Does BCBS of Texas Cover Opioid Rehab?
Many rehab facilities in Texas that treat addiction to opioids are part of the Blue Cross Blue Shield or BCBS network, which is also one of the key insurance providers in the U.S. All these facilities integrate behavioral health care management with a medical care management program.1
One of the key principles of effective treatment is to enter treatment in a timely manner, and another one is for treatment to last an adequate amount of time. Personalized treatment plans that are adjusted periodically may also correlate positively with beneficial treatment outcomes.2
However, the extent of coverage in case of opioid rehabilitation depends on the individual health insurance plan, but also on the scope of services included in the program. The broader the scope of services, the higher the costs. Higher-intensity long-term programs are typically more expensive.3
Not all services are covered by insurance, as insurance only covers those services that fall under the category of medical necessity. This is why BCBS-insured individuals in Texas look for in-network rehab programs and facilities.4
What Insurance Coverage Does BCBS of Texas Offer for Opioid Treatment?
Blue Shield provides coverage for opioid rehab at in-network rehab facilities, which makes paying for the costs of opioid rehab much easier.1
The scope of coverage may include:3
- Screening, Brief Interventions and Referral to Treatment (SBIRT).
- Detoxification services.
- Treatment in an inpatient setting.
- Treatment in an outpatient setting.
- Behavioral therapies and private or group counseling.
- Treatment for co-occurring mental health disorders or other conditions.
As one of the leading insurance providers in the United States, BCBS is present in Texas and nationwide.1 Numerous opioid rehab centers in Texas are in-network facilities that accept BCBS of Texas and coverage from other major insurance providers.4
Coverage depends on the stipulations of individual plans/policies. The covered services and treatments vary depending on where a person lives.1
What Is Excluded From BCBS of Texas Opioid Treatment Coverage?
Certain elements of treatment and rehab programs are not considered essential and do not meet the criteria for medical necessity, which is why they are not covered by insurance:3
- Private treatment services
- Various services in the domain of holistic care
- Alternative forms of therapy
- Any amenities for non-medical purposes
- Recreation activities and programs
- Food preparation and delivery
What Factors Determine the Cost of Opioid Rehab?
The cost of opioid rehab depends on a range of contributing factors, and each person’s situation is unique.3
Individuals who have a chronic opioid addiction and a long and complex history of poly-substance abuse with frequent attempts at abstinence followed by relapse may need to be in high-intensity treatment for a long time. Others may require lower-intensity treatment and may be able to achieve successful outcomes more rapidly so treatment could take and cost less.2
Some recovering individuals make substantial progress rapidly and after they complete detox and start rehab in a long-term inpatient treatment program, they are free to transition to rehab in an outpatient setting. Many outpatient rehab programs are affordable or available free of charge, as well as easily accessible.3
Comprehensive long-term programs are most likely to lead to beneficial treatment outcomes.2
However, these programs often cost more than their more rudimental counterparts. The differences in cost between programs are based on the following:3
- Services offered
- Availability of medical care and supervision
- Service intensity
- Treatment duration
- Amenities available
Private treatment centers often cost more in comparison to facilities relying on government funding or other forms of public assistance because they offer a higher standard of care, service and accommodation.2 For instance, they may offer special forms of rehabilitation such as rehabilitation for couples, or have the resources to accommodate specific requests for urgent admission such as making arrangements for same-day admittance.
What Is the Average Cost of Inpatient Opioid Rehab?
The average cost of inpatient or residential opioid rehab depends on the program duration and intensity. Inpatient programs usually fall under the high-intensity program category. The cost per day in a 30-day inpatient program ($400–$900 per day) is higher than the cost per day in an inpatient program spanning 90 days ($200–$700 per day).2
However, programs spanning a minimum of 90 days are considered to be considerably more effective than programs that last less than that.2
What Is the Average Cost of Outpatient Opioid Rehab?
