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Blue Shield of California Opioid Detox and Rehabs Near Me

On this page, you will learn about Blue Shield of California health insurance coverage for substance abuse treatment and how to confirm what benefits are available under your specific plan.
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Blue Shield of California COVERAGE FOR Opioid REHAB PROGRAMS

Provider Overview

Blue Shield of California: Insurance Coverage for  Opioid Rehab

The opioid epidemic is sweeping the nation, and California is no exception. Every year, over 2,400 people in California die from overdosing on various forms of opioids. In over 45% of cases, prescription opioids are the cause of death, followed by 36% of deaths involving synthetic opioids and 32.4% of deaths caused by heroin.1

Most people who want to get treatment for their substance use disorder (SUD) don’t receive the necessary care because they can’t afford it. Fortunately, most insurance providers offer coverage for those struggling with addiction.2

In 2011, over 21% of people who wanted treatment opted for Medicaid insurance, while a little over 10% opted for private insurance programs like Blue Shield California insurance coverage.2

All health insurance providers are required to provide coverage for mental health and substance use disorder treatment the same as they would for any other medical condition. Therefore, the implied answer to “Does Blue Shield cover drug rehab“, is yes.3 In fact, close to 56% of treatment centers in California accept Blue Shield and other private insurances.4

What Opioid Treatment Services Does Blue Shield of California Insurance Coverage Include?

Blue Shield California insurance coverage follows the same principles and limitations as medical and surgical benefits since mental health and addiction have to be considered equally important as physical health.5

When it comes to addiction treatment in California, Blue Shield may cover some or all of the following:6

  • Screening and professional interventions. These evidence-based procedures help identify patients who abuse opioids at dangerous levels and are usually performed at the treatment centers.
  • Detox. This is the first step in the drug rehabilitation program following the intake procedure. It ‘s the process of cleansing the body of all traces of opioids. Detox can be difficult and uncomfortable due to withdrawal symptoms, but it’s essential for overcoming addiction. It may take anywhere from a few days to over a week.
  • Inpatient treatment. Inpatient treatment is a process in which a patient is admitted to a facility and monitored around the clock. This type of treatment is often reserved for people with severe opioid addiction who cannot safely overcome it on their own.
  • Outpatient treatment. Outpatient treatment is a great option for those who don’t need intensive care but still need assistance with their addiction. It may be a more affordable option than inpatient treatment, and it allows patients to continue living at home while they receive treatment.
  • Behavioral therapies. Behavioral therapies are designed to help people change their behaviors related to drug use. Behavioral therapies can help people learn how to resist cravings, deal with stress and emotions without using drugs, and set goals for their lives.
  • Treatment for co-occurring disorders. People with a dual diagnosis of SUD and a mental health issue require a special type of treatment. Treating co-occurring disorders is most effective when both disorders are addressed simultaneously. Some common treatments for co-occurring disorders following initial assessment include medication, therapy, and self-help groups.

Blue Shield insurance coverage in California includes 22 locations across the state. The main headquarters is in Oakland, and the company employs more than 7,500 employees.7

Are There Services Blue Shield of California Won’t Cover?

While most standard treatment amenities are included in the Blue Shield of California insurance coverage, certain elements of treatment are considered non-essential and are not covered by insurance. These include:5

  • Recreational activities
  • Non-medical services
  • Delivery services for food
  • Private treatment amenities
  • Alternative treatments
  • Holistic health care

How Much Does Opioid Rehab Cost?

The cost of opioid rehab can vary depending on a number of factors, including:3

  • The exect services included in the plan.
  • The intensity and scope of treatment.
  • How long a treatment program lasts. 
  • Whether additional amenities such as same-day admittance are included. 

Depending on the treatment used to combat opioid addiction in various certified opioid treatment programs, the prices can range from $126 to $1176.50 per month or $6,552 to $14,112 on an annual level.8

How Much Is Opioid Rehab at Inpatient Facilities?

