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Anthem Blue Cross Blue Shield of Massachusetts Rehab Programs Near Me

Anthem Blue Cross Blue Shield of Massachusetts: Insurance Coverage for Opioid Rehab

The Mental Health Parity and Addiction Equity Act requires all health insurance plans to cover addiction treatment. Therefore, private insurance policies have to cover alcohol and drug rehab the same way they do medical emergencies.1

Still, millions of Americans are in need of addiction treatment, but only about 10% of them have a private insurance policy that can help them pay for it.2 

Anthem Blue Cross Blue Shield of Massachusetts is a health insurance company based in Boston, Massachusetts. Founded in 1941, the company offers a variety of health insurance plans, including coverage for addiction treatment, to over 3 million members based in Massachusetts.3 

If you have Blue Cross Blue Shield of Massachusetts coverage nationwide and need addiction treatment, your policy will likely cover the costs of rehab. This coverage may include inpatient and outpatient rehab, as well as detox.1

Which Aspects of Opioid Treatment Does Blue Cross Blue Shield of Massachusetts Insurance Coverage Include?

Rehab services that are covered by insurance comprehensive screenings for co-occurring disorders, interventions, detox, inpatient, and outpatient treatment. Behavioral therapies and treatment for co-occurring disorders are also often covered by insurance.4 

It’s important to check with your insurance company to see what services are covered and what the limits are. This can help you make the best decision about which Blue Cross Blue Shield of Massachusetts substance abuse treatment facility is right for you.

Services That Aren’t Typically Included in BCBS of Massachusetts Coverage

Services that aren’t usually covered by insurance companies when someone is seeking addiction rehab treatment include non-therapeutic services such as same-day admissions, recreational activities such as yoga, meditation and hiking, food deliveries, and individual treatment services. Alternative treatment options, such as acupuncture and chiropractic care, are also not typically included in Blue Cross Blue Shield of Massachusetts insurance coverage.1

What’s the Cost of Opioid Rehab at a Substance Abuse Treatment Facility?

The cost of opioid rehab can vary depending on the intensity of services offered, the duration of treatment, and the additional services provided.4 

In general, outpatient opioid rehab tends to be less expensive than inpatient rehab, but the cost can still vary depending on the program.4 Most opioid rehab programs offer either 60- or 90-day treatment options, though some may provide longer or shorter programs.4 

Additional services that may be offered include detox and withdrawal symptom treatment, therapy, medication management, and aftercare planning. All of these may count toward the final price.4

Patients should be able to get their insurance coverage checked by calling the number on their insurance card. An alternative is to directly get in touch with a treatment provider such as American Addiction Centers (AAC). Their admissions navigators to find out what services are covered and what additional private pay options are available.5 

It’s important to note that insurance covers not all opioid rehab programs, and some treatment centers may be out-of-network. Patients should contact their insurance provider or the rehab center to find out what is covered.5

Inpatient Treatment Cost

There are a few factors that determine the cost of inpatient rehab treatment. The treatment program’s length is one factor, with longer programs being more expensive.4

The inpatient rehab facility’s network status (whether it’s in-network with the patient’s insurance provider) is also a factor in determining the cost of treatment.4

However, inpatient treatment is well worth the price, considering all the benefits it offers. Inpatient rehab provides a supportive environment where patients can focus on their treatment without the distractions of daily life.4 

These facilities offer 24/7 access to high-quality care, meaning that patients receive the support they need around the clock.4 Learning to cope with cravings and avoid relapse is an important part of inpatient rehab, and these skills can be invaluable in maintaining sobriety after treatment is complete.6

Outpatient Treatment Cost

Since outpatient treatment lacks the residential element, outpatient treatment prices are much more affordable.4

Outpatient rehab treatment involves patients visiting the treatment center for counseling and therapies every day, but not spending the night. They’ll meet with a therapist one or more times throughout the week, participate in group therapies or support group activities, and have their medications administered.4

Outpatient rehab is an excellent option for people with mild addiction or for those who have obligations (like child care, work, or college) that prevent them from attending an inpatient program. But because outpatient rehab doesn’t offer the same level of intense treatment and support as inpatient rehab, it’s not typically suitable for people with severe addictions.4

The Cost of Partial Hospitalization Programs or Day Treatment Programs 

Opioid partial hospitalization programs or day treatment programs are a form of treatment for people with opioid use disorder. The cost of a partial hospitalization program can vary depending on the location and the amenities offered, such as private rooms, recreational activities, spa, fine dining.7

In general, partial hospitalization is cheaper than inpatient treatment, as it doesn’t involve residing at the facility and paying for your accommodation and meals. However, they are usually more expensive than outpatient treatment, since they involve longer treatment durations and often lunch.7

These programs provide structure and support to people who are trying to overcome their addiction. They can be very helpful for people who need more support than what is available in outpatient treatment but don’t need inpatient treatment intensity.7

Medication-Assisted Treatment Cost

Medication-assisted treatment involves the use of maintenance drugs, such as methadone or buprenorphine, to help with withdrawal symptoms and cravings. This can make it easier for some people to fight their cravings, since the medications bind to the same receptors as the opioids, reducing the intensity of withdrawal symptoms.4

Methadone, buprenorphine, and naltrexone are all maintenance drugs used in opioid medication-assisted treatment. The prices of these medications vary, with methadone being the most affordable at $207/week and naltrexone being the most expensive at $1,343/week. Oral Buprenorphine cost patients $258, while injectable treatment cost $1,757/week.8

These prices include drug administration and dispensing, various forms of therapy such as individual, group, or couple’s therapy sessions at the treatment center, weekly meetings with the counselor, and toxicology tests.8

Some people may struggle to afford these medications, which can be a barrier to receiving help. However, many insurance plans cover addiction rehabilitation and medication-assisted treatment. It’s best to call the BCBS of MA helpine and check what components of your MAT are covered under your insurance plan. 5

How Do the Costs of Rehab and Addiction Compare?

