Does BCBS of Massachusetts Insurance Cover Inpatient Alcohol and Drug Rehab Centers?
Blue Cross Blue Shield (BCBS) of Massachusetts is an insurance provider that offers coverage for addiction treatment.1 As a BCBS of MA member, at least some of the costs of addiction treatment will be covered by your insurance plan. The amount depends on your plan, as coverage varies from plan to plan. To learn about what your plan covers, call the number on the back of your insurance card to speak with a BCBS customer service agent.
You can also contact us at American Addiction Centers (AAC) directly, either by calling us at , using the chat feature on our website, or completing the 2-step form below with your insurance and contact information. We’re here to help you every step of the way.
How to Find BCBS of Massachusetts Covered Inpatient Drug Treatment Centers in MA?
Choosing a rehab facility that is in-network with BCBS of Massachusetts is ideal. An in-network facility has an agreement with BCBS to provide addiction treatment at a discounted rate, which means lower out-of-pocket expenses for you. BCBS of Massachusetts has a national designation program. When you choose a rehab facility that is in-network with Anthem BCBS of Colorado, that means that the facility has an agreement with your insurance provider to provide treatment and other services at a discounted rate. Whenever possible, it’s best to choose a rehab that is in-network to keep your out-of-pocket expenses lower.
Blue Cross and Blue Shield companies—including Anthem BCBS of Colorado—have a national designation program called Blue Distinction.2 The program recognizes nationally accredited treatment facilities that provide patient-focused care to help individuals living with substance use disorder.
If you’re looking for a treatment center close to home and in-network with BCBS of Massachusetts, consider our AdCare Hospital in Worcester, one of the top-tier facilities in the state.
What is BCBS Of Massachusetts?
BCBS of Massachusetts provides health insurance coverage to nearly 3 million members living in the state.1 The company has been operating for over 80 years and is a subsidiary of one of the largest health insurance providers in the country, the Blue Cross Blue Shield Association.1 BCBS of MA is a community-focused not-for-profit health plan headquartered in Boston.3
In Massachusetts, 1 in 10 people struggle with alcohol and/or drug addiction.4 According to BCBS of Massachusetts, the insurance company’s spending on treatment for substance use disorder increased by 10% during the COVID-19 crisis.3
How Much Does BCBS of Massachusetts Cover (Addiction Treatment)?
There are various addiction treatment levels of care available, and the care you access will depend on your specific needs, what substances you are using, and how long you’ve been using. As a BCBS of Massachusetts member, at least some of your addiction treatment will be covered by your insurance provider. Treatments that may be covered by BCBS of Massachusetts include:5
- Medical detox. Medical detoxification uses prescription medications to help you withdraw from alcohol and drugs. The process of detoxification includes evaluation of your current physical health and addiction, stabilization, and preparing you to enter a recovery program, such as inpatient rehab. Medical supervision is provided 24/7 in medical detox to ensure your comfort and safety.
- Inpatient/residential rehab. Inpatient residential rehabs provide a place to live (at a hospital or rehab facility) for a period of weeks or months. Both individual and group counseling are provided. Some facilities offer amenities like fitness classes, a pool, and more.
- Partial hospitalization programs (PHP). Intensive rehab programs that allow you to live at home while attending treatment during the daytime hours approximately 5-7 days a week.
- Intensive outpatient (IOP). IOP programs let you live at home and attend to work and family responsibilities during daytime hours. You will attend treatment in the evenings, approximately 10-20 hours per week, depending on the program you enroll in.
- Outpatient treatment. Outpatient programs allow you to live at home while attending treatment at a clinic, hospital, or rehab facility. Individual and group counseling are a big part of outpatient programs.
Does Blue Cross Blue Shield of Massachusetts Provide Coverage for Mental Health Facilities?
