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Blue Cross Blue Shield Covered Drug Rehab in California




BCBS or Blue Cross Blue Shield is one of the biggest health insurance providers in the United States. Blue Cross Blue Shield plans in California offer individual and family health plans, employer or group plans, and Medicare options. BCBS health insurance plans cover drug rehab in California, and the extent of coverage depends on the plan. Almost all of the Blue Cross Blue Shield plans include testament for substance abuse. The first step for families is to determine the severity and extent of addiction and find the right drug rehab center in California. Families with health insurance plans through Blue Cross Blue Shield can find drug rehab providers within their insurance network and, depending on their plan, could access out-of-network drug rehab providers.

The drug rehabilitation process covered by BCBS health insurance plans in California begins with drug detox, followed by residential or outpatient drug rehab. The purpose of drug rehab is to manage withdrawal symptoms and cravings to allow for a smooth transition into a drug rehab center. Depending on the type of Blue Cross Blue Shield health insurance plan, medical detox or standard detox for drug addiction could be covered. Residential or outpatient drug rehab centers in California are covered by health insurance, but every plan is different from the next. Like drug detox, the severity of addiction and underlying issues determines what drug rehab methods are needed.


How Does Private Health Insurance Cover Drug Rehab in California?

Private health insurance plans like those offered through Blue Cross Blue Shield in California cover drug rehab. California law states that many health insurance policies must cover essential benefits like substance abuse treatment. Overall, health insurance plans through BCBS cover some or all of the cost, yet usually, there is a co-insurance or co-pay option. A co-insurance option is the part of each bill after the deductible has been paid. The co-pay option is a flat amount that is paid to the drug rehab center. The first step for a family in California would be to contact Blue Cross Blue Shield and determine what forms of drug rehab are covered.

Additionally, a drug rehab center in California, whether private or state-funded, will usually have a process in place with how they work with health insurance plans. Typically, health insurance providers limit which drug rehab facilities they cover, and there are usually set amounts that are paid by the insured and the insurance provider. The amount that is paid to the drug rehab center depends on the type of BCBS health insurance plan. Families with a loved one struggling with addiction should explore the option of using health insurance to help pay for drug rehab.


What Type of Drug Rehab Does Health Insurance Cover in California?

The type of drug rehab that is covered by private health insurance like Blue Cross Blue Shield depends on the type of plan and the tier of coverage that the person has selected through BCBS. Drug rehab that is covered by insurance could include all types of facilities, or it could be limited to what is covered by the Affordable Care Act. Some of the types of care that could be covered include inpatient drug rehab, outpatient drug rehab, partial hospitalization rehab, detox, group therapy, family counseling, assessments, and evaluations or alternative approaches. Blue Cross Blue Shield may cover outpatient drug rehab, residential treatment, partial hospitalization, and acute inpatient hospitalization services.


Family Intervention for Drug Addiction in California

Many families in California struggle with a loved one addicted to drugs or alcohol and are unsure what direction to take. After speaking to their Blue Cross Blue Shield health insurance provider and knowing there are drug rehab options available, the next step is convincing their loved one they need drug rehab. The best option for any family is to hire a professional interventionist and have an expert help organize and plan an intervention. Most people struggling with drug addiction are unwilling to admit they have an addiction or ask for help. The purpose of a family intervention is to help the drug-addicted family member see how their addiction is affecting their life and the lives of the people around them.

Typically, the intervention process lasts two days, and the first day is spent with the family educating them about addiction and the intervention process. During this time, everything is planned, such as who is attending, what is said, where it takes place and when, and how the drug-addicted family member is getting to drug rehab. Family interventions benefit everyone involved, and hiring a professional interventionist ensures the process is done correctly. Moreover, a professional intervention helps family members work through issues like family enabling or co-dependency. Unfortunately, family enabling does derail interventions.


Health Insurance for Drug Rehab and Drug Addiction Trends in California

The Affordable Care Act was fully implemented in 2014, and this increased access to health insurance coverage in California. According to the California Health Care Foundation, 85% of Covered California consumers receive a federal subsidy to help them afford coverage. The uninsured rate in California has fallen from 17% to 7.1%–the number of uninsured Californians has dropped by 3.7 million. Approximately 1.5 million Californians receive their health insurance coverage through Covered California. Also, roughly 12.5 million Californians are covered by Medi-Cal.

Additionally, within the state of California, there is a built-in Affordable Care Act that further expands access to health insurance coverage. Health insurance does help cover some of the costs of drug rehab. In California, substance use disorders were most prevalent among young adults aged 18 to 25 and occurred at almost twice the state average. Alcohol use disorder was more prevalent than other types of addiction. Approximately 6% of California residents had an alcohol addiction, while 3% had an illicit drug addiction. Accessing health insurance like a BCBS health plan is an excellent option for families.



California Health Care Foundation. 2018 Edition—Substance Use in California. October 3. 2018.


California Health Care Foundation. 2020 Update. How Many in Your Area Are Covered by the Affordable Care Act? September 24, 2020. https://www.chcf.org/publication/how-many-your-area-are-covered-affordable-care-act/