Horizon BCBS of New Jersey Opioid Addiction Treatment

Does BCBS of New Jersey (Horizon) Cover Opioid Rehab?

BCBS stands for Blue Cross Blue Shield. Blue Cross Blue Shield in New Jersey is also known as Horizon Blue Cross Blue Shield of New Jersey. Opioid rehab is among the health services Horizon BCBS of New Jersey covers.1

When it comes to any form of opioid addiction, whether it stems from excessive use of prescription opioids or the use of dangerous illicit opioids such as heroin, the situation can easily get out of hand. Opioid abuse is highly likely to lead to overdose, especially in case of relapse after a prolonged period of abstinence, or when illicit opioids are mixed with dangerous additives such as fentanyl. Even if overdose does not have a fatal outcome, the effect of opioids can still be life-threatening or lead to permanent brain damage.2

The higher the level of intensity and the more comprehensive the scope of addiction treatment, the higher the treatment costs are likely to be. Treatment may last considerably longer if the person also suffers from a co-occurring mental health disorder. All these factors are taken into consideration when working out the initial treatment plan based on the initial assessment.2

If individuals with BCBS of New Jersey insurance coverage choose to go to rehab at an in-network alcohol and drug addiction programs, the costs of treatment are much lower.3

Out of the 383 substance abuse treatment facilities in New Jersey that took part in the 2020 National Survey of Substance Abuse Treatment Services, 95.6% or 266 facilities were private for-profit or non-profit facilities.4 Many of these rehab centers are in-network with major insurance providers nationwide, including BCBS of New Jersey.

What Does BCBS of New Jersey (Horizon) Insurance Cover for Opioid Treatment?

Numerous opioid rehab centers nationwide accept BCBS of New Jersey (Horizon) insurance. The extent of coverage depends on a person’s unique policy plan, but BCBS of New Jersey is likely to provide coverage for the following services within the scope of opioid rehab:5

• Screenings, interventions
• Detox
• Inpatient
• Outpatient
• Behavioral therapies
• Treatment for co-occurring disorders

Individuals dependent on opioids quickly develop the symptoms of withdrawal which can be downright unbearable. Opioid detoxification, which can take up to 10 days, is accompanied by the withdrawal syndrome, so it is of vital importance that this process is conducted in a safe and secure environment, under the strict, constant supervision of medical staff and with the help of medication.2

Detoxification is the necessary first component of opioid addiction treatment which enables the recovering individual to stabilize and get rid of all the traces of the opioid and other substances in their body, but it is only the beginning of recovery.2

What BCBS of New Jersey (Horizon) Does Not Cover for Opioid Treatment?

The high level of treatment intensity in an opioid rehab program often means high treatment costs but the scope of services is not strictly limited to healthcare services. While these services are essential, there are others to be included in a comprehensive approach to care which recovering individuals need to adopt healthier habits and behaviors and build a balanced and productive life.2

The list of elements not covered by BCBS of New Jersey (Horizon) insurance normally include:5

• Non-medical amenities
• Holistic care services
• Recreation programs
• Food delivery
• Private treatment services
• Alternative therapies 

How Much Does Opioid Rehab Cost?

Treatment-seeking individuals often have a hard time seeking the help they need, but even when they decide to do it, they may encounter yet another challenge: paying for the preferred treatment program. Financing high-intensity opioid rehab can be difficult, because it can last a long time. The longer the treatment and the higher the level of treatment intensity, the higher the cost.3

Various factors affect the cost of opioid detox and rehab. Contributing factors may include:3

• Services offered
• Intensity of services
• Duration of treatment
• Amenities

Fortunately, BCBS of New Jersey (Horizon) insurance coverage may apply to some of these services, so make sure to contact their hotline to get accurate information.

Cost of Inpatient Opioid Rehab

The average cost of inpatient opioid rehab depends on the number of days spent in rehab. Although inpatient rehab is charged by day, the longer the treatment program, the lower the cost.2

Cost of Outpatient Opioid Rehab

The average cost of outpatient opioid rehab is lower than the cost of inpatient rehab, but it may also be less effective and may not be safe during the initial period of treatment and recovery, as there is a higher risk of relapse during that time.2 

When it comes to opioids, relapse can have life-threatening or fatal consequences, especially if the person relapses after a substantial period of abstinence, during which they may have lost their tolerance to their usual dose of opioids.2

Cost of Opioid Partial Hospitalization Programs (PHP)