Rehab can be expensive, but that shouldn’t keep you from getting the help you need. Blue Cross Blue Shield of Massachusetts healthcare plans should cover at least some of the cost of rehab. There are many different types of treatment, so it’s only a matter of finding one that fits your needs and budget.

If you’re struggling with opioid or some other form of abuse, it’s important to get help. Opioid abuse can affect your relationship, professional development, quality of life, and even lead to a fatal outcome, so it’s important to get treatment on time.4

Substance abuse costs significantly more than treatment. Treatment for substance abuse costs close to $1,500 each year, while the average annual cost of substance abuse per capita is roughly $11,500 in healthcare, lost productivity, and criminal justice costs.9

In 2013, the cost of opioid addiction and overdose in the U.S. amounted to $78 billion. Only $2.8 billion or 3.6% of those funds went toward treatment.10

What Treatment Length Does Blue Cross Blue Shield of Massachusetts Insurance Cover?

The best way to treat someone depends on the type of substance they’re using, as well as their individual characteristics and history. It’s important to adjust treatment settings, services, and interventions to an individual’s case and medical needs to achieve complete rehabilitation.6

Opioid abuse can have a negative impact on an individual’s health, relationships, and career. Treatment should typically address the individual’s physical, mental health, social, professional, and legal issues to be effective.6

For that reason, staying in treatment for as long as medical experts advise is vital to complete recovery. Most individuals struggling with opioid abuse need at least 90 days in treatment to achieve progress. Outcomes are best when individuals receive adequate treatment durations.6

Addiction can be a difficult problem to overcome and it frequently requires multiple treatment episodes. Relapses may occur in some cases and should indicate a need for the patient to undergo treatment again.6 

If you need to know what length of treatment is included in your Blue Cross Blue Shield of Massachusetts insurance coverage, you can contact the number on the back of your insurance card. Their dispatchers will be able to tell you how long your treatment is covered for and what you need to do to continue receiving coverage.5

How to Choose Between Inpatient and Outpatient Treatment

There are different treatment programs to choose from in Massachusetts, with inpatient and outpatient rehab being the most common ones.4

Inpatient treatment is a good option if you need a structured environment with 24/7 supervision. Outpatient treatment is a suitable option if you need more flexibility or want to continue working or going to school.4

There are pros and cons to both inpatient and outpatient treatment.4

  • Inpatient treatment can be helpful if you need a lot of support and supervision.
  • However, it can be expensive and requires patients to completely dedicate a few months of their life to recovery.
  • Outpatient treatment can be more affordable than inpatient treatment.
  • However, it can be easy to neglect your treatment and relapse because outpatient programs don’t offer the same level of support or accountability.

Inpatient treatment is more intensive than outpatient because it provides a more treatment-focused setting and peer accountability. Patients in inpatient treatment can get better care since they are surrounded by professionals who are dedicated to helping them recover.4 

Guidance on Using Blue Cross Blue Shield of Massachusetts  Insurance for Addiction Treatment

If you or your loved one have an opioid addiction that needs to be addressed, you should consult your doctor about the best treatment for you. Once you have chosen a local treatment center, you can ask your insurance company if they will cover your treatment there. If they say yes, work with admissions navigators to make sure all the essential services are covered by your Blue Cross Blue Shield of Massachusetts insurance plan.5

How to Find BCBS of Massachusetts Covered Inpatient Rehab Centers Nationwide?

If you are unsure about what your insurance covers or need to find an alternative treatment financing option, all you have to do is reach out to a treatment center near you. The American Addiction Centers admissions navigators will be more than happy to verify your insurance for you by answering any questions or concerns that a potential client might have before they complete their intake questionnaire.

The Substance Abuse and Mental Health Services Administration reports that only 4.2 million out of 20.4 million people over 12 with a SUD received treatment in 2019. This represents only 1.5% of those who needed rehabilitation services.11

If you’re struggling with addiction and have a Blue Cross Blue Shield insurance plan, American Addiction Centers (AAC) has various rehab facilities nationwide that offer specialized treatment with complete privacy and confidentiality guaranteed. There are many different programs available at AAC facilities, so you’ll be able to find an appropriate treatment center that suits your or your loved one’s needs. 

Talk to a representative from AAC to find the best inpatient rehab facilities that are in-network with Blue Cross Blue Shield of Massachusetts nationwide. Feel free to get in touch with their prescription drug treatment hotline or contact their helpline for heroin addiction recovery.

The Boston-based insurance company offers coverage across various areas in Massachusetts, including addiction treatment assistance in Springfield, as well as evidence-based addiction treatment in Boston and specialized recovery programs in Cambridge.

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