Is Opioid Rehab Covered by BCBS of New York (Empire)?

Opioids have become a significant public health concern in the United States, with 136 lives claimed daily. Every year, over 10 million people abuse opioids, and almost 50,000 people die from overdoses. In the state of New York, close to 3,000 people lose their lives to opioid overdose every year, which is 3.4% higher than the national mortality rate.1

The cost of treatment and understanding how to pay for opioid rehab services can be barriers for many people seeking treatment. Fortunately, there are many low-cost or free treatment programs, and most rehab centers accept Medicaid, Medicare, and other state-funded insurance plans. Additionally, the Affordable Care Act ensures that private insurance companies cannot deny drug or alcohol abuse coverage.2

With that in mind, you must be wondering, “does BCBS of New York (Empire) cover drug rehab too”? The question is likely yes; BlueCross Blue Shield of New York (Empire) should cover at least a portion of opioid treatment costs, based on your insurance policy. Learn more about how this coverage could help you or someone you love get the treatment they need before starting the process.2

Learn More About BlueCross BlueShield of New York (Empire)

BCBS of NY (Empire) is one of the largest health insurance providers in the state. They offer a variety of health insurance plans, including individual, family, Medicare, Medicaid, and small business plans. They also offer dental and vision coverage. Empire has been in business for more than 80 years, and they are dedicated to providing quality health care coverage to its members.3

What Opioid Treatment Services Are Covered by Empire Blue?

BCBS of New York (Empire) healthcare plans offer different types of drug coverage for opioid treatment, including screenings, interventions, detox, inpatient and outpatient care, behavioral therapies, and treatment for co-occurring disorders. This comprehensive approach to care ensures that members have access to the resources they need to overcome addiction and achieve lasting recovery.4

Opioid screenings and interventions are becoming more and more common as the opioid crisis continues to worsen. Hospitals, clinics, and other healthcare facilities are starting to screen for opioids to help those addicted to them get the help they need. There are a number of interventions that can be used to help those who are addicted to opioids, and these interventions can be very effective in helping people get the treatment they need.4,5
Medication-assisted detoxification uses medications to help ease the symptoms of withdrawal. Detoxification is just the first step in recovery from opioid addiction. After detoxification, people will need to continue treatment with medication, therapy, and support to maintain their sobriety.4,5
Inpatient treatment for opioid addiction is often the best option for people who are struggling with addiction. This type of treatment involves staying in a rehab facility for a set period of time, usually around 30 days. During this time, patients receive around-the-clock care and support from staff members who are trained in addiction treatment.4,5
Outpatient treatment is another option for people who are struggling with addiction. This type of treatment usually lasts for a few months and involves attending regular therapy sessions and meetings. Outpatient treatment can be a good option for people who have a strong support system at home.4,5
Behavioral therapies are a type of treatment that can be used in opioid treatment. There are different types of behavioral therapies, but they all work differently. Some behavioral therapies help people to understand why they use drugs, while others help people learn new skills to deal with stress and cravings.5
Many people who struggle with opioid addiction also suffer from co-occurring mental health disorders, which health experts may recognize as dual diagnoses upon admission. There are a few different approaches to treatment for co-occurring disorders during opioid use treatment, including medication management or behavioral therapies. The most effective treatment programs usually favor an integrated approach.4,5

Are There Any Opioid Treatment Services Insurance Won’t Cover?

There are a number of different opioid addiction treatment services nationwide that insurance companies may not cover. These include:4,5

Non-medical amenities: Some opioid treatment facilities offer non-medical amenities such as private rooms, access to the gym, personal trainers, or a spa.
Holistic care services: Alternative treatments that focus on treating the whole person, rather than just their addiction. This may include yoga, meditation, and other forms of alternative therapies.
Recreation programs: Programs that help patients enjoy activities and hobbies outside of drug use. This may include sports, art, and music programs.
Food delivery: Services that deliver healthy meals to patients in treatment. This can help them stay on track with their recovery and avoid temptation.
Private treatment services: Luxury services that are not covered by insurance, such as couple’s counseling or rehab, private therapy sessions, and expedited or same-day admission into treatment. These services may be more expensive but can provide a higher level of care.

What is the Cost of Opioid Rehabilitation?

There is no one-size-fits-all answer to this question, as the cost of opioid rehab will vary depending on a number of factors. These include the type of treatment program chosen, the intensity of services required, the duration of opioid treatment, and the amenities offered by the facility.4

In general, outpatient programs are less expensive than inpatient programs, as patients do not need to live at the facility during treatment. Intensive outpatient programs, which provide a higher level of care than traditional outpatient programs, may fall somewhere in between in terms of cost.4

The type of treatment program chosen will also affect cost. For example, different medications used in opioid treatment such as Naltrexone or Methadone, incur different costs.6

How Much Will I Pay for Inpatient Opioid Treatment?

The average cost of inpatient opioid rehab can vary depending on the location and the treatment center. The length of stay in an inpatient opioid rehab center also contributes to the final price.5

The duration of treatment may vary depending on the individual’s needs. Most inpatient treatment programs last between 30 and 90 days. However, some programs can last up to a year or more. In general, longer treatment durations are directly related to higher probabilities of a positive outcome.5

It is important to remember that the cost of inpatient opioid rehab should not be the only factor that is considered when choosing a treatment center. The quality of care and the experience of the staff should also be taken into consideration. Your BCBS of New York (Empire) rehab coverage will cover at least a portion of the cost of treatment.4

How Much Will I Pay for Outpatient Opioid Treatment?

