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BCBS of Rhode Island Opioid Addiction Rehab

Does BCBS of Rhode Island Cover Opioid Rehab?

The opioid epidemic in the U.S. is now considered a national emergency. The number of overdose deaths involving opioids is more than five times higher than in 1999. In 2020, close to 50,000 people overdosed on opioids.1

In Rhode Island, close to 300 people die each year from an opioid overdose and prescription opioids are responsible for close to a third of those deaths.1

Therefore, opioid abuse is a major issue for Rhode Island and the entire nation. However, for some individuals, it can be difficult to get help for this addiction because of the expense of treatment. Fortunately, under an act passed in 2008, insurance companies are required to cover the cost of treatment for substance abuse and cannot deny help to those who need it.2

More than 21% of people in the U.S. in 2011 were covered by Medicaid for substance abuse treatment, while more than 10% relied on private insurance coverage and turned to companies like BCBS of Rhode Island for substance abuse coverage.3

What Opioid Treatment Services Does BCBS of Rhode Island Insurance Cover?

Private insurance companies must cover addiction treatment in the same way they cover any other surgical or medical emergency.4

Private insurance companies may cover a variety of addiction treatment programs, depending on the policy. Some common treatment options that fall under the scope of insurance coverage include inpatient and outpatient rehab, screening and interventions, detoxification, and medication-assisted treatment (MAT).5 

Many private insurance companies also cover mental health services, which can be helpful for people struggling with addiction and those with a co-occurring mental disorder. Mental health services can include behavioral therapy, counseling, and medication management.4

If you are struggling with opioid addiction and have private insurance, it’s important to research your policy to see what types of treatment are covered. You may also want to contact your insurance company to find out which rehab facilities are in-network.2

At least 65% of close to 15,000 treatment facilities surveyed by SAMHSA stated they accept private health insurance plans like BCBS of Rhode Island nationwide, making opioid treatment widely acceptable.6

What Is Not Covered by BCBS of Rhode Island Healthcare Plans?

There are a number of services that are not covered by private insurance for addiction treatment, as they are not considered medically essential. This includes non-medical services such as private accommodation, same-day admittance into the facility, food delivery, room TV, and access to a phone. Private insurance also excludes private treatment and holistic care services, as well as recreational programs such as art therapy, hiking trips, yoga, meditation, or exercise.7

What Is Blue Cross Blue Shield of Rhode Island?

The Blue Cross and Blue Shield Association (BCBSA) was founded in 1929, making it one of the oldest health insurance organizations in the United States. The BCBS of RI is one of the 34 independent Blue Cross and Blue Shield companies that are part of the BCBSA. The company offers coverage for treatment in 50 different states, including Rhode Island’s addiction treatment facilities. The company is committed to providing quality, affordable health coverage to more than 110 million members.8

What’s the Cost of Opioid Rehab?

The cost of opioid rehab depends on the programs and services you need. Inpatient care is a more comprehensive program that involves residing at the treatment facility and having access to all the services around the clock. Outpatient treatment entails visiting the treatment center for scheduled therapies and activities.5

In addition, based on the maintenance drug prescribed the costs may range from close to $130 per week to $1177 per month.9

Based on the intensity and length of treatment, and services provided, the cost of treatment can vary, which is why it’s best to check your payment options with AAC’s admissions navigators or by calling the BCBS of Rhode Island helpline.

How Much Does Inpatient Opioid Treatment Cost?

Inpatient opioid rehab is one of the most effective treatment options for addiction to opioids. It provides a safe and supportive environment for the patient to recover from the addiction. The rehab center staff can help the patient address the underlying causes of the addiction and develop a relapse prevention plan.5

The average cost of inpatient opioid rehab can vary depending on the facility and the program. Some facilities offer higher comfort, more privacy for their patients, and additional amenities at a higher price.5

Most rehab centers offer a variety of payment options to make the treatment more affordable for the patients and their families. Some centers may accept private pay, Medicaid, or Medicare.2

The main factor in determining the price of treatment will be the length of stay. The average length of stay for inpatient opioid rehab is anywhere between 60 to 90 days. However, the length of stay may vary depending on the severity of the addiction and the patient’s progress in treatment.5 

How Much Does Outpatient Opioid Treatment Cost?

