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Anthem Blue Cross Blue Shield of Massachusetts Rehab Programs Near Me

On this page, you will learn about BCBS of Massachusetts health insurance coverage for substance abuse treatment and how to confirm what benefits are available under your specific plan.
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BCBS of Massachusetts Insurance for Substance Abuse Addiction Treatment

Provider Overview

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.

How to Read Your Insurance Provider Card
  • 1Insurance Provider Name
  • 2Policy Member's Full Name
  • 3Policy Membership/Subscriber ID
Sources
  1. HealthCare.gov. Mental health & substance abuse coverage.
  2. Substance Abuse and Mental Health Services Administration. (2011). Health Insurance Status of Adult Substance Abuse Treatment Admissions Aged 26 or Older: 2011.
  3. Blue Cross Blue Shield of Massachusetts. Our History.
  4. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction DrugFacts.
  5. Find Treatment.gov. Paying for Treatment.
  6. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide, Third Edition.
  7. 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.
  8. Centers for Medicare & Medicaid Services. (2020) CY2020 Final Payment Rates for Opioid Treatment Program (OTP). CMS-1715F 
  9. Office of National Drug Control Policy. (2012). Cost benefits of investing early in substance abuse treatment.
  10. National Institute on Drug Abuse (2021) How much does opioid treatment cost?
  11. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health

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Frequently asked questions

How Long Does Blue Cross Blue Shield of Massachusetts Coverage Last for Inpatient Opioid Rehab?
There are various treatment lengths. Some people may only need 30 or 60 days of rehab, while others may need up to 90 days. Each treatment modality has its own pros and cons. The important thing is that each person receives the appropriate treatment length they need to recover from addiction.4 Treatment involving less than 90 days is generally less effective when treating opioid abuse, so longer treatment is recommended to maintain positive results.6 You can find out how much of the treatment is covered by your BCBS of Massachusetts insurance by calling the number on your insurance card or calling an alcohol and drug rehab hotline at the treatment center of your choice.5
Are Christian Rehab Centers Covered by Blue Cross Blue Shield of Massachusetts?
There are many Christian rehab centers across the country, but not all of them are covered by private insurance. It’s important to do your research and find a center that is covered by your insurance plan. Just like luxury rehab facilities, some Christian rehab centers are covered by insurance, while others are not.5 If you are looking for a Christian rehab center that is covered by insurance, there are a few things you should keep in mind. The first thing you need to do is call your insurance company and ask them if they cover Christian rehab centers. If they do, they will be able to tell you which ones are covered. You can also search for Christian rehab centers that are covered by Blue Cross Blue Shield of Massachusetts insurance coverage on the internet. Next, you need to talk to the admissions administrators at the Christian rehab center you are interested in and ask them if they accept insurance. If they do, they will be able to tell you which plans they accept. You can also check the Christian rehab center's website to see if they accept insurance and what payment options are available for treatment. Finally, you need to do is check the cost of the Christian rehab center. Some centers accept insurance, while others may not. There may be some deductibles and co-pay amounts you need to pay before you start receiving treatment that is covered by insurance. If you have to pay out-of-pocket for the center, you can explore different financing options.5
What Does Blue Cross Blue Shield of Massachusetts Opioid Rehab Entail?
The treatment received at a Blue Cross Blue Shield of Massachusetts covered substance abuse treatment facility is different from one facility to another, but generally entails the following:4 Medical detox for opioid addiction is a process in which the patient undergoes treatment for their addiction in a hospital-like setting to help ease the withdrawal symptoms. Detox helps to rid the body of opioids and prepares the person for addiction rehabilitation. An individualized treatment plan for opioid addiction is developed for each patient following a comprehensive assessment. The assessment helps to determine the most appropriate type of treatment for the individual. The plan may include medication-assisted treatment, as well as other forms of therapy. Counseling is an important component of opioid addiction treatment. It can help individuals understand their addiction and how to stay sober. Counseling can also help individuals deal with the emotions that may be triggered by addiction. Different types of therapies can help people recover from opioid addiction. Some therapies involve working with a therapist one-on-one, while others involve groups of people who are also trying to recover. One common type of therapy is cognitive-behavioral therapy, which helps people learn how to deal with their thoughts and feelings in a healthy way. Support groups allow individuals to share their experiences and learn from others who are going through a similar journey. This can be incredibly helpful, as it provides individuals with a sense of community and shared understanding. An aftercare program typically entails continuing to see a therapist, taking medication if prescribed, and attending support group meetings.

Guides for other health insurance providers

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