Outpatient rehab costs and insurance coverage can vary depending on the facility, location, length, and services received. In general, BCBS NY-covered outpatient treatment usually lasts less than a year and is less expensive than inpatient rehab. However, the cost may still vary between different facilities. It is typically best suited to people who can commit to the program and regularly participate in counseling and therapy.5

Depending on the program, attendance may be required daily or one to three times per week. While outpatient rehab usually costs less than inpatient rehab, the cost may still vary according to the provider. It’s usually best suited for people able to commit to the program and attend regular counseling and therapy sessions.5

How Much Do Partial Hospitalization Programs Cost?

A partial hospitalization program or PHO is a program in which individuals attend intensive sessions at a treatment facility while living at home. Treatment at the center is longer and more intensive than outpatient treatment, so the usual cost is higher than outpatient but lower than inpatient treatment. However, many patients transition from PHPs to outpatient treatment as they progress in their treatment.7

What Can I Expect to Pay for Medication-Assisted Opioid Treatment?

MAT is a type of treatment that uses medications to help people who are addicted to opioids stop using drugs. These medications include buprenorphine and naltrexone. Buprenorphine helps to reduce withdrawal symptoms and cravings, while naltrexone blocks the effects of opioids.6

The cost of treatment varies based on the type of treatment prescribed, but may approximately cost:6

$126 per week for methadone.
$115 per week for buprenorphine
$1,170 per month for naltrexone

Opioid Treatment Cost: Is it Worth it?

The cost of opioid rehab can be high. Still, it is vital to consider the potential benefits of treatment when making a decision about whether or not to seek help. The most obvious benefit of treatment is the potential for sobriety, leading to improved physical and mental health, increased productivity, and enhanced relationships. In addition, successful treatment can also lead to reduced crime rates and decreased healthcare costs.5,6

The cost of substance abuse is significantly higher than the cost of treatment. A substance abuse treatment program averages $1,500 annually, while the criminal justice system, lost income, and healthcare expenses associated with SUD cost more than $11,000 each year.8 Overdose and addiction to opioids and their costs accounted for 78 billion dollars in U.S. dollars in 2013. The treatment portion of that cost was just $2.8 billion. Besides, your Blue Cross Blue Shield of NY healthcare plan may cover the cost in full or in part.9

How Long Does BCBS of New York (Empire) Addiction Treatment Last?

Mental health and opioid treatment benefits vary depending on your BCBS of New York (Empire) insurance coverage plan and state. In general, longer treatment periods are associated with higher recovery rates, although there is no one-size-fits-all approach. The duration of inpatient treatment may range from 30 to 90 days, while medication-assisted treatment may last significantly longer.2,5

The BCBS Of New York (Empire) helpline can answer any questions you have about your insurance plan and what length of treatment it covers. You can get assistance from their dispatchers if you would like to know more about your mental health and substance abuse coverage. You can also ask them how the insurance company covers treatment costs, and they can provide you with a list of local treatment centers that are in-network with your insurance company. This will give you a better idea of what to expect when it comes time to start paying for rehab.3

Are There Any Benefits to Choosing Inpatient Over Outpatient Opioid Treatment?

There are several important benefits to choosing inpatient over outpatient opioid treatment. Inpatient treatment offered by BCBS of NY substance abuse providers offers a higher level of care, which can be beneficial for people who are struggling with more severe addiction. Inpatient treatment also offers 24-hour supervision and support, which can help those struggling to stay sober on their own.5

Outpatient treatment costs less and allows people to keep working, but having a strong support system from family or friends is vital to its success. Patients who aren’t committed enough to attend regular therapy sessions or staying away from triggers that might cause them to use might find it hard to fully recover while attending an outpatient opioid program.5

How Does Using Empire Insurance for Opioid Rehab Work?

If you or a loved one is struggling with addiction, you may be wondering how to pay for treatment. Many people don’t realize that their health insurance can help cover the cost of rehab or how the entire process works.2

The first step is to consult with a doctor. This is important because you may need to get an assessment and a referral from a doctor in order to use your insurance. Once you have a referral, you can contact your insurance company to find out what substance abuse coverage they offer.2

Next, you’ll need to determine if you are able to use your Blue Cross Blue Shield NY (Empire) insurance for opioid treatment. Some insurance companies only cover certain types of rehab programs. However, most insurance carriers will cover at least some of the cost of rehab.2

Finally, you’ll need to work with a rehab center to determine and verify your coverage. This is important because not all rehab centers accept all forms of insurance. Once you’ve found a rehab center that accepts your insurance, you’ll need to work with them to determine what coverage they can provide.2

Using insurance for opioid rehab can be a great way to help cover the cost of treatment. However, it’s important to remember that not all insurance companies offer coverage for rehab and not all rehab centers accept all forms of insurance. If you have any questions, you can directly reach out to your insurance company or a treatment center. The American Addiction Centers are a large network of treatment centers nationwide in-network with Blue Cross Blue Shield of New York (Empire).2

Where to Get Help Using BCBS of New York (Empire) Coverage Nationwide?

If you’re looking for help with addiction and want to verify that your BCBS of New York insurance will cover the cost of treatment, American Addiction Centers can help. Their admissions navigators can help guide you through the admissions and intake process via a completely confidential phone call. They will help you verify your Empire Blue insurance coverage on the spot and offer alternative financing or payment methods if needed. You can easily reach them through their website or by dialing one of their numbers:

Sunrise House Treatment Center is one of their leading treatment centers in New Jersey that offers top-notch quality programs to those in the wide NY area, the residents of New York, and more. Their services also include dual diagnosis assessment and treatment, outpatient opioid treatment services, professional medical detox, thorough aftercare planning, gender-specific treatment, and more, serving the following areas.

Empire Blue Cross Blue Shield Opioid Detox and Rehab Centers Coverage