Outpatient opioid rehab does not involve the costs of residence at a treatment facility, since the patients are expected to visit for their scheduled therapy while they continue living at home. This may make outpatient treatment much more affordable compared to some inpatient treatment programs.5

There are a variety of outpatient opioid rehab programs available, so you can find a treatment center that fits your needs. Some programs require you to attend a certain number of sessions per week, while others allow you to choose the days and times that work best for you.5 

How Much Do Opioid Partial Hospitalization Programs Cost?

Partial hospitalization program treatment costs will vary based on the services provided, the number of sessions per week, and the duration of the treatment. These programs typically include individual and group therapy, medication-assisted treatment, and education about opioids and their effects. The program can be offered in a variety of settings, as long as they meet specific criteria.10

The recommended duration of a PHP for opioid abuse is 90 days. However, longer treatment periods at a lower intensity may positively affect the outcome of the treatment as patients are less likely to relapse and more likely to experience an improvement in their social functioning. The longer the treatment, the higher the costs of PHP will be10

How Much Does Medication-Assisted Treatment Cost?

Effective pharmaceutical treatment is available to treat opioid use disorder, including buprenorphine, naltrexone, and methadone. These maintenance treatment options may help many people recover from opioid use disorder.9

The weekly costs of MAT for opioid treatment based on the maintenance drug prescribed are:11

  • Methadone: $207.49
  • Buprenorphine (oral): $258.47
  • Buprenorphine (injectable): $1,757.29
  • Naltrexone: $1,342.67

The costs of MAT also include weekly substance abuse counseling, individual and group therapies, drug dispensing and administration, and toxicology screening. To check whether your BCBS of Rhode Island insurance plan will cover this part of your opioid rehab, make sure to call the company’s helpline or your treatment provider.11

How Do Treatment Costs Compare to the Costs of Opioid Addiction?

The economic cost of the opioid epidemic in the U.S. was estimated at approximately $1,000 billion in 2017. This included the cost of an opioid use disorder, estimated at $470 billion, and the cost of fatal opioid overdoses at $550 billion.12

There were 6000 estimated cases of opioid use disorder in Rhode Island, 277 of which were fatal in 2017. The combined costs of opioid use disorder cases and fatal cases were sitting around $3,198 million, with the cost per capita being $4,271.12

These costs include the costs of health care, substance use treatment, criminal justice, reduced life quality, and lost productivity.12

The benefits of investing in early intervention and treatment for substance use disorders are numerous. Addiction can be treated successfully with appropriate access to quality care. When people with substance use disorders get help early, they are more likely to recover completely and lead healthier lives.13

What Length of Opioid Rehab Does BCBS of Rhode Island Cover?

BCBS of Rhode Island addiction treatment may cover some or most of the rehabilitation treatment, including inpatient rehab and MAT costs, and offers the same level of benefits as for any other medical emergency.4

The specific length of treatment covered by BCBS of Rhode Island insurance coverage will vary based on the selected plan and the state it’s used in. If you need to check what your BCBS of Rhode Island coverage nationwide entails, you can call the number on the back of your insurance card and check your benefits.4

When it comes to opioid treatment, no program is right for every patient. However, longer treatment times are directly linked to higher recovery success rates, which makes staying in treatment for the right amount of time essential.5 

In general, any program shorter than 90 days for inpatient or outpatient treatment may have a limited effect on the treatment outcome. Longer treatment times correspond to higher treatment success rates. In terms of methadone treatment, a minimum length of maintenance therapy should be no less than 12 months, with many patients benefiting from MAT for several years.14

What Is Better: Inpatient Drug Rehab Centers or Outpatient Treatment?

