Rehabs that Accept Blue Cross Blue Shield of Texas

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Addiction Treatment Coverage and Blue Cross Blue Shield of Texas

A combination of the lack of high-quality behavioral healthcare health services and insurance coverage for substance abuse treatment has led to a huge gap in the number of individuals who need care and those who actually receive it. When drug and alcohol addiction reaches its peak, it’s vital that users have payment solutions for different behavioral health services, giving them options regarding the levels of care and forms of therapy they have access to.

Addiction treatment should never be delayed – and not knowing whether your insurance coverage will help foot the bill for any mental health or recovery services can be stressful. If you’re battling drug and alcohol addiction and are looking for rehabs that accept Blue Cross Blue Shield Texas, you might want to read this article until the end. If you’re in dire need of help, contact your local mental health services administration.

Resurgence Texas accepts multiple forms of Blue Cross Blue Shield of Texas for substance abuse treatment. Find out which specific mental health services and health plans are accepted and how Resurgence Texas can help you beat your drug or alcohol addiction today.

What Is Blue Cross Blue Shield of Texas?

Blue Cross Blue Shield of Texas is the largest health insurer in the state, and it has a large network of healthcare providers. Resurgence Texas is one of many addiction treatment facilities that accept Blue Cross Blue Shield of Texas to provide payment for substance abuse and healthcare services used.

In accordance with federal law, Blue Cross Blue Shield of Texas must provide some level of coverage for addiction treatment. Substance abuse treatment falls under the category of mental health therapy, which is listed as an essential treatment as per the rules outlined in the Affordable Care Act under then-president Barack Obama.

Blue Cross Blue Shield of Texas provides a large number of different policies for varying types of customers. This potentially causes confusion among policyholders regarding what types of addiction treatment services are covered under their specific plan.

Different facilities in Texas vary in the exact policy accepted to pay for substance abuse treatment. This means the coverage you receive for specific levels of care or methods of therapy weighs heavily on your specific plan.

At Resurgence Texas, we accept the following Blue Cross Blue Shield of Texas insurance plans for mental health and substance abuse services:

• Blue Essentials
• Blue Premier
• Blue High Performance
• Blue Advantage
• MyBlue Health
• Blue Choice
• Blue Precision
• Blue Options

What Does Blue Cross Blue Shield of Texas Cover?

With a Blue Cross Blue Shield plan, you can choose from a variety of in-network providers for mental health care. This includes treatment for substance use disorders and other mental health issues. In addition group therapy, you’ll also receive coverage for preventative services, yearly exams, and prescription medications.

The latter can prove to be important during any aftercare treatment you might receive for mental health and substance abuse disorders with continuous support from your primary care mental health counselor. It’s important to be concerned regarding treatment for substance use disorders – however, don’t forget about the post-treatment phase when you inquire about your coverage, as this is an integral part of your recovery.

With a Blue Cross Blue Shield of Texas plan, you can get the help you need when it comes to dealing with a mental health or substance abuse issue. You’ll only need to choose a drug and alcohol rehab provider that’s in-network for the best coverage. However, if you choose to go outside of the network, you might be required to pay for some or all of the treatment.

Resurgence Texas is considered an in-network provider according to all of the Blue Cross Blue Shield policies listed above. This means that they’re likely to cover some, if not all, of your treatment during your stay at our facility.

The specifics of your plan are also important. Every client doesn’t opt for the same level of coverage when they sign up for their plan. This means that two people could have the same Blue Cross Blue Shield plan, but one might receive more coverage than the other, or one person might have a higher copayment.

Before we get into the specific levels of care covered under your Blue Cross Blue Shield plan, let’s cover a few important terms you should be aware of regarding health insurance for both inpatient care and rehab as well as outpatient treatment.

Important Health Insurance Terms You Should Understand

Understanding the various terms used by Blue Cross Blue Shield when it comes to treatment for a substance use disorder is important. Without having a solid understanding of these terms, you could have difficulty sorting out what substance use disorder treatment expenses you’re responsible for.

Use the following list as a reference if there’s ever confusion regarding your substance use disorder treatment coverage when you speak with your agent:

