Does Blue Cross Cover Drug Rehab in California?

November 6, 2015 - - 0 Comments Does Blue Cross Cover Drug Rehab in California?

Although substance abuse treatment is being widely covered by today’s major health insurance providers, there are a few that don’t offer any assurances. Blue Cross, however, does have an extensive policy of covering addiction treatments within specific parameters. It’s important that you can read and understand all of your policy’s coverage details before selecting a rehab for yourself or a loved one.

Understanding Your Policy

For many people, a health insurance policy is a long list of items that they may never use. You may just be concerned about the main medical items, such as physicals and basic doctor’s visits. To find your possible drug rehab coverage, look for the section marked as “Behavioral Health.” This section may seem like it should be for psychological coverage only, but insurance companies usually list addiction treatment in this area. The subheading “Substance Abuse” is where you’ll find the core details of rehab coverage.

Medical Necessity Required

Similar to most insurance companies, Blue Cross of California requires you to have a medical necessity designation to your rehab treatment. Medical necessity means that your health will continue to decline at a rapid pace without the rehab treatment. Ideally, your personal doctor should make this diagnosis, so that this visit is covered under the insurance policy too. If you’re not mentally or physically damaged by drug use, rehab won’t usually be covered by Blue Cross.

Inpatient, Residential and Outpatient Qualifications

As you read through the Blue Cross coverage information, you’ll notice several treatment designations. An inpatient service is the most serious treatment because it involves 24-hour monitoring at the rehab facility by qualified personnel. Blue Cross differentiates between inpatient and residential rehab treatments too. Residential rehab may require you to be at the facility 24-hours-a-day, but you aren’t monitored as closely as the inpatient type. Every treatment type, including outpatient, has a long list of required items that must be fulfilled by medical personnel. Once those items are completed at the facility, Blue Cross will pay out the claim.

Locating a Treatment Center

Your Blue Cross of California policy usually covers most of the major treatment centers in the state. However, it’s always a smart idea to verify each facility individually, so that your insurance policy can pay out to its fullest. Blue Cross can offer you a list of centers either by calling them or logging in online.

If you have any more questions about Blue Cross coverage, you’re welcome to give us a call. We can decipher your policy and show you all of the details. Our professionals can even point you in the right direction if you require alternative help. You can find a way toward sobriety with a little help from your loved ones and our expert advice.

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