Many factors affect the average cost of outpatient opioid rehab: whether medications are part of therapy, the duration of the program, the frequency of sessions, the scope of rehabilitation services, and so on.2
Although it is typically the most affordable opioid rehab option available (on average, the price range is $100–$500 per session), outpatient rehab may not be suitable for treatment-seeking individuals who are just starting their road to recovery. These individuals are more likely to stabilize in an inpatient setting.2
Intensive Outpatient Programs with Housing cost between $3,500 and $5,000 per week, but in terms of intensity and effectiveness, they match inpatient programs.2
What Is the Average Cost of Opioid Partial Hospitalization Programs (PHP)?
The average cost of Opioid PHPs depends on the number of days a person spends in the program. For comparison purposes, detox takes between 7 and 10 days and the average price range is $600–$1,000 per day.
What Is the Average Cost of Medication-Assisted Treatment (MAT)?
The average cost of MAT depends on the length and elements of therapy, as well as on the person’s insurance coverage. Therefore, it’s best to check with your insurance provider or preferred treatment facility. 5
Comparing the Cost of Opioid Rehab vs. Continuing Opioid Addiction
Opioids are extremely addictive because they cause a powerful euphoria but also carry a high risk of tolerance and dependence, the driving forces behind the vicious cycle that is opioid addiction.2
It is not uncommon for individuals to switch to illicit opioids such as heroin after becoming unable to procure prescription opioids.2 A hotline can answer all these questions and more.
Having to pay for opioid rehab without financial assistance and support can be difficult, but it is still less expensive than the accumulated costs of substance abuse, deteriorated health and lost income. Additionally, continuing opioid abuse can end in a fatal overdose and other damaging outcomes.2
Rehab center hotline representatives can answer questions about the admission and treatment process, as well as provide information about treatment costs and payment options and perks, such as being in network with major insurance providers, flexible payment plans, or the sliding scale fee.
What Length of Opioid Rehab Does BCBS of Texas Cover?
The optimal program length depends on individual needs and circumstances a person is in, such as policy specifics and tier of coverage.4
But the length of treatment the insurance provider covers depends on that person’s specific plan. Individuals interested in their treatment payment options and extent of their insurance coverage can easily look up their own plan information on their insurance card.4
It is generally considered that longer programs are more effective at addressing opioid addiction and co-occurring disorders caused or exacerbated by substance abuse.2
Choosing Between BCBS of Texas Inpatient vs. Outpatient Opioid Rehab Centers
Many individuals choose inpatient over outpatient opioid rehab because they have had numerous failed attempts at treatment in an outpatient program. The support these programs provide is more consistent, increasing the likelihood of a successful long-term outcome. Inpatient programs also offer 24/7 supervision and highly structured care.2
Inpatient programs may lead to more favorable outcomes based on the following factors:2
- Higher quality of care
- Advanced treatment ecosystem development
- Patient-oriented environment
- Sharper focus on the recovering individual’s accountability
- Ability to take part in support groups on a daily basis
How to Use BCBS of Texas Insurance for Opioid Rehab?
After consulting a doctor and finding a suitable rehab program, treatment-seeking individuals and their families can determine their ability to use insurance either by asking the rehab center to determine coverage or by consulting their insurance provider.1
How to Find Opioid Rehabs That Accept BCBS of Texas Insurance
Every year, many people go into rehab that is partially or fully financed through BCBS of Texas. The only requirement is for the facility to be in the network of their insurance provider.4
It is important to speak to a doctor about treatment and opioid rehab options, but heroin hotline representatives are also available to answer questions about local rehab centers and programs, as well as whether they are in-network with BCBS of Texas. All this is done in absolute privacy. American Addiction Centers is no exception, and AAC admission navigators can verify treatment-seeking individuals’ insurance coverage. All it takes is a phone call.
Greenhouse Treatment Center in Texas is one of the leading treatment centers in the state, and it has a top-notch quality rehab program.