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CareFirst is a non-profit healthcare provider. This BlueCross BlueShield company serves 3.5 million U.S. adults in Washington, D.C., Maryland, and Virginia. CareFirst maintains a vast network of 1.8 million vetted healthcare providers across the Mid-Atlantic region, including treatment facilities specializing in the management of substance use and mental health disorders.
If you have a CareFirst health plan and you need to address an addiction or mental health condition, it will cover most of the costs of rehabilitation. Read on to learn how to access CareFirst drug rehab or alcohol rehab services without undue financial strain.
Types of CareFirst Healthcare Plans
CareFirst health plans are customized to meet the healthcare needs of members. If you purchase an individual or family plan through state marketplaces, you can access BCBS substance abuse treatment or mental health coverage. This is included as an essential health benefit in line with the Affordable Care Act and Mental Health Parity and Addiction Equity Act at rehabs covered by CareFirst.
Group CareFirst health plans offered through employers generally provide better benefits at reduced costs. Employer-sponsored plans often cover more CareFirst behavioral health services and more attractive deductibles for substance abuse treatment programs.
Medicare Supplement and Medicare Advantage plans are designed for individuals aged 65 and older, as well as younger adults who meet specific disability criteria. CareFirst also manages Medicaid coverage for eligible Maryland residents via the Community Health Plan.
BlueCross BlueShield addiction treatment coverage is available with the following plans:
- Platinum
- Gold
- Silver
- Bronze
Deductibles, co-insurance, co-payments, and coverage levels vary based on the plan tier. Higher-tier plans are associated with the most attractive BlueCross BlueShield benefits and reduced out-of-pocket expenses.
Does CareFirst Insurance Cover Drug and Alcohol Rehab?
Federal parity laws like the Mental Health Parity and Addiction Equity require BCBS drug rehab and BCBS alcohol rehab benefits delivered by insurers like CareFirst to be the same as those provided for surgical interventions and medical conditions.
CareFirst health plans typically cover both outpatient and inpatient rehab for drug and alcohol addiction when determined as medically necessary for recovery. Coverage also includes medical detox programs and ongoing therapy sessions, as well as treatment services for co-occurring disorders.
So, BlueCross BlueShield does cover rehab, but the scope and extent of coverage vary by plan type and tier. Some levels of care may require pre-authorization, particularly for long-term inpatient rehab. Most emergency detox services are granted instant approval due to the complications characteristic of drug and alcohol withdrawal.
Get Insurance-Covered Addiction Treatment
What Addiction Treatment Does CareFirst Cover?
CareFirst drug rehab and BlueCross BlueShield alcohol rehab benefits cover all levels of care deemed clinically necessary.
- Supervised medical detox is covered by CareFirst health plans, streamlining the withdrawal process for those dependent on drugs or alcohol. Services may be delivered in an inpatient or outpatient setting, depending on the severity of withdrawal symptoms.
- Inpatient treatment programs receive CareFirst drug rehab or alcohol rehab coverage when treatment providers determine this type of intervention is medically necessary. Residential programs last 30 to 90 days and deliver intensive, evidence-based therapies in a safe and structured setting.
- PHPs (partial hospitalization programs), IOPs (intensive outpatient programs), and traditional outpatient programs enable individuals to receive effective drug or alcohol addiction treatment at an appropriate level of intensity while maintaining their everyday commitments.
- CareFirst health plans cover individual and group therapy sessions. Coverage also extends to CBT (cognitive behavioral therapy), DBT (dialectical behavioral therapy), motivational interviewing, and trauma-informed care.
- Family counseling may be covered by CareFirst plans when the issues that need addressing are directly linked to addiction treatment and recovery needs.
- MAT (medication-assisted treatment) for opioid use disorder involves medications approved by the FDA combined with talk therapies to reduce the intensity of cravings and withdrawal symptoms. BlueCross BlueShield alcohol rehab benefits also extend to FDA-approved drugs like disulfiram, acamprosate, and naltrexone used for the medication-assisted treatment of alcohol use disorder.
How to Check Your CareFirst Insurance Benefits
You can verify your CareFirst drug rehab or alcohol rehab benefits by checking your policy documents and Summary of Benefits. Alternatively, contact CareFirst customer service using the information provided on your insurance card.
Member portals online provide access to coverage details, benefit summaries, and directories of in-network providers. Consulting these online resources can help you estimate out-of-pocket costs and pre-authorization requirements.
Your chosen treatment provider may also verify your CareFirst health insurance benefits before the initiation of therapy.
Some issues to consider when you verify your benefits include:
- Annual deductibles
- Co-payment and co-insurance rates for treatment at different levels of intensity
- Differences between seeking treatment in-network or out-of-network
- Pre-authorization requirements
- Annual coverage limitations for substance abuse and mental health treatment
Does CareFirst Cover Mental Health and Co-Occurring Disorder Treatment?
CareFirst health plans include mental health benefits that extend to the treatment of co-occurring disorders. Mental health conditions commonly co-occur with substance use disorders, which complicates treatment approaches and demands integrated therapy for best results.
CareFirst drug rehab coverage extends to co-occurring disorder treatment when determined to be necessary for achieving and maintaining recovery. Coverage may include medication management, prescription drugs like anti-anxiety medications, antidepressants, and mood stabilizers, as well as therapy sessions with psychiatrists.
About CareFirst
CareFirst is an independent licensee of BCBS (Blue Cross Blue Shield). It has operated as a non-profit healthcare organization for almost 90 years. CareFirst BCBS employs 9,000 dedicated professionals and serves communities across the Mid-Atlantic region.
CareFirst BCBS collaborates with hundreds of regional organizations to address the healthcare needs of communities and widen access to effective treatment for those with financial constraints. Partnerships include addiction prevention and treatment services, as well as a range of recovery support services.
The organization maintains an extensive network of 1.7 million in-network providers across the United States, enabling members to engage in effective and evidence-based treatment for addiction and mental health issues at CareFirst rehab centers.
Effective treatment for addiction, founded by people in recovery.
Get Effective and Compassionate Addiction Treatment with Health Insurance at a Premier Rehab in California
At Renaissance Recovery in Southern California, we work with many major health insurers to treat all types of addictions.
The outpatient programs we offer are available at varying levels of intensity, enabling you to fulfill your everyday commitments without compromising your recovery.
All addictions are unique, so all Renaissance treatment plans are tailored to individual needs. Therapies include:
- Individual therapy
- Family therapy
- Group therapy
- Medication management
- Behavioral therapies
- Motivational therapies
- Holistic treatments
- Aftercare support
Call admissions today to verify your insurance benefits and begin your recovery from any addiction at 866-330-9449.
Sources
- https://www.hhs.gov/healthcare/about-the-aca/index.html
- https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity
- https://www.niaaa.nih.gov/sites/default/files/publications/video-RSA2017/Mason_508.pdf
THERE IS ALWAYS HOPE
At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.
