Does Blue Cross Blue Shield of Oklahoma Cover Alcohol Rehab?
Substance use disorders and mental health conditions are both major problems in Oklahoma. According to a 2012 survey, Oklahoma ranks 3rd in the nation for mental health condition rates, with 22.4%. In addition, Oklahoma ranks 2nd in the nation at 11.9% for substance abuse disorders. This means that while up to 950,000 people in Oklahoma need treatment, most do not receive it.1
Close to 200,000 individuals aged 12 or older in Oklahoma each year between 2013 and 2014 abused alcohol or were dependent on it. This means that within a year, 6.4% of all individuals aged 12 or older in Oklahoma had an alcohol problem severe enough to be classified as an alcohol use disorder (AUD). However, only close to 17,000 individuals, or 7.2% of those with AUD sought and received treatment for alcohol use in the same period.2
Even though most states including Oklahoma provide some funding for treatment, most people are still reluctant to seek it. Most cite lack of funding as the main reason, even though all private insurance companies have to cover at least a part of the treatment costs according to the Mental Health Parity and Addiction Equity Act passed in 2008. This includes Blue Cross Blue Shield of Oklahoma healthcare plans as well.3
Under the same act, Blue Cross Blue Shield of Oklahoma does cover alcohol rehab, though coverage may vary depending on the individual plan. Some of the options that are covered include inpatient and outpatient treatment, as well as various rehabilitation programs. There are also a number of different providers that BCBS covers for alcohol addiction treatment, so you can find the perfect program for you or your loved one.3
Blue Cross Blue Shield of Oklahoma: What You Need to Know
BlueCross BlueShield of Oklahoma is a non-profit insurance company that provides health insurance to Oklahoma residents. The company has a history of providing quality health insurance plans and coverage options to over 700,000 members.4
The company offers a variety of health insurance plans, including individual and family health insurance plans, group health insurance plans, and Medicare Advantage plans. The company also offers a wide range of coverage options, including hospitalization, prescription drug coverage, vision care, dental care, and more.5
Which Services Does BlueCross Blue Shield of Oklahoma Cover?
All Blue Cross Blue Shield of Oklahoma healthcare plans provide coverage for medically necessary mental health and alcohol use disorder treatments and services. The extent of coverage varies based on the choice of the treatment facility and treatment modality. In-network primary care physicians and facilities will offer the maximum amount of coverage.3,6
Blue Cross Blue Shield of Oklahoma alcohol rehab plans should cover most of these services:3,7
- Screening for alcohol abuse and professional intervention include looking for signs that a person may have a drinking problem and helping them accept this issue. Screening can be done through questions about a person’s drinking habits or by doing blood or other tests. Roughly 98% of all treatment centers in Oklahoma offer comprehensive SUD screening.
- Inpatient treatment is the most common and intensive level of care and usually involves a stay in a hospital-type residential facility, where patients receive around-the-clock care.
- Outpatient treatment for alcohol abuse is a form of rehabilitation that does not require the individual to reside in a treatment facility. The program usually lasts for nine to twelve weeks and includes weekly counseling sessions and occasional screenings.
- Behavioral therapies are a type of psychotherapy that focuses on modifying behaviors. They can be used to treat a range of issues, such as co-occurring disorders and addiction. Some of the most commonly offered forms of this treatment include cognitive-behavioral therapy, motivational interviewing, and rational-emotive behavioral therapy.
- A wide range of treatments for co-occurring disorders, for patients whose assessment shows a dual diagnosis, are offered at 95% of treatment centers in Oklahoma. Some of the more common treatments include medication, individual therapy, group therapy, and family therapy.
Which Alcohol Rehab Services Does Insurance Not Cover?
Different substance abuse treatment facilities employ different practices, and some of them may not be covered by insurance. In these cases, the insurance company may require the patient to make a co-payment, which is a fixed amount of money, or a coinsurance, or a percentage of the treatment cost.4
For the treatment to be covered by BCBS of Oklahoma, it must be deemed medically necessary and evidence-based. Any treatment or services that do not fall under one of these two categories may not be covered by insurance. Examples of these include:8
- Alternative treatments such as reiki or acupuncture.
- Holistic practices such as meditation or yoga.
- Recreational activities such as hiking or nature therapy.
- Private treatment amenities, such as massage or personal training.
- Private catering or food delivery services.
- Non-medical luxury services such as access to a spa, gym, or a private room.
What’s the Average Alcohol Treatment Cost?
The cost of addiction treatment can vary significantly, depending on the individual’s needs. Since treatment programs are tailored to meet the person’s individual needs and circumstances, they vary greatly from one patient to another, as does the cost of treatment. Therefore, forming a treatment plan and the cost of rehab is only possible after an in-depth evaluation by a team of medical experts.8
Some of the major factors that contribute to the treatment cost are:4
- Type and scope of services required.
- Level of intensity and care during the treatment.
- The length of the treatment.
- Any additional services offered or required.
How Much Does Inpatient Treatment Typically Cost?
Inpatient treatment for alcohol use is a form of rehabilitation that helps people with alcohol use disorder to get abstinent and stay abstinent. The cost of inpatient rehab is based on the length of treatment and services offered during that period. It involves living at a rehab facility for a certain period of time, usually between 60 and 90 days.8
During inpatient treatment, patients receive intensive therapy and counseling, and support from staff and other patients. Inpatient treatment can be extremely effective, and it has helped many people with alcohol use disorder to get sober and stay sober.8,9
How Much Does Outpatient Treatment Typically Cost?
