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Does BCBS of Michigan Insurance Cover Inpatient Alcohol and Drug Rehab Centers?

Table of Contents

Blue Cross Blue Shield of Michigan Coverage for Inpatient Rehab

Alcohol and drug rehabilitation services are located throughout the state of Michigan, and Blue Cross Blue Shield of Michigan can help you enter one of the many inpatient programs available. Part of the behavioral healthcare coverage offered under their plans includes access to rehab centers. State-funded rehab in Michigan—as well as private centers—can help you get your life back on track.

You can check your coverage in a few different ways. If you have the Blue Cross mobile app downloaded onto your smartphone, you can check your status under My Coverage. You may also browse through the member handbook you received in the mail or call and speak to a customer service representative. You can find the number to call on the back of your Blue Care Network ID card. Also, you are welcome to contact American Addiction Centers (AAC) over the phone, online chat, or the SSVOB form located on the AAC website.

How To Find BCBS of Michigan-Covered Inpatient Drug Treatment Centers in MI?

AAC can help verify your insurance coverage for you. If you do not feel comfortable doing so over the internet, you can call AAC’s helpline and speak to a customer service representative who can check your benefits while you are still on the line.

If you’re feeling hesitant about calling and asking for help, the representative on the other end of the line will understand. They are aware that, in any given year, about 463,000 (4.63% of the state’s total population) Michiganders misuse alcohol, and that over 1 million (16.73% of the population) use drugs.1 (“Michigan” Tables) A representative can answer your questions and give you detailed information on AAC’s highly rated treatment centers throughout Michigan. Whether you’re in Detroit, Lansing, Grand Rapids, Muskegon, Kalamazoo, or Traverse City, you can find the right treatment center for you right at home in the Mitten State.

What Is BCBS of Michigan?

BCBS Michigan is a non-profit mutual insurance company founded in 1939.2 (“Who we are”) They are Michigan’s largest health insurer, serving over 4.5 million people in the state.2 (“Who We Are”) They boast the biggest network of doctors and hospitals across the state and are an independent licensee of the Blue Cross and Blue Shield Association.2 (“Who we are”) They sell traditional, PPO, HMO, Medicare, Medicaid, and state plans—to name a few.2 (“What We Do”)

There are many Blue Cross Blue Shield of Michigan drug treatment centers to choose from. You can select one close to home or in another part of the state if you wish to distance yourself.

How Much Does BCBS of Michigan Cover (Addiction Treatment)?

Blue Cross Blue Shield of Michigan substance abuse treatment coverage exists. Depending on the type of plan you have, it might cover some or all of the costs associated with inpatient (or residential) rehab, outpatient rehab (or therapy), intensive outpatient programs (IOP), and partial hospitalization programs (PHP).

There are multiple plans available through BCBS of MI. Bronze plans—which have the lowest monthly payments for folks over 30—will have you paying full cost for quite a few services before you pay the deductible.3 On the HMO Preferred Bronze, you have an $8,500 individual/$17,000 family deductible, and you’ll need prior authorization for inpatient substance abuse services.4 (Pages 1&4)

Should you have the Preferred HMO Silver plan, you get a $3,000 individual/$6,000 annual deductible, but get a 30% coinsurance for inpatient substance abuse services if they are in-network.5 (Pages 1&4) Anything out-of-network is not covered.

On the Premier PPO Gold plan, your deductible for in-network providers is $750 individual/$1,500 family.6 (Page 1) Substance abuse outpatient services are $30 per visit and have a 20% coinsurance for other outpatient services if you’re in-network.6 (Page 4) Out-of-network, you have a 40% coinsurance.6 (Page 4) If you use inpatient services within the network, you have a 20% coinsurance.6 (Page 4) Going out-of-network leaves you with a 20% coinsurance for substance abuse services but 40% for all other inpatient services.6 (Page 4) Also, you can only use BCBSM approved facilities and must have prior authorization.

Does Blue Cross Blue Shield of Michigan Provide Coverage for Mental Health Facilities?

BCBS Michigan complies with the Affordable Care Act (ACA), which requires insurance companies to cover mental health care and treatment options. This means that treatment for a co-occurring disorder and stand-alone drug rehab are covered to some extent.

Somewhere around 9.2 million American adults have a co-occurring disorder, which is the existence of any two substance use disorders (SUDs) and mental disorders as identified by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).7 Those with SUDs are more likely to develop at least one chronic disease or primary condition, such as a mental health condition.7 (Paragraph 1) For these people, rehab can mean using medication-assisted treatment (MAT) in conjunction with traditional therapy approaches to simultaneously treat both conditions.7 (Paragraph 1)

Does Blue Cross Blue Shield of Michigan Cover Addiction Treatment Therapies?