There are many different types of addiction treatment, but inpatient and outpatient treatment are two of the most common models. Inpatient addiction treatment has the person stay at a rehab facility for the duration of their treatment. Outpatient addiction treatment is when the patient goes to a rehab facility for counseling and therapy sessions but is not expected to stay at the facility overnight.14

There are pros and cons to both inpatient and outpatient addiction treatment.14

  • Inpatient addiction treatment has the advantage of providing a safe and supportive environment for the person recovering from opioid abuse 
  • The patient can also receive medication-assisted treatment while they are at the rehab facility.
  • Outpatient addiction treatment has the advantage of being less expensive than inpatient addiction treatment. 
  • The person can also continue to work or perform daily activities while they are receiving outpatient treatment.
  • However, outpatient treatment can be less safe than inpatient treatment because the person is not supervised around the clock.

Which type of addiction treatment is right for you? That depends on your situation and your needs. Talk to your doctor or a counselor to find out which type of addiction treatment is best for you or your loved one.14

What Is the Process of Using BCBS of Rhode Island Insurance Coverage for Opioid Addiction Treatment?

When you are looking to check your BCBS of Rhode Island coverage nationwide, it’s best to call the number on the back of your card or the number on the website. This will allow you to speak with a representative who can help you find out what coverage is available to you.2

To save money on healthcare costs, you can ask your insurer for a list of preferred facilities and providers in the area. Choosing a local facility on this list will make it easier to avoid unexpected expenses because insurance companies are more likely to cover services received at a preferred facility.2

Individuals with health insurance often have to pay a deductible before their benefits kick in. This means you need to ask your insurance representative about the deductible amount and the amount you have already paid. Any medical expenses may count toward the total, not just opioid treatment.2

Medical care can be expensive, so it’s important to understand the costs associated with treatment. Most facilities require a co-pay, which is a small sum you need to cover upfront. Make sure you know how much this cost is and how many appointments or days in therapy are covered annually.2

When you are looking for a treatment center, it’s important to find out if they accept your insurance. Most treatment centers accept most major insurance providers like BCBS of Rhode Island healthcare plans, but you should always check. You can also ask the admissions navigators at the center directly about their payment policies. They will likely be able to tell you what your immediate expenses will be.2

Opioid Rehabilitation Centers That Accept BCBS of Rhode Island Rehab Coverage

American Addiction Centers has a team of professional admissions navigators who can verify your insurance coverage for you, and offer additional tailored payment. All you have to do is speak to a doctor about treatment and then call the AAC drug and alcohol addiction helpline. The staff at American Addiction Centers can check your benefits right while you’re on the phone. 

Following a short assessment, a professional will determine the optimal course of treatment.  Many people are hesitant to seek help for addiction, but treatment can save your life. AAC has many in-network facilities that accept BCBS of Rhode Island insurance coverage, such as Clinical Services of Rhode Island (CSRI).

AdCare Rhode Island

AdCare Rhode Island is an innovative, affordable, and quality-oriented treatment center in North Kingstown. The facility focuses on helping individuals and their families deal with the pitfalls of addiction through multiple treatment modalities and appropriate levels of care. Some of the facility’s standout treatments include expressive therapy, individual and family counseling, medically-monitored rehab, and cognitive-behavioral therapies.

Clinical Services of Rhode Island (CSRI)

Clinical Services of Rhode Island (CSRI) is an addiction treatment center that takes a holistic approach to help clients overcome their addictions. The center is a member of the American Addiction Centers network and has numerous financing options available.

They work closely with the client’s partners, family, support network, and the community to create personalized treatment plans and provide evidence-based treatment following a professional case assessment. CSRI focuses on more than substance abuse by working with the client to build habits that will lead them to a sober, prosperous future.

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