Does CareFirst BCBS Insurance Cover Inpatient Alcohol & Drug Rehab Centers?

If you live in Maryland and are struggling with addiction, you may be wondering how you can recover and overcome your addiction. While the path looks different for every single person, many do enter rehab, whether that be at an inpatient alcohol and drug rehab center or an outpatient alcohol and drug rehab center, in order to get treatment for their addiction. Like any healthcare service, though, getting treatment for a substance use disorder can come at a cost.

Fortunately, under the Affordable Care Act, almost all U.S. health plans are required to provide some level of coverage for mental and behavioral health services, including treatment for substance use disorder.¹ This means that if you have a CareFirst BCBS health insurance plan, you may be able to use it to help cover some or all of the costs associated with addiction treatment.

To find out whether your plan covers the costs of inpatient alcohol and drug rehab, or other types of addiction treatment, you can call the number on the back of your insurance card. You can also reach out to American Addiction Centers (AAC) through different channels, such as chats or phone, for help in verifying your benefits and coverage. You can also enter your information in the form below for instant benefits verification.

How to Find CareFirst BCBS Covered Inpatient Drug Treatment Centers?

Depending on the CareFirst BCBS plan that you have, you may be required to attend an in-network facility in order to have your plan cover any of the costs associated with treatment, which could include inpatient drug treatment centers. That’s why it’s so important to find covered drug treatment centers under your plan when you’re seeking care.

AAC is here to help you find a covered outpatient or inpatient drug or alcohol treatment center near you. Our trained staff can also check whether your insurance plan is accepted at one of the top-notch treatment facilities owned and operated by AAC throughout the country. To get started, call the AAC helpline today to speak to a trained staff member who can help you check your benefits right while you’re on the phone.

What Is CareFirst BCBS Insurance?

The Blue Cross Blue Shield Association, CareFirst BCBS’s parent company, is a national association of independent licensees of the BCBSA brand.² There are 34 total independent licensees, which are community-based and locally operated companies that represent the BCBS name.² Collectively, the BCBSA serves 114.5 million people across all 50 states, Puerto Rico, and the District of Columbia.²

In Maryland, BCBSA is licensed by CareFirst BCBS.³ More specifically, CareFirst BCBS is the Mid-Atlantic region’s largest not-for-profit health insurance plan company, serving residents of Maryland, Washington, D.C., and northern Virginia.⁴ CareFirst BCBS has been in business for 85 years and currently serves 3.6 million members.⁴ Covered members have access to the largest network for medical, dental, and vision insurance.⁴

Specifically, having a CareFirst BCBS insurance plan gives members access to millions of providers in the United States and more than 90% of specialists and doctors in Washington, D.C., Northern Virginia, and Maryland.⁴

There are many different types of plans that CareFirst BCBS offers, including individual plans, group plans (i.e., employer-sponsored health plans, private plans), Medicaid plans, Medicare plans, student health plans, dental plans, and prescription drug plans.⁴ Every plan is different, so it’s best to look on your insurance card to find out what type of plan you have, and call the number on the back of your insurance card to find out what your plan may cover.

What States Does CareFirst BlueCross BlueShield cover?

CareFirst BCBS covers residents of Maryland, Washington, D.C., and northern Virginia and their families. ^{4 para 1} Specifically, in Virginia, residents of the cities of Alexandria and Fairfax, Arlington County, and the town of Vienna have access to CareFirst BCBS plans. Covered members have access to 1.7 million U.S. providers as part of the CareFirst BCBS networks.⁴

How Much Does CareFirst BCBS Cover (Addiction Treatment)?

When it comes to determining how much your CareFirst BCBS health plan covers in regard to addiction treatment, the plan that you have, the care you need, and where you seek care will have a significant impact. Depending on your plan, you may have partial or full coverage for the following treatment methods:

• Inpatient or residential rehab. Patients who are in an inpatient or residential rehab program will receive round-the-clock medical supervision for the duration of their care, as they will live at the facility until their program is over.⁵
• Outpatient rehab or therapy. Patients who are in an outpatient therapy or rehab program will travel to a facility 1 or 2 times a week, or less frequently, where they’ll have counseling or therapy sessions, and then they’ll return home afterward.⁵
• Intensive outpatient programs (IOPs). Patients who are in an IOP generally must attend a minimum number of hours of outpatient care each week, but they are not required to stay overnight or live in the facility.⁵
• Partial hospitalization programs (PHPs). Patients who are in a day program, which is what a PHP is commonly known as, attend 4–8 hours of treatment a day, multiple days a week. However, no overnight stay is required with a PHP.⁵

Please keep in mind that despite these treatment methods being listed above, it is not guaranteed that they will be recommended to you for your journey to recovery. In similar fashion, it is not guaranteed that they will be covered under your health insurance plan through CareFirst BCBS. Be sure to call the number on the back of your insurance card to learn more about the various addiction treatment methods that may be covered under your plan.

Does CareFirst Blue Cross Blue Shield provide coverage for mental health facilities?

