Premera BCBS Insurance Plans Cover Opioid Rehab?

As a Blue Cross Blue Shield licensed private insurance company, Premera Blue Cross offers various health insurance plans, serving over 2 million people. One of the most common questions people have is “does Premera BCBS cover drug rehab” and the answer is simple.1

Thanks to the Affordable Care Act, insurance companies are obligated to provide alcohol and drug rehab coverage in their health plans and treat these conditions in the same way they would any other medical condition. This means that, based on your Premera BCBS insurance coverage, your opioid addiction treatment costs may be covered.2

Opioid abuse is a serious issue nationwide, particularly in Washington and Alaska, where 737 and 68 people die each year from opioid overdose respectively. Heroin and prescription opioids are common factors in most of these fatalities, with synthetic opioids following closely.3

Therefore, knowing help is available and that Premera BCBS substance abuse coverage may help cover some of the recovery costs can help encourage individuals to seek the help they need.

What Opioid Treatment Services Are Covered by Premera BCBS Healthcare Plans?

Premera BCBS insurance coverage may cover some or most of your opioid treatment, which, depending on your plan, may include:3,4

Opioid screening. The screening process for drug treatment includes a mental health evaluation and a physical examination, usually at a treatment facility or health center.
Interventions. The intervention process for drug treatment should involve a medical professional or an interventionist and aim to inspire a person with an opioid use disorder to seek help and raise their awareness of the issue.
Medical detox. Medical detox is the process of safely removing opioids from the body and dealing with subsequent withdrawal symptoms. Medical detox is an important step in opioid treatment, as it helps to ensure that the person is able to transition to long-term treatment without any complications.
Inpatient opioid treatment. Inpatient opioid treatment is a common method of getting help for people who are addicted to opioids. People in this type of treatment stay at a hospital-like facility or special treatment center while they receive help, with complete privacy guaranteed by law. This can be a good option for people who have a severe addiction or have overdosed.
Outpatient opioid treatment. Outpatient treatment involves visiting a doctor or a therapist in a local treatment center on a regular basis. Patients will usually take medication and receive counseling, or participate in various individual or group activities, such as 12-step programs and cognitive-behavioral therapy.
Behavioral therapies. Behavioral therapies for opioid addiction treatment involve disciplines such as cognitive-behavior therapy (CBT) or dialectical-behavior therapy (DBT) to help people with addiction to opioids. These therapies can help people learn how to live without opioids, manage their addiction, and cope with problems.
Treatment for co-occurring disorders. Co-occurring disorders are common among opioid patients and are treated with a combination of medication and therapy. The treatment deals with symptoms and causes of both. Following an assessment for co-occurring disorders, doctors will devise a treatment plan that deals with opioid abuse and mental health issues that likely played a part in developing it.

What Does Premera BCBS Rehab Coverage Not Include?

Rehab insurance will not cover the cost of treatment considered to be alternative in nature. This may include certain types of experimental therapy or holistic treatment like yoga, acupuncture, or chiropractic care.2

The insurance will likely not cover any non-medical services either, including private rooms, fine dining, and food delivery, TV in rooms, recreational activities such as working out with a trainer, horseback riding, or swimming.2

What Is the Cost of Opioid Rehab?

The cost of opioid rehab can vary depending on several factors, including the extent of your Premera BCBS healthcare plan coverage. The intensity of treatment and treatment duration are two major factors that may affect the cost. People who need longer or more intense treatment might have to pay more. Additionally, services offered also affect the price, such as medication treatments, group counseling, dual diagnosis treatment, or other therapies.4

While understanding the cost and how to finance treatment can be difficult, it’s important to ask questions and understand what kind of support you’re eligible for. This will help make sure you can afford the care you need. Admissions agents at the AAC alcohol and drug rehab hotline are available to provide any additional details such as various financing options available to patients. They can also help verify your insurance coverage on the spot and help you find the nearest Premera BCBS substance abuse treatment facility.4

How Much Does Inpatient Treatment Cost?

The cost of inpatient treatment depends on the duration and location of the facility. It also depends on what kind of treatment and services are offered. Generally, the longer you stay and the more specialized the services, the higher the cost. However, many treatment centers offer sliding fee scales and payment options that can make inpatient care more affordable.4

How Much Does Outpatient Treatment Cost?

The cost of outpatient treatment is based on the number of treatment sessions per week, and what type of therapies are offered. In general, people attend between three and five therapies per week. Most commonly patients will attend a combination of counseling, behavioral therapies, and group therapy sessions. Some Premera BCBS healthcare plans cover outpatient treatment, while some programs offer additional financing options for those in need.4

How Much Do Partial Hospitalization Programs Cost?

Partial hospitalization programs’ price also depends on the duration and intensity of treatment. These programs usually require 4 to 8 hours of treatment per day and can be used as a transition from inpatient care or as a way to replace inpatient care. The treatment team for outpatient care usually includes a physician or psychiatrist, nurses, counselors, and social workers.4,5

How Much Does Medication-Assisted Treatment Cost?

The cost of medication-assisted treatment varies depending on a lot of different factors. The cost can be affected by the type of medication used, the length of treatment, and the insurance coverage available. Weekly costs based on the treatment used in 2020 were as follows:6

Methadone: $207
Buprenorphine (oral use): $258
Buprenorphine (injected): $1757
Naltrexone: $1342

These prices include drug dispensing and administration, various forms of counseling, individual or group therapy, and drug testing if needed.6

Is Opioid Therapy Worth It?

