Blue Cross/Blue Shield For Rehab In Austin, TX

The costs of attending long-term treatment for substance use disorders can be a barrier for some. Many clients are worried about how to pay for rehab. As a result, many people avoid getting the treatment they need altogether. That is why The Prairie Recovery Center works with companies like Blue Cross/Blue Shield for rehab in Austin, Texas.

At Prairie, we hope to minimize the worries and stresses of potential clients. Therefore, we can answer any questions about our treatment program—including costs and insurance coverage. By partnering with a popular insurance provider like Blue Cross/Blue Shield, we can expand our mission to serve individuals and their families in achieving wellness from the effects of addiction and co-occurring mental health disorders.

About Blue Cross/Blue Shield

Blue Cross/Blue Shield has been providing healthcare insurance since 1929. At that time, it was known as the Baylor Plan and sought to make healthcare more affordable for patients at Baylor University Hospital in Dallas, Texas. Since that time, Blue Cross/Blue Shield (BCBS) has expanded and now boasts to cover one in three Americans.

Does Blue Cross/Blue Shield Cover Rehab in Austin, TX?

Yes, BCBS covers rehab in Austin, Texas. Many insurance carriers began providing substance use treatment following the passage of the Affordable Care Act (ACA). This is because the ACA includes substance use disorders as an essential health benefit.

Oftentimes, medical necessity determines coverage. In other words, is substance use treatment needed for a person’s physical well-being? The answer to this question is usually a resounding “yes,” since substance use disorders negatively impact all areas of a person’s health and well-being.

However, individual plans and coverage can vary. In addition, each state has different regulations for insurance. So, it is best to contact BCBS directly for specific questions about individual coverage.

Verify Insurance With Our Staff

Potential clients can also contact our admissions staff about Blue Cross/Blue Shield rehab coverage. We can help our clients understand their coverage when it comes to our treatment plans. For instance, some parts of rehab, like therapy or detox services, are generally covered by insurance. However, holistic therapies might not be included.

In addition, we can customize each client’s treatment plan to adjust for the costs. That way, we can still meet a person’s needs while also keeping the out-of-pocket costs to a minimum.

Furthermore, most insurance carriers cover evidence-based treatments, like cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT). Since we build our programs around the most up-to-date evidence-based practices, a majority of therapies should be covered by Blue Cross/Blue Shield for rehab in Austin.

What Does BCBS Cover for Substance Abuse Treatment?

As previously mentioned, coverage can vary from state to state and person to person. One person’s individual plan might offer additional coverage for auxiliary services while another plan might only cover the bare necessities. Also, inpatient rehab incurs other costs, such as meals, room fees, and other amenities. These fees are usually not covered by insurance providers.

Stabilization and Detox

However, BCBS will generally cover things that are medically necessary. These usually include any type of stabilization services, such as medical detox. Detox is the first step to recovery from drug and alcohol addiction. Attempting to detox without professional support can lead to relapse, overdose, and medical issues. In some cases, detoxing alone can be dangerous and even deadly.

Inpatient and Outpatient Rehab

In addition, inpatient or residential rehab, as well as outpatient services, could be covered by BCBS. As mentioned above, the determining factor is usually “medical necessity.” That includes any medical issues resulting from substance misuse. Therefore, potential clients should consult with their family doctor or primary care physician (PCP) about their substance misuse.

Will BCBS Cover Rehab After a Relapse?

People with addiction, like those with other chronic diseases, may relapse during their recovery. According to the National Institute on Drug Abuse (NIDA), “[w]hen a person recovering from an addiction relapses, it indicates that the person needs to speak with their doctor to resume treatment, modify it, or try another treatment.” Thus, a relapse is not a sign of failure but rather a sign that a person needs additional help.

Because of this, many rehab programs focus on relapse prevention as well as what to do if a relapse occurs. One solution for relapse could be additional time in rehab.

Blue Cross/Blue Shield could help cover additional time in rehab if it is deemed medically necessary. This can include outpatient or inpatient readmissions. Again, each person’s plan may vary, so it is always best to discuss coverage for our rehab in Austin with Blue Cross/Blue Shield representatives.

Furthermore, some clients could be at a higher risk of relapse. This could be due to the level of addiction, lack of resources or support outside of a facility, or the substance that a person uses. Therefore, another option could be extending a client’s initial stay in rehab to reduce the risk of a relapse.

Do I Need to Get In-Network Care?

Many insurance carriers require that a person get their treatment in-network to ensure coverage. Out-of-network programs could be more costly than in-network coverage as a result. By going out-of-network, a person might need to pay more out-of-pocket expenses than staying in-network. Or, they might not receive any coverage out-of-network at all.

Of course, for some people, there might not be a facility in their community that provides the treatment they need. Thus, using Blue Cross/Blue Shield for rehab in Austin could be the only option for some people in need of treatment. Furthermore, some people do better when going out of town for rehab because they can focus on recovery with minimal distractions.

That is why it is important to discuss coverage with the insurance carrier. They might be aware of in-network facilities nearby. They may also work with clients if an in-network provider is unavailable.

Have additional questions? Learn more about addiction and treatment options on our FAQ page.

Find Drug and Alcohol Rehab in Austin, TX

Drug and alcohol addiction affects several aspects of a person’s life. From family issues to medical problems, substance use disorders are disruptive to a person’s well-being and quality of life. However, inpatient rehab programs can be costly and many people avoid treatment due to this barrier. Fortunately, The Prairie Recovery Center partners with popular carriers such as Blue Cross/Blue Shield for rehab in Austin, Texas.