Inpatient opioid rehab, also known as residential treatment, involves admitting the patient full-time at a facility while participating in a recovery program. The costs of inpatient treatment are higher than those of outpatient programs since the patient has continuous access to medical care and caregivers 24/7 for the duration of their stay.6

Inpatient rehab programs offer a high level of care for people struggling with opioid addiction and other mental health disorders. The length and cost of inpatient rehab can vary depending on the level of care needed, ranging from 30 to 90 days or more. Inpatient rehab is often the best option for people who require a high level of care, have a severe addiction, or have relapsed.6 

How Much Is Opioid Rehab at Ourpatient Facilities?

Outpatient rehab is a less restrictive and less expensive type of opioid treatment. It allows patients to stay and home and perform their daily activities while receiving adequate treatment. Treatment can consist of counseling, individual or group therapy, and support groups. Outpatient therapy aims to support patients in recovery while teaching them valuable skills and coping mechanisms.In the long run, outpatient treatment has proven both efficient and cost-effective.9

How Much Is Opioid Rehab in Opioid Partial Hospitalization Programs (PHP)?

Partial hospitalization programs (PHP) are a form of outpatient treatment in which a person receives daily treatment at a facility for a set number of hours each day. PHP can provide a person the level of care they need while still allowing them to live at home.10 

The cost of a PHP depends on your specific needs and level of care. It may include meeting with your counselor daily in the treatment facility for 6 hours, access to hospital services and facilities, and various forms of behavioral and medication therapy.10

How Much Is Medication-Assisted Treatment (MAT)?

The cost of medication-assisted treatment or MAT can vary depending on a variety of factors. Addiction coverage may be different depending on your insurance company and what type of plan you have. The price of MAT may also vary depending on the provider you go to for treatment: a doctor’s office or an inpatient facility.11

In general, the weekly MAT costs based on the treatment prescribed cost are:8

  • $126 for methadone treatment.
  • $115 for Suboxone/Buprenorphine treatment.
  • $1,176.50 per month for Naltrexone treatment.

All treatment prices include medication, administration, therapy, counselor meetings, and related services.8

What About the Cost of Opioid Rehab vs. Opioid Addiction?

The cost of rehab can be a deterrent for some people when considering treatment for substance abuse, as only 18.5% of those who require treatment actually get it. However, Blue Shield of California insurance coverage may include some aspects of addiction treatment. The cost of treatment shouldn’t keep you from seeking help for your problems.6

Substance abuse can have a significant impact on your finances, as well as your health and quality of life. Treatment is an investment, but it’s one that can pay off, in the long run, considering opioid abuse can affect your quality of life, relationship, and mortality.6

The cost of substance abuse is significantly greater than the cost of treatment for substance abuse. Annual treatment for substance abuse costs an average of $1,583 per person, while the average cost of opioid abuse per year is roughly $11,487.12  Please note that this is an approximate figure and that treatment costs depend on the factors mentioned above.

The social and economic toll of illicit drug use in the United States is significant. In 2007, it cost the country an estimated $193 billion. This includes public health costs, crime costs, and lost productivity. Substance abuse treatment can offset these costs in the long run. On average, for every dollar spent on substance abuse treatment, $4 is saved in healthcare costs, while $7 is saved in law enforcement and criminal justice costs.12

What Opioid Treatment Length Does Blue Shield of California Cover?

There are no “one-size-fits-all” solutions when it comes to treatment length, as different patients will progress through their opioid addiction treatment at a different pace. However, good treatment outcomes are proportionate to the length of the treatment.13

Generally, participation in inpatient or outpatient treatment for less than 60 days is of limited effectiveness, and significantly longer treatment or participation in an aftercare program are required for long-term positive outcomes.13

There are many different types of policies and tiers of coverage, so the length of time that a person is covered by Blue Shield California insurance will depend on their specific plan and benefits included within.3,5 

You can learn more about your Blue Shield insurance plan and what it entails through the information on your insurance card or by contacting the Blue Shield California helpline. If you are looking for information on whether your insurance will cover a specific facility within the American Addiction Centers network, admissions navigators can verify your insurance via a phone call.

Should I Choose Inpatient or Outpatient Treatment?