• Deductible. Your deductible is the amount of money you’ll have to pay before your healthcare benefits start. For instance, if your annual deductible is $250, you’ll have to pay that amount before your insurance covers the cost of your medical treatment. Certain services, such as yearly checkups, might be fully covered without satisfying a deductible payment first.
• Copay. The copayment is the amount you’re required to pay when you visit a healthcare facility or pick up a prescription. It’s important not to confuse your copayment with your deductible. The deductible is paid when you receive your insurance bill – your copayment you’ll pay in person at the time you receive any medical services.
• Premium. Your “premium” is another term that’s easy to confuse with your “copayment” or “deductible” when you receive mental health treatment. The monthly cost out of your pocket each month is your premium, or in other words, your monthly bill. For those who receive private health insurance through work, this comes out of your paycheck. If you’re self-employed or an independent contractor, you’ll pay your insurance company monthly just like any other bill. If you receive Medicaid through the Mental Health Services Administration or Social Services, you likely won’t have a premium, copay, or deductible – however, your options for in-network providers may be limited.
• Coinsurance. So, does insurance cover everything beyond the deductible? Not exactly. The portion of the cost that you’ll pay after reaching your deductible is called the coinsurance. Some plans offer 60% after you meet your deductible – some offer 80% – the number varies depending on your policy. If you have a plan that covers 80% of the cost of inpatient or outpatient programs, you’ll pay 20% or the remainder of the costs. If you haven’t met your deductible, you’ll have to pay 100% until you reach the deductible and 20% beyond that point.
• Benefits. Your benefits are the services rendered outlined by your insurance policy.
• Annual limit. Your plan may limit the amount of money that it offers to pay for outpatient programs or other types of substance abuse treatment. It can also limit the number of total benefits offered in a single calendar year. If you go over your annual limit, you’re responsible for 100% of the costs at any treatment facility.
• Primary care doctor. This is your regular counselor you visit accredited by the Mental Health Services Administration – or the M.D. you see for your regular visits and checkups. It’s important to secure a primary care mental health counselor if you don’t have one for aftercare plans.
• In-Network/Out-of-network providers. In-network providers for substance abuse treatment fall within a certain directory of substance abuse treatment facilities, according to BCBS of Texas or any other insurance company. The companies that fall under this network have a standing relationship with the insurance company, and some, if not all of the services are covered when an inpatient or outpatient rehab is “in-network.” However, if an outpatient rehab or any substance use treatment center is “out-of-network,” the insurance company may provide little-to-no coverage at all. In some cases, the insurance company may provide payment for services if they receive a prior authorization form.
• Prior authorization form. A prior authorization form is paperwork that a drug or alcohol addiction treatment facility fills out and returns to an insurance company. Sometimes your primary care mental health provider may have to fill this out as well. It explains to your insurance company why attending a specific facility or receiving a certain treatment is in your best interests for your recovery. For example, some insurance companies might pay for residential treatment or medical detox but might require prior authorization for medication-assisted treatment. Another example is when your insurance provider doesn’t cover an out-of-network residential treatment facility that provides dual diagnosis treatment – but that’s your recommended therapy based on a personalized treatment plan. The prior authorization form explains why your insurance provider should pay for these services.

Now that you’ve got a solid understanding of the language insurance providers to use, we’ll outline the types of treatment programs explicitly covered under the policies mentioned earlier.

What Treatment Programs Does BCBS of Texas Cover?

Depending on your level of Texas coverage, your BCBS of Texas insurance providers may cover some or all of the following treatments. Again, remember that if you’re not initially covered, this doesn’t mean your BSBC Texas coverage won’t pay for the treatment. You might need prior authorization from certain medical professionals first – don’t get discouraged. All of the following programs are available at Resurgence Texas:

Medical Detox

Medical detox is a crucial step in recovery for people struggling with certain drug abuse challenges. Normally, medical detox is the first step during any residential treatment program or outpatient plan for drug abuse. It helps clients overcome the physical withdrawal of opioids, benzodiazepines, and alcohol.

Inpatient or Residential Treatment

Residential rehab centers provide a safe environment that’s supervised and controlled to ensure no outsiders can enter without the staff’s knowledge. This facility also offers a safe haven without access to illegal drugs. Inpatient rehab centers also provide various activities, group or individual, and intensive therapy sessions with mental and behavioral health industry professionals.

Outpatient Rehab Treatment and Intensive Outpatient Program

Outpatient rehab treatment provides many of the same services as inpatient rehab centers. The two are often linked with one another, with the former being less intensive, requiring no overnight stays at the facility. When your Blue Cross plan covers outpatient services or inpatient rehab program, normally you’ll receive around 6 hours of treatment per week. Intensive outpatient is the same, with a more intense regimen and schedule consisting of about 9 hours of weekly therapy.

Partial Hospitalization

This partial hospitalization program is a step down from inpatient drug rehab. A partial hospitalization program generally requires participation for 6 to 8 hours daily, with the client returning home in the afternoon/evening.

What Types of Therapy Are Covered During Drug Rehab by BCBS of Texas?

A number of different types of therapies are covered under one of the levels of care mentioned above. The specifics of your personalized care plan are discussed between you and your care team at Resurgence Texas. However, we provide the following options, all covered by BCBS of Texas. Again, the exact amount depends on your specific policy and treatment provider.

• Co-occurring disorder treatment (Co-occurring disorders are treated using dual diagnosis treatment)
• Various behavioral therapies
• Therapy involving family members
• Medication-assisted treatment for opioid use disorder and other forms of substance abuse (benzos, alcohol, etc.)
• 12-Step Recovery
• SMART Recovery
• and more

We Can Help Regardless of Your Texas Insurance Plan

At Resurgence Texas, we work daily with clients who have BCBS of Texas insurance coverage. Because we accept such a wide variety of BCBS insurance plans, the chances are high that your policy will cover some or most of the treatment our specialists offer.

Regardless of your insurance coverage, we encourage you to contact us if you have any questions regarding coverage levels, specific treatment costs, and any other recovery and treatment-related questions. Our admissions team is always willing to lend a helping hand, and we look forward to helping you take the next step in your recovery journey!