Yes. BCBS of Massachusetts provides some coverage for mental health treatment and stays at mental health facilities when deemed medically necessary. In 2014, the Affordable Care Act (ACA) was enacted. The law states that mental health treatment must be covered in the same way that physical health is covered by insurance companies.6 In addition, the Mental Health Parity and Addiction Equity Act ensures that mental health and addiction treatment coverage is provided for those who need it.7
Addiction treatment falls under these laws. If you struggle with addiction to drugs or alcohol, your treatment will at least be partially covered by BCBS of MA. If you have substance use disorder plus another mental health condition, such as anxiety or depression, this is known as a dual diagnosis, sometimes called a co-occurring disorder. BCBS of Massachusetts has a number of resources for members struggling with their mental health. Visit the member portal on their website or app to learn more.8
Any addiction treatment, as well as other mental health treatments, must at least be partially covered by your insurance plan. If you have another mental health condition (e.g., anxiety, PTSD, depression) along with substance use disorder, this is known as a dual diagnosis, or co-occurring disorder. The amount of coverage provided for mental health and addiction treatments depends on which insurance plan you have. If you need assistance, Anthem BCBS of Massachusetts can help you find and access mental health treatment.8
Most rehab facilities offer treatment for both mental health conditions and substance use disorders at the same time. Ask any rehab facilities you are considering how they provide treatment for those with a dual diagnosis.
How Long Does BCBS of Massachusetts Insurance Cover Alcohol and Drug Rehab Programs?
The amount of coverage provided for alcohol and drug rehab programs and the duration of your stay that is covered by insurance varies from plan to plan. All plans cover at least part of the costs of addiction treatments. How long your coverage lasts depends on your needs, your insurance plan, and how long you’ve been using drugs or alcohol.
Evidence suggests that individuals who are in treatment for 3 months or more have the best outcomes, meaning a lower chance of relapsing.9, bullet 5 To determine how long coverage is provided for addiction treatment under your plan, call the Blue Cross Blue Shield of Massachusetts phone number on the back of your insurance card to speak with a customer service agent and ask for details about your plan. Alternatively, you can call us at , and one of our admissions navigators will verify your insurance benefits for you while you’re on the phone and determine how long your coverage will help pay for treatment.
What If My BCBS Of Massachusetts Policy Does Not Cover an Inpatient Drug Rehab Program?
As a BCBS of Massachusetts member, at least some of your inpatient drug rehab program and treatments will be covered by your insurance plan. Exactly how much is covered and for how long depends on your plan. It’s always a good idea to know exactly what to expect when it comes to finances before entering treatment. Call the number on the back of your insurance card to ask questions about your plan’s coverage. Some sample questions to consider include:
- What do I need to do to access addiction services? Do I need pre-authorization before insurance coverage kicks in?
- What rehab facilities are in-network with BCBS of MA?
- How much is my deductible?
- What percentage of rehab costs will be covered by insurance?
- What are my co-pays?
If your insurance doesn’t cover all of your rehab expenses, there are other ways to cover your out-of-pocket expenses. These payment options include:
- Private loans. Some banks and credit unions offer loans to help pay for healthcare costs.
- Payment plans. Treatment facilities provide individuals with the opportunity to pay back their costs over time.
- Scholarships and grants. Treatment facilities sometimes offer scholarships and grants to help individuals with a financial need pay for rehab. There are also state and federal government scholarships and grants available to low-income individuals to help pay for treatment.
- Asking friends and family for financial support isn’t always easy, but it can help cover your out-of-pocket expenses so you can focus on what matters: getting and staying sober.
BCBS Of Massachusetts In-Network vs. Out-of-Network Inpatient Drug Rehab Centers
In-network rehab centers have an agreement with BCBS of Massachusetts to provide addiction services at a discounted rate. When you choose one of BCBS of Massachusetts rehabilitation centers, it means lower out-of-pocket expenses for you and less “red tape” and paperwork for insurance coverage.
Out-of-network rehab facilities do not have an agreement with BCBS of MA. This means that your out-of-pocket expenses will likely be higher and you may be required to complete additional paperwork in order for your insurance company to provide any type of coverage at this facility. Some insurance companies do not offer any coverage for out-of-network facilities.
There are many top-tier rehab facilities in Massachusetts that accept BCBS insurance. Call the number on the back of your insurance card to ask about what treatment facilities accept your insurance, or call us at to speak with an admissions navigator who can walk you through the process.
How to find BCBS Of MA covered Inpatient drug treatment centers Near Me?
You can find a Blue Cross Blue Shield addiction treatment center by contacting American Addiction Centers (AAC) or learn more about AAC locations here. Our facilities are available nationwide with individualized treatment, medical detox programs, and co-occurring disorder treatment. At AAC, we can verify your insurance coverage right away. It only takes a minute to find out if our facility is in-network for you.
If you prefer to speak to someone in person, just reach out to our 24/7 hotline, where a representative can verify your insurance right away. Just call at .