The inpatient facility may be more expensive but worth the investment. The setup of a residential program has staff living on-site and patients who can’t or won’t leave their rooms 24/7. This level of care ensures that each person receives all the treatment needed to overcome addiction and withdrawal symptoms, get a full night’s sleep, and be protected from environmental triggers (such as drug-using friends) that may interfere with their recovery.13

Recovering individuals looking for outpatient programs will have to negotiate time for medical appointments whereas those in residential facilities don’t need to spend any extra time away from treatment unless they want to take advantage of the onsite amenities offered.13

In general, inpatient treatment offers various benefits that improve the chances of long-term recovery including:13

  • Better quality of care and easy and continuous access to essential tools and resources needed for recovery.
  • A treatment-focused ecosystem, free of distractions and temptations.
  • Support from both medical professionals and peers in recovery.
  • A more focused and structured environment.
  • Increased accountability.

How to Use Blue Shield California Insurance For Opioid Rehab?

If you are considering getting treatment and wondering how to use Blue Shield California insurance for opioid rehab, the process is the following:3

  • Consult your doctor about your opioid addiction. They are likely to recommend an inpatient treatment program based on your assessment.
  • Find a suitable treatment center through Blue Shield California helpline or via resources such as SAMHSA.
  • Ask your insurer about coverage for substance abuse by calling the number on the back of your insurance card or visiting their website.
  • Work with the chosen rehab center to determine coverage. You can reach out to AAC’s alcohol and drug rehab hotline to talk to their admissions navigators who can help you confirm your insurance benefits and verify your coverage with Blue Shield.

What Opioid Rehabs Accept Blue Shield of California Insurance?

Over 700 treatment centers in California alone accept private insurance policies and are in-network with Blue Shield insurance. Almost 4.5 million people in California are covered by Blue Shield of California‘s policies for SUD treatment.

There are several ways you can see if you’re eligible for some of the in-network Blue Shield inpatient drug rehab centers in California or across the state. The first step to getting help is calling their hotline, but if that number isn’t accessible or if you would like to check what additional benefits or what other payment options are available, American Addiction Centers will verify your insurance and check what other payment options such as financing might work for you. When it comes to recognized AAC facilities, Laguna Treatment Hospital is one of the in-network Blue Shield California addiction treatment options available.

Laguna Treatment Hospital

Laguna Treatment Hospital is located in Orange County, CA. This treatment facility focuses on treating people who require continuous care due to the severity of their addiction. This local center employs MAT as well as different behavioral therapies.

The treatment center provides:

  • A safe and professional medical detoxification.
  • Residential rehab program with MAT assistance.
  • Various aftercare tools and programs to ensure long-term recovery.
How to Read Your Insurance Provider Card
  • 1Insurance Provider Name
  • 2Policy Member's Full Name
  • 3Policy Membership/Subscriber ID
  1. National Center for Drug Abuse Statistics. Opioid Epidemic: Addiction Statistics.
  2. Substance Abuse and Mental Health Services Administration. (2011). Health Insurance Status of Adult Substance Abuse Treatment Admissions Aged 26 or Older: 2011.
  3. Find Paying for Treatment.
  4. Substance Abuse and Mental Health Services Administration. (2018). National Survey of Substance Abuse Treatment Services (N-SSATS): 2017. Data on Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  5. Mental health & substance abuse coverage.
  6. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction DrugFacts.
  7. Substance Abuse and Mental Health Services Administration. (2018). National Survey of Substance Abuse Treatment Services (N-SSATS): 2017. Data on Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  8. National Institute on Drug Abuse (2021) How much does opioid treatment cost?
  9. Mojtabai, R., & Zivin, J. G. (2003). Effectiveness and cost-effectiveness of four treatment modalities for substance disorders: a propensity score analysis. Health services research.
  10. Center for Substance Abuse Treatment. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Treatment Improvement Protocol (TIP) Series 47. DHHS Publication No. (SMA) 06-4182. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  11. Substance Abuse and Mental Health Services Administration. (2022) Medication-Assisted Treatment (MAT)
  12. Office of National Drug Control Policy. (2012). Cost benefits of investing early in substance abuse treatment.
  13. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide, Third Edition.
  14. National Institute on Drug Abuse. Opioids.
  15. American Chronic Pain Association (2017) ACPA Resource Guide To Chronic Pain Management; An Integrated Guide to Medical, Interventional, Behavioral, Pharmacologic and Rehabilitation Therapies

