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Empire Blue Cross Blue Shield Insurance for Alcohol Rehab

Alcohol Rehab and Addiction Treatment Coverage by BCBS of New York (Empire)

Alcohol addiction presents a worldwide issue, and the United States is no exception. Recent statistics published by the National Center for Drug Abuse Statistics show that alcohol use disorder (AUD), alcohol abuse, and alcoholism are directly related to more than 3 million deaths per year. It also plays a major role in 2.2% of disease among women and 7.1% among men.1

Many individuals argue that they can still maintain a functional lifestyle despite a pattern of ongoing alcohol abuse. In reality, although many people who struggle with substance use disorder (SUD) do manage to maintain a level of control in their daily affairs, this is frequently just a phase in a downward spiral.2 Despite this, many people are still reluctant to seek help due to the perceived high cost of treatment.3

If you or your loved ones are battling AUD, you may be wondering if your Blue Cross Blue Shield (BCBS) of New York (Empire) insurance covers treatment for alcohol and/or drug addiction. The good news is, many healthcare plans offer full or partial coverage for alcohol addiction treatment. However, the precise level of coverage and the benefits you’re entitled to can vary depending on your policy.3

What Does BCBS of New York (Empire) Insurance Cover for Alcohol Treatment?

BCBS of New York (Empire) Insurance healthcare plans cover all phases of evidence-based drug and alcohol addiction treatment. Depending on your policy, you may receive coverage for some or all of the following services:4

The exact amount of coverage you can receive will also vary depending on which rehab center you choose. If you opt for a non-preferred or out-of-network provider, you will likely have to pay for rehab out of pocket or explore other financing options for your addiction treatment.3

Fortunately, BCBS of New York (Empire) is in-network with numerous reputable alcohol rehab providers nationwide, so you should be able to find an in-network facility in your area that meets your needs and preferences.5

What Part of Alcohol Treatment Will Not Be Covered by BCBS of New York (Empire) Insurance?

Of course, your BCBS of New York (Empire) insurance might not cover all aspects of your stay in a rehab center. For example, you may require some special types of treatment that don’t fall into conventional behavioral or medical approaches. Here are some services that are usually excluded from rehab coverage plans:4

  • Certain non-medical amenities 
  • Recreation programs, including fitness activities and yoga
  • Holistic care services (special diets, spiritual counseling, homeopathy, etc.)
  • Special food delivery services (from outside of the facility)
  • Private therapy sessions that don’t address AUD or co-occurring mental health disorders
  • Alternative approaches to therapy or treatment, without sufficient scientific or clinical background

What Is the Cost of Different Alcohol Rehab Programs?

There are many variables that are calculated into the total price of your alcohol rehab treatment. As with any other type of substance use disorder, there are different modalities and approaches that aim to address the issue on different levels and at different stages. Primarily, there are four factors that will contribute to the final cost of alcohol rehabilitation, as covered by BCBS of New York (Empire):3

  • What services are offered by the rehabilitation facility
  • How intense is the approach
  • How long it takes for the rehabilitation to be successful

Average Cost of Inpatient Alcohol Rehab

Inpatient alcohol rehab is usually the most costly option, as it includes constant medical supervision, which requires a stay in an enclosed and safe environment, away from distractions and with regular daily programs. The price can also involve detoxification, regular medication, behavioral therapy, and treatment and assessment for co-occurring disorders. Given that it’s the most intense modality of treatment which can last from a couple of weeks to a couple of months, it’s expected to be the most expensive option.3, 4

Average Cost of Outpatient Alcohol Rehab

Outpatient rehab is usually recommended to treatment-seeking individuals who have a milder version of substance use disorder and a supportive home environment. It may also be the second phase of recovery, once the inpatient program has been completed. Given the fact that the patient is living and sleeping at home while attending regular weekly and monthly meetings, it is usually a far less intensive, and therefore a less expensive mode of alcohol addiction treatment.3, 4

Average Cost of Alcohol Partial Hospitalization Programs (PHP)

Partial Hospitalization Programs (PHP) share many features with outpatient rehab, combining them with a more intense focus on daytime activities within the facility, which is a trait it shares with the inpatient mode of treatment. The patients get to sleep in their own home, while traveling to spend the day in rehab, where they attend group meetings, therapy sessions, take medication, and work on establishing a fully sober and healthy lifestyle.4

Given the fact that PHP alcohol addiction treatment programs are usually shorter than inpatient rehab, and that they are right in the middle between outpatient and inpatient programs in terms of intensity, the expected price range can also be somewhere in the middle. The best way to find out the price of PHP programs is to call your preferred facility nearby. If you have BCBS of New York (Empire) Insurance, you can plan out and finance your treatment.3

Average Cost of Medication-Assisted Treatment (MAT)

There’s a variety of medication-assisted treatments (MAT) that address the needs of people who are struggling with alcohol abuse disorder. Some of the medications used are more expensive or need to be taken for a longer period of time, and the price is determined accordingly.3, 6

You should check with your treatment provider to see if your BCBS of New York (Empire) healthcare plan can cover the cost of medication and ongoing treatment for alcohol abuse. With sufficient coverage, you may count on behavioral, medical, and pharmaceutical support on your road to recovery.6

What Is the Cost of Prolonged Alcohol Addiction?

