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Does Blue Cross Blue Shield Cover Drug & Alcohol Rehab?

Seeking treatment for addiction can be a life-changing decision, but it can also be expensive. This is where insurance coverage comes in. In this article, we will discuss whether Blue Cross Blue Shield covers drug and alcohol rehab.

April 3, 2023

Understanding Blue Cross Blue Shield's Coverage

Blue Cross Blue Shield is a health insurance company that provides coverage to individuals and families across the United States. It is a federation of 36 independent, community-based and locally operated Blue Cross Blue Shield companies. Each company operates in a specific region, and the coverage options and benefits vary depending on the state and the plan.

Blue Cross Blue Shield's Coverage

Does Blue Cross Blue Shield Cover Rehab?

Yes, Blue Cross Blue Shield provides coverage for drug and alcohol rehab, but the extent of coverage depends on the plan and the state. Generally, Blue Cross Blue Shield covers inpatient and outpatient treatment for substance abuse, including detox, counseling, and medication-assisted treatment.

In most cases, Blue Cross Blue Shield requires pre-authorization for drug and alcohol rehab services. This means that you need to get approval from the insurance company before you start treatment.

The pre-authorization process involves submitting a treatment plan to the insurance company, which outlines the type of treatment, the duration, and the cost.

Types of Blue Cross Blue Shield Plans

Blue Cross Blue Shield offers different types of plans, including HMO, PPO, and POS. The type of plan you have will determine the extent of coverage for drug and alcohol rehab. Here's a breakdown of the different plans:

  • HMO: Health Maintenance Organization plans usually have lower out-of-pocket costs but require you to use in-network providers. HMO plans typically cover drug and alcohol rehab services, but you may need a referral from your primary care physician.
  • PPO: Preferred Provider Organization plans allow you to see out-of-network providers, but you'll pay more for the services. PPO plans usually cover drug and alcohol rehab services, but you may need to meet a deductible or pay a co-pay.
  • POS: Point of Service plans are a combination of HMO and PPO plans. You'll need to choose a primary care physician, but you can see out-of-network providers for a higher cost. POS plans usually cover drug and alcohol rehab services, but you may need a referral from your primary care physician.

How to Check if Your Blue Cross Blue Shield Plan Covers Drug and Alcohol Rehab

If you're unsure whether your Blue Cross Blue Shield plan covers drug and alcohol rehab, there are a few steps you can take to find out.

  1. Check your policy documents: The first step is to check your policy documents, which outline the benefits and coverage of your plan. You can usually find this information on the insurance company's website or by calling their customer service line.
  2. Talk to your provider: If you're still unsure about your coverage, you can talk to your healthcare provider. They can help you understand what services are covered under your plan and recommend treatment options that are covered by your insurance.
  3. Contact Blue Cross Blue Shield directly: Finally, you can contact Blue Cross Blue Shield directly to ask about your coverage for drug and alcohol rehab. You'll need to provide them with some information about your plan, such as the name of the plan, the state where it was purchased, and any other relevant details.

It's important to note that even if drug and alcohol rehab is covered by your plan, there may be certain restrictions or limitations on coverage. For example, some plans may only cover a certain number of days in treatment or require pre-authorization before treatment begins. Be sure to review all of the details of your coverage carefully so that you know what to expect when seeking treatment for addiction.

Common Types of Addiction Treatment Programs Covered by Blue Cross Blue Shield

Blue Cross Blue Shield covers a wide range of addiction treatment programs, including:

  • Inpatient Rehab: Inpatient rehab is a type of residential treatment program that provides 24/7 care in a hospital or clinic setting. This type of program is best suited for individuals with severe addiction who require intensive medical and emotional support.
  • Outpatient Rehab: Outpatient rehab is a less intensive form of treatment that allows individuals to receive care while still living at home. This type of program is best suited for individuals with mild to moderate addiction who are able to maintain their daily responsibilities.
  • Detoxification: Detoxification, or detox, is the process of removing drugs or alcohol from the body. This can be done on an inpatient or outpatient basis and typically involves medication-assisted treatment to manage withdrawal symptoms.
  • Counseling: Counseling is a key component of addiction treatment and can be provided on an individual or group basis. Different types of counseling may be used, including cognitive-behavioral therapy, motivational interviewing, and family therapy.
  • Medication-Assisted Treatment (MAT): MAT combines medication with counseling and behavioral therapies to treat substance abuse disorders. Medications such as methadone, buprenorphine, and naltrexone may be used to manage cravings and prevent relapse.

It's important to note that not all plans cover every type of addiction treatment program. Some plans may only cover certain types of programs or limit the number of sessions allowed per year.

It's important to review your plan documents carefully so that you understand what services are covered under your plan.

If you're unsure about what addiction treatment programs are covered by your Blue Cross Blue Shield plan, you can contact the insurance company directly for more information.

They can help you understand your coverage options and recommend providers in your area who accept your insurance.


In conclusion, Blue Cross Blue Shield covers drug and alcohol rehab, but the extent of coverage depends on the plan and the state. If you or a loved one is struggling with addiction, it's essential to check your insurance coverage and understand the benefits and limitations. Seeking treatment for addiction is a courageous step, and having insurance coverage can make it more accessible and affordable.

Dr. Elizabeth Drew
Medical Director

Medical Director Dr. Elizabeth Drew graduated from Hahnemann University School of Medicine and completed her family practice residency at Lehigh Valley Hospital in Allentown PA. In 2005, she opened her family medicine office in Doylestown, and in 2008 she treated her first patient for opiate addiction.

Since then Dr. Drew has attained her board certification in Addiction Medicine, treated more than a thousand patients for addiction to opiates and alcohol, participated in programs to educate the community, traveled to Washington DC to educate our legislators, and served as Medical Director at some of the best addiction treatment programs in Pennsylvania.

She understands that addiction is a chronic disease that no one would choose to have, and her treatment philosophy is based on respect, compassion, and empowerment. She is excited to be the Medical Director of MPower Wellness and work to provide superior addiction treatment in Chester County.

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