Does BCBS of Oklahoma Insurance Cover Inpatient Alcohol and Drug Rehab Centers?
If you are seeking inpatient rehab for drug or alcohol addiction, Blue Cross Blue Shield of Oklahoma offers coverage to help you kickstart your recovery journey. This insurance provider falls under the nationwide BCBS umbrella, which is accepted at numerous addiction treatment facilities.
Before entering rehab, it is best to know what BCBS Oklahoma can cover. You can check your coverage by calling the number on the back of your insurance card or asking your intended rehab center to check into it for you. You can also reach out to American Addiction Centers by calling, chatting online, or using the SSVOB form located on the website.
How To Find BCBS of Oklahoma Covered Inpatient Drug Treatment Centers in OK?
Every year, about 17,000 people with alcohol use disorders and 12,000 with illicit substance use disorders receive treatment in Oklahoma.1(pg. 16-17) Blue Cross Blue Shield of OK has helped many of those individuals. An important first step for them in getting help is having their insurance coverage verified. American Addiction Centers is happy to verify your insurance coverage for you. You can call to learn more about treatment options and to verify your insurance coverage. Doing it over the phone is simple and takes relatively little time.
Of course, you can also check your insurance coverage online. Simply go to the Insurance Verification form and put in the required information. AAC will instantly check your insurance coverage, and there is even a chance you can receive treatment at an AAC facility for a reduced rate. And, although it is not required, entering your policy membership identification can help speed up the verification process.
There are quite a few top-notch treatment centers in Oklahoma to choose from. Valley Hope, for example, is an exquisite mansion in Cushing that provides a tranquil but stately atmosphere for recovery. Valliant House, LLC in Valliant offers a 12-step program plus cognitive-behavioral therapy (CBT). Also, The Oaks Rehabilitative Services Center in McAlester provides a clean, well-maintained facility run by compassionate counselors and staff.
What Is BCBS of Oklahoma?
BCBS of Oklahoma is the state’s sole statewide, customer-owned health insurance provider.2 They are a division of Health Care Service Corporation, a Mutual Legal Reserve Company, and an independent licensee of the Blue Cross and Blue Shield Association. They have over 700,000 members and focus on the mental and physical health issues impacting all Oklahomans. Their philosophy? Everyone in Oklahoma deserves access to affordable, high-quality healthcare as well as superb services from a company that isn’t engrossed in its shareholders.
There are currently 127 locations in Oklahoma that accept Anthem Blue Cross Blue Shield Oklahoma, many of which offer inpatient rehabilitation services. You can pick the one that works best for you and go from there.
How Much Does BCBS of Oklahoma Cover (Addiction Treatment)?
Blue Cross and Blue Shield of Oklahoma can cover some or all your addiction treatment, but that depends on which plan you have. Health insurance costs have multiple factors. If you have a government plan like Medicaid, your low- or no-cost health insurance plan might cover your entire stay.3
If you have the HMO plan, outpatient services have a $50-per-visit co-pay with in-network providers.4 (pg. 4) Any out-of-network provider is not covered. Some services will also require preauthorization. Inpatient services with in-network providers have a $250-per-day co-pay while, again, out-of-network services are not covered. The $250/day co-pay is for the first 3 days of each benefit period, and preauthorization is required.
If you have the Blue Preferred Bronze PPO 206, your coverage will be different. Outpatient services with an in-network provider have a 40% coinsurance (the percentage of costs of a covered health care service that you pay after your deductible), while out-of-network providers have a 50% coinsurance.5 (pg. 4) Preauthorization is a requirement. With inpatient services from an in-network provider, it is $400 per visit plus 50% coinsurance. With an out-of-network provider, it is $2,000 per visit plus 50% coinsurance. Again, you’ll need preauthorization, which can carry a penalty fee of $500.
Does Blue Cross Blue Shield of Oklahoma provide coverage for mental health facilities?
Of course, there are different levels and types of care facilities that BCBS of OK works with. A skilled nursing facility can provide inpatient services for substance abuse.6 (pg. 79) A psychiatric hospital and residential treatment center can also provide monitored care with 24/7 physician availability and nursing services on site.6 (pg. 78) Partial hospitalization and intensive outpatient services will require preauthorization from the plan at least 2 days before starting your program.6 (pg. 5) Costs for those services will vary based on your plan’s copayment and coinsurance amounts.
Co-occurring disorders can be treated in tandem – and should be. Recent reports illustrate that over 9.2 million Americans have a co-occurring disorder of substance use and any mental illness (AMI).7 (page 3, par. 2) In 2018, SAMHSA research found that substance use was more common among btoh adults and adolescents who had a mental health issue than those who did not. (page 3, par. 3) That same year, about 21.2 million people ages 12 and older (or about 1 in 13 people) required treatment for substance use disorders. (page 3, par. 6) About 65.7 percent of adolescents received treatment for co-occurring disorders while only 51.4 percent of adults obtained the same type of treatment.(page 4, par. 6-7)
These conditions need to be treated together, as integrated care has been shown to elicit the best long-term recovery responses from people.7 (par. 11) Integrating treatment can reduce negative symptoms of mental health conditions, get pharmacological therapy to address both disorders, strengthen support through group therapy, and reduce chances of relapse.7 (par. 12) Staff members at facilities that do dual diagnosis treatment have specialized qualifications and training in this type of treatment. Also, note that under the Affordable Care Act (ACA), insurance providers are required to provide both physical and mental health care. Therefore, this mandate includes stand-alone heroin treatment and treatment for co-occurring disorders.
How Long Does BCBS of Oklahoma Insurance Cover Alcohol and Drug Rehab Programs?
Remaining in your treatment program for an adequate amount of time is imperative for recovery success. In fact, research shows that a minimum of 3 months is optimal for drug and alcohol rehab.8 (under #5) Many treatment facilities offer 30-, 60-, or 90-day treatment programs for inpatient services. But is your stay beholden to your insurance coverage?
If you have the Bronze Plan through BCBS, your mental illness treatment and substance abuse rehab office visit carries a 40-50% coinsurance.9 (Table 1) On Blue Preferred Silver PPO 201, you get a 50% coinsurance while PPO 306 offers 40%. 10 (Table 1) The Blue Advantage Silver PPO program has similar rates. Blue Preferred Gold PPO 205 carries a 40% coinsurance while Blue Advantage Gold PPO 309 has 25% and 604 has a 30% coinsurance.11 (Table 1) No specific timelines are given on how long you can stay at rehab, but how long you stay will likely depend on how much you can afford out-of-pocket after your insurance coverage.
Since insurance coverage varies quite a bit, it is important to look up your plan through the information on the back of your card. Knowing what will be covered lets you know how much leftover you will need to pay and determines how long you can stay in an Oklahoma drug rehab.
What if my BCBS of Oklahoma policy does not cover an inpatient drug rehab program?
Depending on which rehab center you select, you might be able to get a scholarship or financial assistance. As a patient, you will likely be able to choose from different block grants, government grants, and full and partial scholarships. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a block grant called the Substance Abuse Prevention and Treatment Block Grant (SABG), which provides funding for substance abuse treatment to all 50 states as well as the U.S Virgin Islands, Puerto Rico, the District of Columbia, 6 Pacific jurisdictions, and 1 tribal entity.12 (par. 1) This block grant specifically targets intravenous drug users among several populations and service areas. The goal is to provide information dissemination, education, alternative activities, problem identification and referral, a community-based process, and environmental services to influence the general population’s use of illicit substances.12 (“Primary Prevention Strategies” section)
Partial scholarships offer funding that will cover a specific portion of rehab center costs. Full scholarships cover the entire amount. Finding these scholarships is dependent upon each program you look at. You will want to find a program that offers grants and scholarships and will offer them to you. When you apply, it helps to tell them your financial situation and why you need help covering the cost of rehab. Many BCBS of Oklahoma rehabilitation centers offer this kind of assistance, but you need to apply to receive it.
Putting treatment off can lead to you never getting help. Think about the estimated 70,000 annual deaths from drug overdoses in the United States alone.13 (par. 1) How many of those people put off getting help? Getting the right treatment now can stop you from becoming another statistic. Finding the rehab center for you and calling the Blue Cross Blue Shield of Oklahoma phone number to get your insurance sorted out is a huge step in the recovery process.
BCBS of Oklahoma In-Network vs. Out-of-Network Inpatient Drug Rehab Centers
Before you check into one of the residential treatment centers in Oklahoma, you need to know whether it is in- or out-of-network. An in-network BCBS of Oklahoma treatment center essentially means that BCBS partners with that center to help cover costs. Blue Cross Blue Shield of Oklahoma drug treatment coverage for in-network providers will vary a little bit depending on which plan you have.
If you have an out-of-network provider in mind, BCBS of Oklahoma will not be able to provide a deductible or coinsurance to help cover your stay. Therefore, it is important to look up Blue Cross Blue Shield of Oklahoma drug treatment providers from the BCBS of OK website or by using the information on the back of your insurance card to learn more about your coverage.