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Blue Cross Blue Shield’s Addiction Treatment Coverage

Now that you might have decided on a treatment program and location, it is time to figure out your payment method. A few options you have with Blue Cross Blue Shield (BCBS) are Blue Preferred PPO and Blue Advantage PPO. BCBS is known for being client-focused and for working closely with its medical providers. Their goal is to provide their clients with the services they need while not focusing on profit for themselves or shareholders.

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Blue Cross Blue Shield

Blue Cross Blue Shield’s Preferred PPO has three tiers of coverage; Gold, Silver, and Bronze. While they may have higher monthly premiums, it comes with its perks. The patient is able to choose their doctors and hospitals all throughout Oklahoma. Another perk is that substance abuse treatment is covered within all three tiers. Although, there might be a copay, coinsurance, or deductible.

With Blue Cross Blue Shield’s Blue Advantage PPO, client pay obtains lower monthly premiums along with their choice of doctors and hospitals in the area. Similar to the Blue Preferred option, the tiers of coverage are Gold, Silver, and Bronze. Substance abuse treatments can be covered by all tiers but may require copays, coinsurance, and deductibles.

You may be wondering what the difference between HMO and PPO is. HMO tends to offer lower monthly premiums and you might pay less yourself. While PPO does have higher premiums you can have more flexibility with providers and without needing referrals. Although, out-of-pocket costs may be higher as well.
Getting back your life and freedom from your addiction should be the main focus. You should not have to worry too much about paying for it. Let’s find out which insurance is best for you, call us at 405-583-4390 to learn more about Blue Cross Blue Shield or other possible insurance coverage.

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Other Payment Options Available

If your insurance company does not offer coverage for addiction treatments, you do have other options. Fortunately, many treatment centers in major Oklahoma cities accept Medicare and Medicaid. While both are U.S. federal healthcare plans they cover different groups. Medicare applies to people who are 65 years of age and older, while Medicaid helps people who need economical assistance.

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Depending on what you decide, whether it is to stay in Oklahoma City or receive help somewhere else, you can find the right place and program for you. You can contact us at 405-583-4390, to learn more or to enroll.

Medicare Coverage

With Medicare, there is not a specific benefit category provided for substance abuse treatment, but people can still get some assistance. If you have a severe addiction or have a need for treatment, services might be covered. There must be a necessity for treatment, this requirement applies to both inpatient and outpatient programs. Medicare commonly covers adults ages 65 or older, with the expectation of people with disabilities who are younger. The insurance coverage is split up into four parts. Part A covers hospital care, Part B covers medical, Part C covers a combination of Part A, Part B, and often D, while Part D covers prescription drugs.

Medicaid Coverage

Substance abuse treatments are covered by Medicaid for both alcohol and drug addiction. It covers adults seeking outpatient or residential programs, along with other services. Medicaid is helpful for people who are low-income or need additional assistance from the state. Almost anyone, including pregnant women, children, and those with disabilities, who do not have the means for healthcare can be assisted and covered by Medicaid.
To find out more about each insurance and their addiction treatment options you can look under the behavioral and mental health sections of their websites. For specific programs or facilities, you can also find that on the insurance website to see is it is covered. If you prefer any other payment option, there is also the option of payment assistance or services on a sliding fee scale from several Oklahoma facilities.

Treating Your Addiction Comes First

With so many things to consider and weigh out, you should never think twice about getting the help you need. Treating your addictions should be the main goal and you should not have to worry about whether it is worth the cost. You and your recovery are worth it.

There are many options and ways to pay for treatment, so the cost should not be an obstacle. Medicaid assists those who may otherwise not be able to afford healthcare. It also has coverage for substance abuse treatment for adults. Medicare is intended more for adults ages 65 or older but can include people younger than 65 with disabilities or health conditions. It does not typically cover any addiction treatment without being reasonable and necessary.

Another option if you wish to enroll or already have it is Blue Cross Blue Shield’s insurance coverages. You can pay higher monthly premiums but have flexibility with providers or pay a lower monthly premium with other benefits. With both coverages, you can receive additional treatment coverage but may have to pay a copay, coinsurance, or deductibles.

Whether you decide to use BCBS’s offered coverage or the other payment services, we can help you make the best decision for you. Call us at 405-583-4390 to learn more. We are here for you.


If you have questions on insurance, payments, or Medicare vs Medicaid coverage then let one our experts assist you with a 100% Free Consultation.

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