Considerations

BlueCross BlueShield provides a Federal Employee Program, which has two levels, basic and standard. The level of care you receive varies depending on which type of plan you have. For instance, if you get outpatient care, the standard option covers around 15% of the plan allowance. The basic option usually requires you to pay a co-payment per day for each facility you attend.

If you require inpatient treatment, the standard option starts at $35 per admission, with no limit on the number of days. The basic option requires a co-payment of around $175 each day, capped at $875 for unlimited days. There might be an increase or decrease in the co-payment amount, depending on the plan you have.

Do I Need to Pay Costs Not Covered?

Getting into recovery doesn’t have to mean depleting your savings or spending a fortune. While you’ll usually need to meet the deductible before your insurance policy starts paying out, there are several ways you can cover any additional costs.

There are options for credit cards and personal loans you can take out to help with the financial aspects of rehab, including options that are specifically for the health industry. Additionally, more and more people who are looking for help with the cost of recovery are turning to crowdfund. There are websites where you can set up an account to request small donations from charitable people to help with your cause.

Get Back on Track With Holdfast Recovery

Money often causes people to hesitate when thinking about starting a rehabilitation program but don’t let it hold you back. If you need further advice about how much coverage your individual insurance policy provides, speak to one of the friendly advisers here at Holdfast Recovery by calling us at (800) 680-7738 today.