Mental health facilities are essential to providing addiction treatment services, and due to the ACA’s mandate, mental health services rendered at such facilities must be covered in some capacity by almost all health plans in the country.¹ This means that if you need mental health care and treatment, such as stand-alone heroin rehab or co-occurring disorder treatment, it may be fully or partially covered under your health plan.¹

If someone has both a mental illness and substance use disorder at the same time, it’s known as a co-occurring disorder or dual diagnosis.⁶ The 2 conditions are said to be interconnected and influential to the other, as someone who has a mental illness is twice as likely to develop a substance use disorder during their lifetime, and vice versa.⁶

Because of the connected nature of the 2, tandem treatment, where each condition is treated during the course of rehab, is recommended.⁶ Thanks to the terms of the ACA, most health plans are required to cover such services.

Does CareFirst Blue Cross Blue Shield cover addiction treatment therapies?

CareFirst BCBS may cover a variety of addiction treatment therapies. Coverage is unique to your specific plan and may be subject to various out-of-pocket costs, such as deductibles, copays, and coinsurance. You may owe these out-of-pocket costs before your insurance coverage fully kicks in. However, every plan is different. To find out what is and is not covered under your health plan, call the number on the back of your insurance card.

How Long Does CareFirst BCBS Insurance Cover Alcohol and Drug Rehab programs?

It’s important to know that how long you stay in rehab, per the guidance of your mental healthcare provider, is essential to the overall success of your recovery. While every person is different, most experts believe that longer treatment times are generally considered to be the most effective.

Specifically, it’s recommended that treatment lasts at least 90 days to improve overall outcomes and reduce or stop drug use.⁷ Be sure to work with your healthcare provider to determine how long you should remain in rehab.

You should also work with your insurance plan to find out how long treatment may be covered under your health plan. You can look up your own plan information on your insurance card, and you can call the number on the back of your insurance card. Your plan representative can walk you through your plan’s benefits and coverage details.

What if my CareFirst BCBS policy does not cover an inpatient drug rehab program?

Depending on your CareFirst BCBS policy, your plan may not cover the costs associated with an inpatient drug rehab program. However, if this happens to you, you may have alternative payment options based on the rehab center you choose.

Some rehab centers provide financing or scholarship options to program enrollees that can help offset the costs of care. Be sure to ask rehab staff if this option is available to you. Remember that getting the treatment you need right now—rather than pushing it down the road—is best.

CareFirst BCBS In Network vs. Out of Network Inpatient Drug Rehab Centers

Knowing the difference between in- and out-of-network inpatient drug rehab centers can help you save money on your healthcare costs. A network refers to a group of providers or facilities that work with your CareFirst health plan to provide care at predetermined rates, which are often less expensive than out-of-network providers.⁸

CareFirst’s network is vast, boasting over 1 million physicians, hospitals, care centers, and facilities.⁹ To find a provider that’s within your network, use CareFirst’s Find a Doctor tool or call the number on the back of your insurance card.⁹

Rehabs That Take Blue Cross Blue Shield Insurance 

American Addiction Centers (AAC) has various rehab facilities around the country that provide drug and alcohol addiction treatment. If you have a Blue Cross Blue Shield insurance plan, the following AAC facilities accept Blue Cross Blue Shield for drug and alcohol addiction rehab.

• AdCare Rhode Island: With various facilities located in Rhode Island, AdCare provides innovative, quality, and cost-efficient addiction treatment. Its integrated system of care offers an inpatient treatment center in North Kingstown and a network of outpatient offices throughout Rhode Island. AdCare’s continuum of care includes detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, inpatient and outpatient services, and tele-health.
• Desert Hope Treatment Center: Located in Las Vegas, Nevada, Desert Hope provides individualized care programs as well as offering a full continuum of care including detox services, residential treatment dual-diagnosis treatment, intensive outpatient services, and tele-health.
• Greenhouse Treatment Center: Located in Grand Prairie, Texas, Greenhouse offers individualized treatment plans and many levels of care including detox services, residential treatment, dual-diagnosis treatment, intensive outpatient services, outpatient services, and tele-health, all in a luxurious setting with high-end amenities.
• Laguna Treatment Center: Located in Orange County, California, Laguna is a chemical dependency recovery hospital that focuses on treating people who are medically compromised and need 24/7 oversight. Provided care includes detox services, residential treatment, dual-diagnosis treatment inpatient treatment, and intensive outpatient services.
• Oxford Treatment Center: Located in Etta, Mississippi, Oxford offers gender-specific rehab while offering an opportunity to connect with nature and try new activities. Provided care includes detox, residential treatment, dual-diagnosis treatment, inpatient and outpatient treatment, intensive outpatient services, and tele-health, all with individualized treatment programs.
• River Oaks Treatment Center: Located in the Riverview, Florida, River Oaks offers comprehensive addiction treatment for individuals struggling with addiction and co-occurring disorders. River Oaks is a Blue Cross Blue Shield Blue Distinction Facility, in recognition of their expertise in high-quality care for addiction treatment.

There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs. You can search by location and filter by Blue Cross Blue Shield insurance.

How to Verify CareFirst BCBS Insurance Coverage for Drug Rehab Centers?

If you have a CareFirst BCBS insurance plan and are in need of addiction treatment services, AAC is here to help you take the first step. Call our helpline today and speak to a person who can verify your benefits for you right while you’re on the phone. We can help you learn more about your CareFirst BCBS health benefits and find a covered AAC facility or local rehab center to get started on your path to recovery today.