Many people are reluctant to enter into rehab given the fact that the whole process can be quite costly and hard to afford. However, these concerns are frequently unfounded. There are many affordable state-funded options that can be your first step toward sobriety. Of course, as a rule of thumb, more comprehensive, in-depth, and intense rehabs will require more funds, and having insurance can be of great help.3

Unfortunately, some people struggling with alcohol abuse may still argue that it’s far less stressful and costly to simply continue drinking. Here are 5 reasons why alcohol addiction costs more in the long run and why it causes more financial strain on the individual, their family, community, and nation as a whole:7, 8

  • Substance abuse itself is a costly venture. The cost of daily alcohol purchases can take a considerable toll on a person’s income. These costs are only likely to increase over time as the individual builds up tolerance and requires more alcohol to attain the same level of inebriation.
  • Cost of lost income due to sick leaves or workspace injuries. Prolonged alcohol use poses an even greater risk, since it can lead to wasted opportunities, postponed jobs, sick leaves, and risk of workplace injuries that will not be covered, given that the person was under influence.
  • Plethora of health problems that result from prolonged alcohol use that can lead to temporary or permanent disability. Medical bills that are incurred as a result of alcohol-induced illnesses and delayed rehabilitation are a major financial burden for the individual, their loved ones, their neighbors, and the community as a whole. Detox is not always affordable, and alcohol addiction treatment can become even more financially demanding if postponed.
  • Cost of driving under the influence of alcohol. Drunk driving poses a risk for the person behind the wheel, their passengers, other motorists, their vehicles, pedestrians, and anything on or around the road.
  • Cost of legal proceedings. Prolonged alcohol abuse is also linked to greater risk of aggravated assault, battery, domestic violence, murder, and sexual assault. While the cost of losing a life, being mugged, or serving a sentence might seem drastic enough, you shouldn’t ignore the costs of the legal proceedings that take place in the meantime.

Does BCBS of New York (Empire) Cover Only Short-Term or Long-Term Alcohol Treatment?

Your BCBS of New York (Empire) healthcare plan will most likely cover a part of your alcohol rehab program, be it short-term or long-term. While it’s more likely that it would suffice for a monthly intense treatment in comparison with a 6-month or 12-month program, it’s usually wise to accept a partial coverage of a long-term treatment.5

According to the National Institute on Drug Abuse, the chances of full recovery are far greater with long-term treatment, given that the correlation is positive between these two measures. There’s also a negative correlation between relapse rate and length of treatment.9

BCBS of New York (Empire) Inpatient vs. Outpatient Alcohol Rehab Centers: How to Choose? 

While outpatient rehab may seem to be a great option for people who have already passed through a course of inpatient treatment, or those who have put their abuse pattern under control, inpatient alcohol rehab centers have been shown to offer a greater chance of long-term recovery.9

Staying longer in an inpatient rehab facility may give you more time to work on your triggers, identify problematic behavioral patterns, observe the efficiency of different programs, and support you on establishing healthy habits and an independent lifestyle.9

Here are 5 reasons why inpatient alcohol rehab tends to be a more effective way to achieve lasting remission:9

  • There is generally a greater quality of care offered at inpatient facilities.
  • Inpatient facilities foster a supportive treatment ecosystem, without stigma and with many options that can be used to personalize the treatment itself.
  • There are usually support groups at inpatient facilities, so you’d be able to share your thoughts and support with one other.
  • A focused environment, which means that you won’t be tempted by distractions that may lead you away from your road to recovery.
  • Accountability.

What is the Process of Claiming BCBS of New York (Empire) Insurance for Alcohol Rehab?

The process of claiming your BCBS of New York (Empire) Insurance coverage is relatively straightforward, but it does require that you go step by step. Here are the steps in the process:5

  • First, you’d need to talk to a medical professional about your condition so they can perform an assessment and document it. They will also give you a recommendation for the length and mode of treatment.
  • Next, you can start browsing your nearby alcohol rehab facilities and available programs that can help you battle and recover from your substance abuse disorder. Be sure to look for any specialized care that you or your loved one may require, such as couples-based alcohol rehab programs or facilities that offer same-day admittance.
  • You should call your BCBS of New York (Empire) insurance agent and get better insight into your plan and determine if they have some local in-network facilities that would suit your plan or that you’d be able to cover partially.
  • Finally, you need to call the facility and check whether they accept your type of BCBS of New York (Empire) healthcare plan and see whether substance abuse is covered. The facility will be able to tell you if they accept your type of insurance.

If you have further questions about the available payment options, the intake process at your facility of choice, or anything else in regards to your treatment, don’t hesitate to call a specialized drug and alcohol abuse hotline and discuss your situation in absolute confidentiality with a trained navigator.10

Where Can I Find Nearby Alcohol Rehab Facilities That Accept BCBS of New York (Empire) Coverage?

American Addiction Centers (AAC) is a nationwide network of alcohol and drug addiction treatment centers that can help you find evidence-based rehab programs in your area for yourself or your loved one.

To obtain the information you need, call our 24-hour alcoholism and alcohol abuse hotline and discuss your or your loved one’s situation in total privacy.10 Our knowledgeable navigators will answer your questions, verify your BCBS of New York (Empire) insurance coverage, and recommend a course of action that’s most likely to lead to long-term recovery, all during a single call.

They will also be able to provide information on accredited treatment centers in New York or within 120 miles, including: 

Treatment-seeking individuals in the New Jersey area can also benefit from enrolling in our Sunrise House Treatment Center, which is a state-of-the-art alcohol and drug rehab facility that offers a variety of modern features and amenities that will help you or your loved one feel comfortable while in treatment while helping restore both your emotional and physical health.

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