CareFirst BCBS Rehab Coverage
CareFirst Blue Cross Blue Shield is one of many independent insurance providers under the national network of Blue Cross Blue Shield (BCBS) insurance companies. To get a CareFirst BCBS plan, contact your nearest Blue Cross and Blue Shield Association in Washington, D.C., Northern Virginia, or Maryland.
Although a CareFirst BCBS insurance plan is only available to people living or working for a company in the states or regions mentioned above, it offers coverage in every state. All CareFirst BCBS health insurance plans cover some mental health and addiction treatment services. Nevertheless, the amount covered varies depending on your location and the chosen plan.
Do you need to find an insurance plan for yourself or a loved one that covers the cost of addiction centers? f you’re unsure about the specifics of your insurance coverage for drug and alcohol rehab, reach out to our team at Zinnia Health by calling (855) 430-9439. Our helpline is completely free and available 24 hours a day.
Does CareFirst BCBS Insurance Cover Alcohol Rehab?
The Affordable Care Act established certain essential benefits for insured individuals, and alcohol rehab and substance abuse treatment are considered essential care services. Almost every insurance carrier, including CareFirst BCBS, must cover at least a portion of the costs associated with rehab for substance abuse, alcohol abuse, substance use disorder (SUD), and other treatments.
Alcohol addiction sometimes requires detox before beginning an outpatient program, so you may need to consider things like per-visit copays. There may also be a limit on the number of visits per policy period. If you exceed your visits, you may have to pay out of pocket.
Does CareFirst BCBS Insurance Cover Substance Abuse Treatment?
CareFirst BCBS plans offer insurance benefits to cover both inpatient and outpatient substance abuse treatment programs. Substance abuse treatment often involves an inpatient program, but it’s important to consider exclusions and restrictions. For instance, the rehab center may need to request prior authorization before providing services.
Actual coverage can be as much as 90% of total treatment costs but vary by plan.
Does CareFirst BCBS Cover Mental Health Treatment?
CareFirst BCBS plans offer coverage for mental health treatment. However, coverage for substance abuse and mental health services is in the same category and share coverage on your plan, so this might mean that drug rehab could reduce your coverage for mental health services. Health benefits generally reset at the start of a new policy period.
CareFirst BCBS Inpatient Coverage
The level of coverage provided by CareFirst BCBS for inpatient treatment options depends on your plan. However, your insurance will pay some portion of your inpatient treatment costs. There is no out-of-network care for some plans, such as any CareFirst Gold level HMO plan.
Many health insurance providers, including CareFirst Blue Cross Blue Shield, limit coverage of certain services. For instance, hypnotherapy and outdoor camps, even if aimed at helping people with mental health or substance use disorders, aren’t covered.
CareFirst BCBS Outpatient Coverage
Outpatient treatment is covered for those with a BCBS health insurance plan, but the coverage level depends on your CareFirst plan type. If you don’t have a plan yet, there are several CareFirst BCBS plan types.
When assessing these benefits, it’s important to consider coverage caps. For instance, some plans may not cover any out-of-network doctor visits at all, while others have a cap on the number of visits or “stays” per policy period.
Intensive outpatient programs, or partial hospitalization programs (PHPs), sometimes require several appointments each day or week.
If you need assistance finding your insurance coverage information, reach out to a compassionate admissions specialist at Zinnia Health by calling (855) 430-9439. With your permission, we can contact your insurance company on your behalf and find out your exact levels of coverage.
Rehabs That Accept CareFirst Blue Cross Blue Shield Insurance Near You
Regardless of its state of origin, Blue Cross Blue Shield coverage applies across the nation. If you’re looking for an in-network facility that accepts CareFirst BCBS insurance, look for an inpatient or outpatient rehab facility near you operated by Zinnia Health.
We have convenient locations around the country that are in-network with Blue Cross Blue Shield.
- Zinnia Health Miami | Miami
- Zinnia Health Lake Okeechobee | Pahokee
- Zinnia Health Deerfield Beach | Deerfield Beach
If you would like to speak with a treatment specialist who can help you find in-network drug and alcohol rehab programs in your area, reach out to Zinnia Health at (855) 430-9439 to learn more.
How to Check Your CareFirst BCBS Coverage
With 32 independent providers in the national Blue Cross Blue Shield insurance network, you must get direct answers from your CareFirst BCBS insurance provider. You can use the official Blue Cross Blue Shield website to do so.
- Find your BCBS insurance card. You will need to know the first three characters of the Identification Number shown on your card.
- Head to the Member Benefits page on the Blue Cross Blue Shield website. Enter your three-character prefix into the search bar.
- You will be taken to your state’s BCBS provider website. From here, you can search and compare plans or log in to your account to view your benefits.
If you’re having trouble using this online service, it’s best to directly contact your state’s BCBS provider. The phone number is on your CareFirst BCBS identification card.
If you don’t have an insurance card, contact BCBS Customer Service.
Types of CareFirst BCBS Plans That Cover Addiction Treatment
All Blue Cross Blue Shield health insurance plans cover addiction treatment, but the coverage amount varies depending on the type of plan.
- Bronze plans typically cover 60% of the costs of most services, including mental health and substance use disorder treatment. This means you’re responsible for 40% of the costs.
- Silver plans typically cover 70% of the costs of most services, including mental health and substance use disorder treatment. Your responsibility will be 30% of the costs.
- Gold plans typically cover 80% of the costs of most services, including mental health and substance use disorder treatment. You’ll be responsible for 20% of the costs.
These plan tiers align with the standards set by the Affordable Care Act. However, your Blue Cross Blue Shield plan may cover substantially more, depending on variables like your deductible, your coinsurance costs (if any), and whether you have vision or dental care included in your plan.
In addition to checking your coverage, you also need to assess your annual deductible, out-of-pocket maximum, and access to out-of-network services. For instance, if your plan has an annual deductible of $1,500, you may need to pay that much yourself before you unlock full coverage. However, your insurance policy will begin covering all your costs when you reach your out-of-pocket maximum (which includes your deductible).
Frequently Asked Questions
What Length of Stay Will CareFirst Cover?
There are caps on how long you can stay in an inpatient facility and how many outpatient visits you can make each calendar year. These limits vary from one plan type to the next, which is why it’s important to contact your local Blue Cross Blue Shield Association for more information about your benefits.
How to Pay for Costs CareFirst Doesn’t Cover?
Insurance rarely covers 100% of treatment costs for drug and alcohol abuse, opioid treatment programs, or any other type of treatment. If you’re worried about covering the out-of-pocket expenses, like copays, deductibles, treatments that BCBS may not cover, or other terms of your policy, speak directly to the treatment facility.
Many offer payment plans, and grants and other programs may cover out-of-pocket expenses.
What to Do if CareFirst Doesn’t Cover Rehab?
CareFirst BCBS covers some costs of rehab, behavioral health, or mental health types of co-occurring disorders, and healthcare for other health conditions in most cases. However, it might not cover certain facilities, especially those that employ nontraditional techniques.
If you have chosen a treatment provider but are worried about the cost of drug or alcohol recovery, speak to the treatment center. They can give you information on grants, payment options, and alternatives to ensure you get the care you need.
Do Rehab Facilities Need to Be In-Network?
The type of health insurance plan you have will determine whether an inpatient rehab center needs to be in-network. With HMO plans, you will only receive coverage if you see someone in your network. With PPO plans, you have some coverage for all providers, but you will have less coverage for those out of network.