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Premera BlueCross is a leading health insurance provider that serves 2.6 million members in the Pacific Northwest, from Washington to Alaska. Premera is an independent licensee of the BlueCross BlueShield Association, providing healthcare coverage that includes medical services, substance abuse treatment, and mental health services.
If you have Premera BlueCross coverage and need help addressing an addiction or mental health condition, your plan will cover most of the costs associated with treatment.
Premera Blue Cross Overview
Premera BlueCross is a non-profit offering health insurance benefits for behavioral health services, vision and dental benefits, workplace wellness programs, and disability protection.
The health insurer has an extensive network of preferred providers and works with hospitals, physicians, and treatment facilities across the region. This network enables members to engage in evidence-based addiction treatment with reduced out-of-pocket costs.
Premera offers a variety of health insurance plans to accommodate different needs and budgets. The main plan categories include:
- HDHP plans – High Deductible Health Plans have low monthly premiums, but high deductibles, which must be satisfied before Premera BlueCross rehab coverage kicks in.
- PPO plans – Preferred Provider Organization plans cover significant portions of the costs of addiction treatment at in-network or out-of-network providers.
- EPO plans – Exclusive Provider Organization plans provide members with network access via coordination with primary care providers.
Does Premera Blue Cross Cover Alcohol and Drug Rehab?
Premera BlueCross drug rehab coverage extends to alcohol and drug addiction treatment. Federal laws like the Affordable Care Act and the Mental Health Parity and Addiction Equity Act require health insurers like Premera to cover substance abuse treatment at the same levels as treatment for chronic medical conditions or for surgical procedures.
Premera BlueCross rehab benefits are contingent on the specifics of your health insurance plan, including network treatment provider requirements, co-payment and co-insurance structures, and deductibles. Most plans cover addiction treatment at all levels of intensity when it’s determined essential for long-term recovery. The scope of coverage varies according to plan type and tier.
Choosing treatment with an in-network provider typically results in enhanced coverage and reduced expenses out of pocket.
What Types of Treatment Does Premera Blue Cross Cover for Rehab?
Premera BlueCross rehab coverage includes all levels of care when treatment is deemed clinically necessary and integral to sustained recovery.
Addiction treatment covered by Premera often begins with medically supervised detox. This helps individuals address physical dependence on drugs or alcohol with 24-hour monitoring, emotional care, and the administration of medications to ease withdrawal symptoms and reduce the intensity of cravings.
Inpatient treatment programs, also known as residential rehab, last 30, 60, or 90 days and involve immersive treatment that includes individual counseling, family therapy, group therapy, medication management, and educational sessions. Premera Blue Cross rehab coverage for inpatient rehab almost always requires authorization before treatment begins.
Partial hospitalization programs are intensive day treatment programs that run for 30 hours or more weekly, enabling individuals to live at home while receiving highly structured addiction treatment that includes therapeutic interventions, skill-building classes, and psychiatric services.
Intensive outpatient programs involve 12 to 15 hours of therapy sessions each week, scheduled around a person’s existing commitments. IOPs may be indicated as a step-down option from more intensive levels of care or as standalone treatment options.
Standard outpatient programs help people transition smoothly from rehab to independent living through weekly or twice-weekly therapy and counseling sessions.
MAT (medication-assisted treatment) is covered by Premera health plans when it’s determined to be medically necessary to promote recovery from alcohol or opioid use disorders. MAT combines medications approved by the FDA with talk therapies and counseling to reduce the risk of relapse and encourage ongoing recovery.
How Long Will Premera Blue Cross Insurance Cover Drug and Alcohol Rehab?
The length of treatment covered by Premera health insurance varies according to plan type. Most plans extend coverage to all therapy deemed medically necessary for recovery from drug or alcohol addiction.
Healthcare providers conduct initial assessments to help inform treatment planning. They then submit recommendations for treatment to Premera for approval, outlining the expected duration of treatment and the projected therapeutic interventions required.
Extended coverage typically requires reviews that demonstrate the ongoing necessity of treatment and documenting progress. Long-term treatment coverage may be approved based on clinical recommendations, treatment response, and personal circumstances.
Most Premera BlueCross rehab plans carry benefit maximums, which can be applied on an annual basis or across a member’s lifetime.
Get Insurance-Covered Addiction Treatment
How to Use Premera BlueCross for Addiction Treatment & Rehab
To make the most of your Premera BlueCross rehab benefits, follow these straightforward steps:
- Call customer service at Premera – Call Premera’s customer service division to check your benefits, deductible, and co-payment or co-insurance requirements. You can also inquire about in-network treatment providers in your area to help streamline your search.
- Get treatment recommendations – Consult a primary care provider, addiction specialist, or licensed mental health professional. They can establish the most appropriate level of treatment based on the severity of your addiction, previous engagements with treatment, and your circumstances. These healthcare professionals can provide the documentation you need for authorization from Premera.
- Check the provider’s network status – Confirm that the treatment providers on your shortlist are part of the Premera network. Choosing an in-network provider will result in enhanced benefits and reduced out-of-pocket expenses.
- Obtain any required pre-authorization. Consult the rehab center to help complete any pre-authorization processes. They will collaborate with Premera to handle this phase on your behalf.
- Clarify your financial responsibilities – Review your deductible, co-insurance, and co-payment commitments before the initiation of treatment to prevent any unexpected costs.
Premera BlueCross Coverage for Co-Occurring Disorder Treatment
Co-occurring disorders treatment involves the coordinated management of addictions and mental health conditions, proven to deliver better outcomes than treating each condition separately [5].
Services covered by Premera insurance include:
- Psychiatric assessments.
- Medication management.
- DBT (dialectical behavior therapy).
- CBT (cognitive behavioral therapy).
- Trauma-informed therapies.
Effective treatment for addiction, founded by people in recovery.
Get Treatment for Drug or Alcohol Addiction Covered by Health Insurance at a Southern California Rehab Center
If you are addicted to prescription medications, illicit drugs, or alcohol, we offer evidence-based addiction treatment covered by health insurance at Renaissance Recovery in Southern California.
Our intensive outpatient programs allow you to fulfill your everyday commitments while receiving personalized treatment for any addiction. Therapies might include:
- One-on-one counseling.
- Family therapy.
- Group therapy.
- Holistic therapies.
- Medication management.
- Talk therapies.
- Motivational therapies.
- Aftercare support.
Check your insurance benefits and begin the recovery process by calling admissions today at 866-330-9449.
Sources
- https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity
- https://www.ncbi.nlm.nih.gov/books/NBK64119
- https://library.samhsa.gov/sites/default/files/pep19-matbriefcjs_0.pdf
- https://pubmed.ncbi.nlm.nih.gov/30352668/
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.
