Insurance & coverage
Treatment centers that accept Blue Cross Blue Shield insurance
If you have Blue Cross Blue Shield insurance, you have coverage for substance use and mental health treatment. The Mental Health Parity and Addiction Equity Act requires Blue Cross Blue Shield to cover behavioral health services at the same level as medical and surgical services. Here is how to use your benefits effectively.
What Blue Cross Blue Shield typically covers
Blue Cross Blue Shield plans generally cover medical detoxification, inpatient and residential treatment (often with prior authorization), partial hospitalization programs (PHP), intensive outpatient programs (IOP), standard outpatient therapy, medication-assisted treatment (MAT) including Suboxone, methadone, and Vivitrol, and psychiatric medication management. The specifics — copays, deductibles, covered days, and in-network requirements — vary by plan. Always verify your specific benefits before choosing a facility.
How to verify your BCBS coverage
Call the member services number on the back of your Blue Cross Blue Shield card. Ask specifically: Does my plan cover substance abuse and mental health treatment? What levels of care are covered? Do I need prior authorization for residential treatment? What is my deductible and out-of-pocket maximum? What are my copay or coinsurance amounts for behavioral health? Can you provide a list of in-network treatment facilities in my area? Write down the representative's name, the date, and a reference number for the call.
In-network vs. out-of-network
Choosing an in-network Blue Cross Blue Shield facility will significantly reduce your out-of-pocket costs. In-network facilities have pre-negotiated rates with Blue Cross Blue Shield, meaning lower copays and coinsurance. Out-of-network facilities may be covered, but at a lower rate — meaning you pay more. If the specific treatment you need is only available out-of-network, ask about a single case agreement to get in-network rates.
If your claim is denied
Insurance denials are common but not final. Request the denial in writing with specific clinical criteria. Ask your treatment provider for a peer-to-peer review. File a formal internal appeal with additional clinical documentation. If the internal appeal fails, file an external appeal with your state insurance department. For more detail, read our guide to appealing medical necessity denials.
Facilities accepting Blue Cross Blue Shield
Browse all →Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.