PHP programs for opioid addiction provide day treatment. The average cost of opioid PHPs depends on the number of days spent in the program and the services received.2

Cost of Medication-Assisted Treatment (MAT)

MAT treatment programs provide methadone/buprenorphine maintenance or naltrexone treatment along with behavioral therapy. The average cost of MAT depends on the individual situation a person is in and the pace at which they make progress upon entering in treatment.6

For some individuals, such as those who have been battling opioid addiction for a long time and require long-term methadone maintenance therapy. MAT may need to continue for a minimum of 12 months. However, adequate insurance coverage makes this treatment affordable.2

Opioid Rehab vs. the Cost of Opioid Addiction

Going to rehab may not always be affordable, but it can be a life-saving step. Additionally, the cost of rehabilitation is considerably lower than the combined costs of substance abuse, lost income and health problems that may occur or become aggravated over time.2

The longer substance abuse continues, the worse it gets and the higher the risks of lasting, irreparable damage. On the other hand, longer treatment options, although more expensive, are also more effective at lowering these risks and ensuring favorable outcomes.2

What Length of Opioid Rehab Does BCBS of New Jersey (Horizon) Cover?

The length of opioid rehab depends on the specific situation a recovering individual is in. Longer treatment times are generally considered most effective for chronic drug and alcohol addiction treatment, however each patient’s individual needs are a little different, which is why individual treatment plans are adjusted periodically.2

The coverage BCBS of New Jersey provides depends on the individual health insurance plan, as there are diverse policies and tiers of coverage. This is the key factor determining the length of time covered by the insurance provider.1

Individuals interested in opioid rehab can easily call the BCBS of New Jersey hotline and inform themselves about the specifics of their insurance coverage plan.

Choosing Between BCBS of New Jersey (Horizon) Inpatient vs. Outpatient Opioid Rehab Centers

Many treatment-seeking individuals choose inpatient over outpatient opioid addiction treatment and rehab because treatment in an inpatient setting often provides a higher level of structured care, as well as supervision and support from qualified staff. Inpatient rehab represents a secure environment, allowing recovering individuals to stabilize safely and begin recovery that can lead to meaningful change in their lives.2

Benefits of these programs include:2

• Quality of care
• Treatment ecosystem
• Support group
• More focused environment
• Accountability

BCBS of Illinois insurance coverage correlates positively with improved outcomes, continuity of care, and clinical efficiencies, as well as reduced costs over time.1

How to Use BCBS of New Jersey (Horizon) Insurance for Opioid Rehab?

Treatment-seeking individuals with BCBS of Illinois insurance need to take the following steps to be able to take advantage of their insurance coverage:1

• Consult a doctor
• Find a suitable rehab program
• Determine their ability to use insurance
• Work with their chosen rehab center to determine coverage 

How to Find Opioid Rehabs That Accept BCBS of New Jersey (Horizon) Insurance

Opioid addiction treatment typically requires an evidence-based, clinically-driven approach to treatment and recovery. Adequate treatment duration is of essence, and so is urgent treatment admission.2

Finding an appropriate treatment center that is readily available for entry can be a time-consuming process if going to rehab in a location nearby is the key factor, however, treatment centers are distributed across the nation. When it comes to opioid rehab, it often takes place in an inpatient or residential setting, which eliminates the need for commuting and traveling a long distance to attend sessions as would be the case with outpatient treatment.

But before all that, treatment-seeking individuals are given personalized recommendations based on the initial assessment. If a person has been diagnosed with any comorbidities, this is also taken into consideration for assessment purposes.2

Interested individuals can simply call a hotline to learn more about rehab in absolute privacy, as well as get information about their privacy and confidentiality rights while in rehab.

Admission navigators can provide information about all forms of substance abuse, including prescription and illicit opioids, as well as details on treatment costs, available rehab payment options and accepted insurance coverage.

Some treatment centers even offer uniquely tailored programs such as couples’ rehab and luxury rehabilitation.2

Opioid rehab hotline support representatives can navigate callers through the intake process and, if necessary, make arrangements for same-day admission. Among other things, American Addiction Centers admission navigators can verify callers’ insurance coverage.

In addition to speaking to a doctor about treatment and opioid rehab options, treatment-seeking individuals or their family members can also call the AAC helpline to speak to a person who can immediately check their benefits. The leading treatment center in New Jersey is part of the AAC nationwide network: Sunrise House Treatment Center is an in-demand rehab facility with a top-quality rehabilitation program.