The opioid epidemic has had a devastating impact on the US economy, costing an estimated $1,000 billion in 2017. There is an estimated $470 billion cost associated with opioid use disorders, as well as $550 billion in the cost of fatal overdoses.7

Health care costs, costs of lost productivity, substance use treatment, and criminal justice costs all affect how much opioid abuse costs the nation. In Washington, there were an estimated 68,000 cases of opioid use disorder in 2017, which cost the state a total of over $23,600 million (including fatal opioid cases). Of that, only $112.9 million was spent on substance use treatment.7

The most cost-effective way to address opioid abuse is to intervene early before it progresses to addiction. This can reduce the costs addiction has on the nation and contribute to a healthier society.8

Several states have found that offering adequate mental health and opioid abuse treatment benefits can drastically reduce healthcare costs. Study results from Washington State showed that granting full treatment benefits to those alcohol and drug abuse issues saved Medicaid $398 per patient per year. After treatment, monthly medical costs for those in treatment were $311 lower than for people who did not receive treatment when needed. In addition, state hospital monthly expenses for people in treatment were, on average, $48 lower.8

What Program Length Does Premera BCBS Addiction Treatment Cover?

Health insurance plans vary in terms of the amount of time they cover. This means that the amount of time a person is covered by their addiction insurance plan will vary depending on the specific policy they have. You can find out more about your plan by contacting the Premera BCBS helpline, where you can learn more about your benefits and coverage length.2

The longer you stay in treatment, the higher your chances of recovery are, particularly when it comes to opioid use disorder. Treating a severe opioid addiction could take 90 days or longer, with MAT continuing for months or years after.9

Patients who finish inpatient treatment may transfer to sober-living facilities, partial hospitalization programs, or outpatient treatment to continue monitoring their addiction in a safe and structured environment. These treatment options could also last between a few months, up to a year, or more.9

Inpatient or Outpatient: Which Treatment Program Is Better for Opioid Addiction?

Inpatient treatment provides a more structured and treatment-focused environment than outpatient care. This can be beneficial for those who need more support to address their addiction and achieve lasting sobriety. Inpatient facilities also provide a supportive peer community and accountability from professional staff. This can be helpful in maintaining sobriety and preventing relapse.9

People who are willing to attend regular treatment and counseling sessions may benefit from outpatient treatment. This type of care doesn’t require overnight stays, so it’s important to have support from friends and family, a stable place to reside in, and means of transportation.4

Opioid treatment varies on the type of opioid used and the patient’s anamnesis, so there is no such thing as the best treatment or treatment that’s equally effective for everyone. While some patients may benefit from inpatient treatment settings, others may find outpatient treatment less constraining and therefore easier to complete. Finding the right treatment modality for an individual is the key to helping them return as a productive and healthy member of society.9

How to Use Premera BCBS Substance Abuse Coverage for Treatment?

If you or your loved one are experiencing symptoms of opioid abuse, you should make an appointment with your primary care provider or mental health professional. They can evaluate their health situation and recommend the best course of care.5

You can call the number on the back of your insurance card to get the list of all providers that are in your network. Make sure to check with the selected facility whether they still accept your Premera BCBS insurance coverage and whether they accept Premera BCBS coverage nationwide. The admissions agents at recognized facilities such as American Addiction Centers will be able to verify your insurance during a single phone call and work with your insurance company to ensure a smooth process. Making sure you select an in-network inpatient facility will ensure you have better control of your costs.5

Finding Premera BCBS Inpatient Drug Rehab Centers Nationwide

There are many AAC inpatient treatment centers nationwide that provide outstanding treatment programs. Calling their heroin hotline or reaching out via email or contact form will connect you with an admissions agent who can verify your Premera BCBS insurance, help guide you through your intake and what it entails, and offer additional private pay options.

They will help you find an in-network treatment center and explain the entire process, from the initial assessment process and admission into the facility to what aftercare programs are available.

Frequently Asked Questions

What Is the Length of Premera BCBS’s Inpatient Opioid Treatment Coverage?

The treatment duration and insurance coverage vary based on the individual’s profile and insurance policy. In general, inpatient opioid treatment lasts between 60 and 90 days, with longer treatment required for people with severe addiction.9

Calling the AAC hotline will connect you to an admissions agent who can help you determine your coverage length and offer the most appropriate treatment center.9

Does Premera BCBS Cover Stay at a Luxury Treatment Center?

Some luxury treatment centers may be in-network with Premera BCBS. However, please note that some amenities offered at these centers, such as same-day admittance, access to gym and spa, various recreational activities, and other non-medical amenities may not be covered by your Premera BCBS insurance coverage.4

Are Christian Rehab Centers Covered by Premera BCBS Healthcare Plans?

Some Christian rehab centers may be in-network with Premera. To get the list of all Christian rehab centers that are in-network with Premera BCBS, make sure to call their helpline and ask for the list of Christian treatment centers included in the coverage.5

These treatment centers may help those with opioid addiction get better through various faith-based activities such as Bible study and communion, paired with the best evidence-based treatment.11

Christian drug and alcohol rehab can provide a number of benefits to those who are struggling with opioid addiction. These benefits include the use of evidence-based treatment methods as well as spiritual guidance. Through spiritual guidance, some patients are able to confront their negative attitudes and perceptions.11

Do Premera BCBS Offers Assistance With Medicare Plans?

Medicare can be used to cover the cost of rehab for many types of addiction including opioid abuse, but there are rules about the providers people can use with Medicare. Some types of addiction treatment are not covered by Medicare at all, so it’s a good idea to contact Medicare directly to find more precise information.12

Medicare Part B (Medical Insurance) covers various services offered in opioid treatment programs. The services covered by Medicare include medication, counseling, drug testing, individual and group therapy, screening and intake process, and periodic assessments.12

Premera Opioid Treatment Centers in Washington and Alaska