BCBS of Michigan covers Michigan drug rehab services that are both inpatient and outpatient. Hospitalization is also covered, and your pre-therapy detox falls within the boundaries of your specific plan. Most BCBS plans include residential treatment, but you might have a few requirements to meet first.8 Therefore, it is important to check your coverage before settling on a particular rehab. Also, bear in mind that all Blue Care Network HMO plans require preauthorization for behavioral services, but only some PPO plans require it. Whenever preauthorization is needed, providers will contact BCBS.

How Long Does BCBS of Michigan Insurance Cover Alcohol and Drug Rehab Programs?

A stay in rehab might last somewhere between 30 and 90 days.  Long-term care has many noted advantages, such as better promoting the person’s sense of responsibility.9 (“Conclusion”) Motivational constructs and immersion in a supportive community for a longer period of time can influence long-term sobriety.10 (“Implications and Future Directions”, par. 1) You might find you have more social support with the backing of recovery and 12-step groups after leaving your inpatient rehab program.10 (“Implications and Future Directions, par. 1)

Since there are numerous types of plans with multiple coverage tiers in each, the length of time covered by BCBS will depend on your plan. Some plans might cover 90 days, while others only cover 30—hence why it is vital to look up your plan using the contact information given on your insurance card.

What If My BCBS of Michigan Policy Does Not Cover an Inpatient Rehab Program?

Depending on which rehab you choose, you might have access to financing or scholarship options. Scholarships are often awarded on an as-needed basis, providing partial or full funding for the cost of care. Some state-funded facilities will offer funding for people in the form of grants.

You can also try reaching out to local non-profit organizations, churches, and charities to see if they can help cover the cost of treatment. In addition, you may also be able to find specific corporations that have addiction scholarships and grants available in Michigan.

Don’t put off getting treatment. Even if you don’t think you have the money, there are ways to get your stay financed. Getting treatment now can save your physical and mental health, not to mention all the money you’d end up spending down the road.

BCBS of Michigan In-Network vs. Out-of-Network Inpatient Rehab Centers

In-network providers are those that accept your insurance plan. Some doctors, hospitals, and rehabs only accept certain insurance providers. Anyone they don’t accept is out-of-network. You can check with BCBS of Michigan to see if the Michigan drug rehabilitation center you wish to attend is in- or out-of-network by inquiring about your plan. You can also contact the rehab facility directly and ask them if they accept BCBS.

How To Verify BCBS of Michigan Insurance Coverage of Alcohol and Drug Rehab?

Your search for drug rehab centers in Michigan might feel overwhelming, but AAC is here to help, and can verify your insurance online or over the phone. Verification only takes a matter of minutes.

Thousands of Michiganders with BCBS plans attend rehab each year, and you could be one of them. There is no shame in reaching out for help. You could end up starting your recovery journey in one of AAC’s top-notch treatment centers and graduating from a highly rated treatment program. Taking the first step happens now, and it happens by verifying your insurance coverage.

Sources

  1. Substance Abuse and Mental Health Services Administration. (2019). 2016-2017 NSDUH state-specific tables.
  2. Blue Cross and Blue Shield of Michigan. (2015). About us.
  3. Blue Cross and Blue Shield of Michigan. (2021). 2021 Michigan health plans.
  4. Blue Cross and Blue Shield of Michigan. (2021). Blue Cross Preferred HMO Bronze.
  5. Blue Cross and Blue Shield of Michigan. (2021). Blue Cross Preferred HMO Silver.
  6. Blue Cross and Blue Shield of Michigan. (2021). Blue Cross Premier PPO Gold.
  7. Substance Abuse and Mental Health Services Administration. (2021). Co-occurring disorders and other health conditions.
  8. Blue Cross Blue Shield of Michigan. (2021). Behavioral health coverage.
  9. Pettersen, H., Landheim, A., Skeie, I., Biong, S., Brodahl, M., Benson, V., and Davidson, L. (2019). Helpful ingredients in the treatment of long-term substance use disorders: a collaborative narrative study. Substance Abuse: Research and Treatment, 13.
  10. Laudet, A.B., Savage, R., and Mahmood, D. (2002). Pathways to long-term recovery: A preliminary investigation. Journal of Psychoactive Drugs, 34(3): 305-311.