Check Your Policy Coverage

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Frequently asked questions

What Does Opioid Refer To?
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and others.14 All opioids have a similar chemical composition and trigger opioid receptors. Opioid pain relievers (OTR) work by binding to the body's or brain’s natural receptors for endorphins which may produce a sense of euphoria as well as pain relief. OTRs can be addictive even when taken as prescribed due to their sedative effects on the central nervous system. This effect also increases rates of accidental overdoses and death incidences.14
Should I Choose Residential Opioid Rehab Over IOP?
Inpatient drug rehab treatment generally involves a residential stay in a rehab facility. Patients receive around-the-clock care and supervision and are able to focus exclusively on their recovery. This can be an effective way to overcome addiction, especially for those who have struggled with relapse in the past.6 Intensive outpatient treatment, or IOP, is a relatively new and innovative form of treatment for individuals with mental health issues. It’s an outpatient program that offers a high level of care, typically more than what is available in an outpatient setting. IOPs can be very beneficial for people who are unable to attend traditional inpatient treatment programs.10 IOPs usually offer a range of services, including individual therapy, group therapy, and medication management. They also offer support for family members and caregivers. IOPs can be very helpful for people who are struggling with a mental illness but are not able to commit to inpatient treatment.10 Inpatient facilities are more expensive but offer a number of benefits that can improve the chances of long-term recovery. There are many benefits, such as improved care, easier access to recovery tools and resources, a distraction-free environment free from temptation, support from both medical professionals and peers in recovery, and increased accountability.13 Concerning opioid addiction treatment, there is no universal treatment length that will guarantee complete recovery for everyone. Treatment length will vary from patient to patient, as each individual will progress through treatment at a different pace. Still, positive treatment outcomes are linked to treatment length. In general, treatment programs under 60 days have shown limited results, and long-lasting positive outcomes require longer treatments or an aftercare program.13
What’s the Best Treatment for Opioid Use Disorder?
Two different medication options are effective in treating opioid addiction: a combination of buprenorphine and naloxone and extended-release naltrexone. However, since naltrexone requires complete detoxification starting active users on this treatment may prove to be difficult. These medications help many people recover from opioid addiction.14
How Long Does an Opioid Take to Work?
Opioids are a class of drugs that relieve pain. They work by attaching to opioid receptors in the brain. There are two types of opioids: short-acting and long-acting. 15 The short-acting kind often has an opioid as the only pain medicine or a combination of an opioid and another type of pain reliever, such as ibuprofen. Short-acting opioids can take 15 to 30 minutes to produce an effect, which should last for 3 to 4 hours.15 Long-acting opioids provide pain relief for 8–12 hours due to extended delivery into the body and a longer half-life of the active substance. They are given at regularly scheduled intervals, such as once every 12 hours.15
What Does Luxury Opioid Rehab Include?
Luxurious rehab centers offer SUD treatment in extravagant surroundings, often in exotic locations. The accommodations are typically very comfortable, with complete privacy guaranteed for all patients. Lavish furnishings, beautiful exteriors, and revered medical personnel and staff help create a comfortable experience. These upscale rehab facilities provide services to CEOs, musicians, athletes, and celebrities managing both their busy lives and opioid addiction. They offer enhanced computer and conferencing centers as well as outside communication so that patients can stay connected during their rehabilitation process. Luxury rehab centers offer a variety of services that may include: Recreational activities like tennis, horseback riding, or swimming. Meditation classes as well as yoga sessions. Exercise facilities with programs such as massages and physical therapy. Fine dining is also available for patients along with concierge service to handle any requests they have during their stay at the facility.

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