Outpatient treatment for alcohol abuse is a great option for those who are not able to take time off from work or school to attend an inpatient program. It also allows for more freedom and flexibility, as patients can come and go as they please. However, outpatient treatment does not offer the same level of support and supervision as inpatient treatment, and it is not recommended for those who have a history of relapse.8,9
The cost of outpatient treatment is determined by the frequency of scheduled sessions, the intensity of treatment, and the number of different services provided.8
Outpatient treatment for alcohol abuse typically consists of weekly meetings with a counselor or therapist, as well as group meetings. Patients in outpatient treatment may also be required to attend 12-step meetings such as Alcoholics Anonymous. Treatment typically lasts for 3-6 months, though some patients may need to continue treatment for a year or more.8
How Much Do Partial Hospitalization Programs Typically Cost?
Partial hospitalization programs (PHP) offer a more intensive treatment modality compared to outpatient programs, but still do not require the patient to stay at the treatment facility. These programs usually involve attending at least 20 hours of treatment per week, and last between a month or several months, based on the patient’s progression. The length of treatment and hours per week determine the cost of these programs.10
The additional costs that Blue Cross Blue Shield of Oklahoma addiction treatment plans might not cover might include transportation, meals, and services that are medically unnecessary, but beneficial to the patient nonetheless.10
How Much Does Medication-Assisted Treatment for Alcohol Use Cost?
Medication-assisted treatment or MAT is covered by insurance when and if it is determined to be medically necessary. The cost of treatment will depend on the duration of care and related services provided. Alcohol addiction is a chronic disease, so the prescribed medication must be used regularly in order to be effective.11
The most common prescription medication for AUD include Naltrexone, Disulfiram, and Acamprosate. These treatments have been shown to be effective in helping patients with AUD overcome addiction and remain sober. The use of MAT can also reduce the chance of relapse, which is one of the most difficult challenges of addiction.11
What’s the Real Cost of Alcohol Addiction?
Several reasons contribute to people’s unwillingness to seek treatment, including financial hardship or lack of private insurance. Only 2.6 million Americans over 12 years of age received SUD treatment in 2009, despite being estimated that 23,1 million Americans needed treatment the next year. Even though treatment costs may seem high, addiction is arguably significantly more expensive.12,13
Excessive drinking cost the United States over $220 billion in criminal justice, law enforcement, healthcare, and lost productivity costs in 2006.13
People often underestimate how severe their alcohol abuse is. Even when they acknowledge the threat alcohol poses to their health, personal and professional life, the cost of addiction treatment deters them from seeking help.13
How Long Can The Treatment Covered by Blue Cross Blue Shield of Oklahoma Last?
The length of alcohol addiction treatment covered by Blue Cross Blue Shield of Oklahoma healthcare plans will depend on the severity of the addiction and the patient’s life circumstances. Longer treatment times are generally more effective in achieving lasting sobriety, but treatment outcomes may vary from case to case.8
You can find out more about your substance abuse coverage by asking your healthcare or insurance provider. You can do this by contacting the number on the back of your Blue Cross Blue Shield of Oklahoma insurance card.3
Another great way to get help for alcohol abuse is to call one of the free, 24-hour addiction hotlines. If you’re looking for support when it comes to alcohol abuse, trained helpline representatives can verify your insurance coverage, help evaluate your situation, offer you accurate financing information, and refer you to specialists or quality local rehab facilities. The confidentiality of your conversation is protected by law, so feel free to discuss any details you feel may be relevant.10,14
Is Inpatient Treatment More Beneficial Than Outpatient Alcohol Use Treatment?
Both inpatient and outpatient rehab programs have their own benefits that can help those suffering from alcohol abuse. Inpatient programs offer a more structured environment where people can focus on their recovery without having to worry about outside distractions and triggers. Patients in inpatient treatment centers typically live on-site, and staff members are available 24/7 to provide assistance and support.8
Outpatient programs tend to be less expensive and more flexible, but they require more motivation and discipline from the patient. Patients in outpatient treatment programs typically meet with counselors or therapists a few times each week and may also attend group meetings.8
Both inpatient and outpatient treatment programs can be effective for those suffering from alcohol abuse, and it’s important to choose the right program based on each individual’s needs.8
How to Use Blue Cross Blue Shield of Oklahoma Insurance As My Substance Abuse Treatment Coverage?
In order to find a suitable substance abuse treatment facility, there are several key steps to follow:15
- Speak to your primary care practitioner about your alcohol use. They will help you determine the best course of treatment and link you to local SUD treatment centers and practitioners. Your primary care provider will coordinate your treatment with a team of behavioral health providers to determine the appropriate treatment plan.
- Locate a treatment program or a facility following a comprehensive SUD evaluation and co-occurring mental health disorder assessment.
- Verify your insurance coverage and treatment length via the insurance company helpline. They will be able to provide a list of in-network facilities that best meet your needs.
- The admissions navigators at the selected treatment center will coordinate with your primary care practitioner and your insurance company and determine what scope of treatment is covered.
How to Find a Blue Cross Blue Shield of Oklahoma Substance Abuse Treatment Facility?
The best way to find a rehab center that is right for you and that is covered by your insurance is to call the Blue Cross and Blue Shield of Oklahoma helpline. You can locate their number on the back of your insurance card.
If you are looking for a reputable in-network SUD program in Oklahoma, American Addiction Centers (AAC) is a great option. Their admissions navigators can answer any questions you may have about the program and verify your BCBS of Oklahoma insurance during your call.
They will inform you about different valid payment methods, check your insurance policy, take you through the assessment and intake process, and offer expedited same-day admissions if you need to enroll urgently. You can find additional resources on their website and check your insurance coverage through an online form.
There are a number of different alcohol treatment centers in Oklahoma that can help you or a loved one get sober, including: