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Does Premera BCBS Insurance Cover Inpatient Alcohol and Drug Rehab Centers?

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Premera  BCBS Alcohol and Drug Addiction Treatment Centers

Yes, Premera Blue Cross does cover at least some of the costs of inpatient alcohol and drug rehab centers. If you are a member of Premera Blue Cross and are seeking treatment for substance use disorder, your insurance plan should cover a portion of the costs of detox, inpatient or outpatient rehab, or long-term residential programs. Exactly what is covered and how much you will be responsible for paying out-of-pocket depends on your specific insurance plan.

You can check your coverage by calling the number on the back of your insurance card to speak with a Premera Blue Cross customer service agent. You can also call the rehab center directly to speak with an admissions navigator. They will verify your insurance coverage for you while you’re on the phone and help you navigate the next steps to getting started in rehab.

If you prefer, you can chat with a live admissions navigator in our chatbox on the website or complete the form below with your information. You will receive an email within minutes verifying your insurance.

What is Premera BCBS?

Premera Blue Cross is a non-profit, independent licensee of the Blue Cross Blue Shield Association. The company provides health insurance at an affordable price to people living in the Pacific Northwest.

Premera is the largest health plan in the region, serving more than 2 million members.1 The company offers individualized services to customers in Washington and Alaska including programs focused on wellness and prevention, disease management, and safety. The Premera network includes thousands of doctors, healthcare providers, and hospitals, giving members a wide variety of healthcare providers to choose from.1

Premera Blue Cross offers a variety of plans. The options allow members to choose the plan that fits their budget to access affordable healthcare. The company offers individual and family plans, Medicare plans, Medicaid plans, and small business plans for employers.2 Plans for individuals and families are offered in 3 categories:3

  • Bronze plans offer the lowest monthly premiums and high deductibles. These plans are best for members who do not need a lot of medical care and see the doctor infrequently. Bronze plans cover 60% of your healthcare costs once the deductible is met.
  • Silver plans offer average monthly premiums and lower deductibles. They are best for people who visit the doctor a couple of times a year. Silver plans cover 70% of healthcare costs once the deductible is met.
  • Gold plans have high monthly premiums and low deductibles. These plans are best for members who have a lot of healthcare needs and see the doctor frequently. They cover 80% of healthcare costs after the deductible is met.

All plans offer essential health benefits plus the flexibility to see any doctor within the Premera network. No referrals are required to see a specialist. All members have access to virtual care/telehealth, including for substance use disorder, and unlimited primary care and specialist visits.3

How Much Drug Treatment Does Premera BCBS Cover?

If you are a Premera Blue Cross member, your health insurance policy will cover at least some of the costs of addiction treatment. Services covered by Premera Blue Cross include (but are not limited to):4

  • Medical detox helps you withdraw from drugs and alcohol under round-the-clock medical supervision. Medications are used to help you safely and comfortably withdraw so you can prepare for the next step in rehab.
  • Inpatient or residential rehab provides a safe place for those in recovery. You will live in the facility for a set amount of time (anywhere from 1-3 months, generally), depending on the program you are enrolled in and your specific needs.
  • Partial hospitalization programs, also known as day treatment, provide the opportunity to live at home while accessing treatment at a treatment facility during daytime hours.
  • Intensive outpatient programs require you to attend treatment approximately 3 days a week for approximately 10-12 hours per week. You can live at home and attend to work and family responsibilities during the day.
  • Outpatient treatment takes place in hospitals, clinics, mental health clinics, and counselors’ offices. You live at home and work during the day, and attend treatment approximately 1-3 times per week. Outpatient treatment programs can last up to a year or more.

Does Premera BCBS Insurance Cover Mental Health Care?

In 2008, Congress passed the Mental Health Parity and Addiction Equity Act to ensure coverage of treatment for mental health care and addiction.5 This includes treatment for co-occurring disorders—a term used to describe when someone has a mental health diagnosis (e.g., anxiety, depression, PTSD) along with substance use disorder. The extent to which addiction and mental health treatment are covered and for how long depends on your insurance plan.

Premera Blue Cross can help coordinate care for you when you access treatment. If you are a Premera Blue Cross member and need to access mental health care and addiction treatment, take comfort in knowing your insurance provider is committed to caring for members with mental health conditions.

Most treatment facilities offer co-occurring disorder treatments for people who have mental health conditions and addiction to drugs and alcohol. All Premera health plans include access to in-person and virtual mental health care, including treatment for substance use disorder.6 Therapy, rehab, counseling, and other resources are available to members at no additional cost.

How Long Does Premera BCBS Insurance Cover Inpatient Alcohol and Drug Rehab Programs?

Premera Blue Cross offers a wide variety of health insurance plans for its members, and each policy covers at least some of the cost of addiction treatment. The duration of treatment covered by insurance is determined by your individual needs and the plan you have.

Generally, the longer you stay in rehab, the more positive your outcomes will be. Research shows that people who attend 3 months or more of treatment have a higher chance of getting and staying sober in the long run.7

You can look up your Premera Blue Cross plan information on the member portal to learn how many days of addiction treatment are covered by your plan in a calendar year. Alternatively, you can call the number on the back of your insurance card to learn more about how long you can stay in rehab with insurance coverage and what other services your plan will help pay for.

What if My Premera BCBS Policy Does Not Cover an Inpatient Drug Rehab Program?

It’s a good idea to have a full understanding of what your Premera Blue Cross plan will cover before selecting and entering a treatment program. Be sure to find out:

  • What your plan requires to access treatment.
  • Which services and treatments are covered under your plan.
  • How much you will be responsible for paying out-of-pocket.
  • What percentage of costs are covered by your insurance plan.

If your insurance policy does not cover all of your rehab expenses, don’t let money stand in the way of your sobriety and wellness. Fortunately, there are other ways to pay your out-of-pocket costs, including:

  • Private loans and/or payment plans. Some financial institutions offer loans to help cover healthcare costs, including the expenses for addiction treatment.
  • Payment plans: Most, if not all, treatment facilities offer payment plans that allow you to pay for treatment over time.
  • Scholarships and grants. Some states offer assistance to low-income residents seeking treatment. Also, certain rehab facilities offer scholarships to those who need help paying for treatment.
  • Fundraising and crowdfunding. Asking family and friends for support can be challenging, but most people are happy to help when someone they care about is ready to enter treatment. Fundraising and crowdfunding can help offset out-of-pocket costs.

Premera BCBS In-Network vs. Out-of-Network Inpatient Drug Rehab Centers

Premera Blue Cross has an agreement with some treatment facilities to offer addiction treatment at a lower rate than other providers. Attending treatment at one of these in-network providers typically means lower out-of-pocket costs for you.

Out-of-network rehab facilities do not have an agreement with Premera Blue Cross. This means services and treatments received at these facilities will likely come at a higher cost for you. If you choose to attend an out-of-network treatment program, it’s important to understand that Premera may not cover any of your rehab expenses.

Whenever possible, aim to choose a facility that is in-network with Premera. This provides peace of mind as well as less paperwork. Thus, you will have an easier time receiving coverage for treatment.

How to Find Premera BCBS Covered Inpatient Drug Treatment Centers?

Insurance coverage for inpatient drug treatment centers varies from plan to plan, which is why it’s so important to check ahead to determine what is covered by your insurance plan. There are a few ways to verify your Premera Blue Cross plan’s coverage:

  • Premera Blue Cross member portal. Log in to your account on the member website to learn more about your policy, what is covered, and where you can seek treatment in-network.
  • Premera Blue Cross customer service. Call the number on the back of your insurance card to speak with a customer service representative. They can walk you through the details of your policy to help you understand what is covered and what you need to do to receive coverage for inpatient rehab.
  • Call the rehab facility. Speak directly with an admissions navigator who can check your insurance benefits for you while you’re on the phone.

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