Blue Cross Blue Shield Coverage for Mental Health & Addiction Treatment 

Many people avoid getting the help they need for addiction or mental health treatment because of the high costs. However, you can apply Blue Cross Blue Shield therapy coverage to treatment for mental health, and Blue Cross Blue Shield addiction treatment coverage benefits for help with a substance use disorder.

How Blue Cross Blue Shield Helps with Mental Health and Recovery

Blue Cross Blue Shield offers health insurance to nearly 200 million Americans, representing 36 independent companies. If you are a Blue Cross Blue Shield insurance policyholder, it’s important that you review your benefits so you know exactly what is covered for therapy and addiction treatment.

Coverage benefits are usually broken down into the type of service that is provided, and the financial support you get from Blue Cross Blue Shield is based on that category, along with something like a copay or deductible.

Copay

With Blue Cross Blue Shield, a copay is the amount of money that you have to pay every time you go to a therapist’s office. This can be $0 if you have extensive coverage through Blue Cross Blue Shield, but it might be $30 for some of the other levels of coverage. 

Tip: If you look at the back of your insurance card or the front of it, you might find the copay amount listed.

The treatment options that you have available to you when applying your Blue Cross Blue Shield therapy benefits will always include individual and group therapy.

Typically, support group meetings like AA or NA don’t come with any out-of-pocket expenses other than getting yourself to and from your meetings, so these are not covered under your insurance.

The copay that you have to meet is charged per visit, so if your copay is $30 and you have a weekly individual therapy session, you would have to pay $30 every week, but your insurance provider would cover the rest of the cost. Even if your therapist raised prices, your copay would remain the same.

Deductible

If you are participating in an addiction treatment program like Skycloud’s outpatient MAT program or you are receiving treatment for a mental health condition that involves medication management, Blue Cross Blue Shield may or may not require a copay for your medication, depending on the policy you have.

In many cases, Blue Cross Blue Shield health insurance plans provide complete coverage for generic medications, but any other medication might still have a deductible.

The deductible is the amount of money that you have to pay every year for all of your health insurance before your insurance will start to cover the rest. This amount is typically higher if you have a very low monthly premium and vice versa. 

However, it applies to all of your out-of-pocket expenses for the year. So, if you have a $6,000 deductible but you have already paid $3,200 out of pocket for other medical services, the remaining cost you have to pay out of pocket for therapy or medication associated with mental health treatment or addiction is only $2,800. After you pay that remaining amount on your deductible, your Blue Cross Blue Shield insurance will cover anything else that you have for the rest of the year.

BCBS Addiction Treatment Coverage

The level of coverage from Blue Cross Blue Shield is based on the plan you have. If you are struggling with addiction like opioid addiction, you will find different access based on your plan.

Again, the different types of treatment covered are based on the plan you have. 

Detox

The first level of coverage applies to detox for addiction. This extends to the medication that you receive during your detox. With Skycloud, for example, our services for opioid addiction treatment involve medication-assisted treatment like ongoing access to Suboxone to help you manage cravings and recovery. 

With your Blue Cross Blue Shield plan, this would be covered, though you might still have to pay a copay or meet your deductible.

Outpatient Services

BCBS also covers outpatient treatment at qualifying facilities. This means coverage gets applied to treatment sessions, including individual and group therapy, as well as medication that you might be prescribed. 

BCBS Mental Health Treatment Coverage

Blue Cross Blue Shield therapy coverage can be applied to in-person and virtual therapy sessions with our outpatient programs.

At Skycloud, we offer in-person and virtual therapy as well as medication management. This means you can get access to therapy and prescription medications to help you manage a mental health condition like anxiety or depression.

How to Verify Coverage for BCBS

If you are trying to find qualifying coverage for mental health disorders or addiction, it’s important that you verify your benefits.

• You can do this by calling the number on the back of your insurance card
• You can do this by logging into an online portal and looking at your summary of benefits
• You can do this by reaching out to Skycloud

At Skycloud, we make it easy for you to better understand what your coverage is and how it applies to the actual treatment plan you want. 

While you can look at your summary of benefits online or call the number on the back of your card, this can be very difficult to understand because it refers to all of your benefits rather than the things you are looking for relating to EMDR therapy or Suboxone treatment. Even calling the helpline will only connect you to someone else who is looking at the exact same document for your benefits.

Our team, however, can help communicate directly on behalf of your insurance provider to compare the benefits and coverage you have available to you in your area.

Skycloud’s Outpatient Treatment

With Skycloud, you can maximize your coverage options by applying your Blue Cross Blue Shield therapy coverage and addiction coverage to reduce the cost. We know how important it is to get the right type of treatment when you need it, and that’s why our team is here to offer a thorough assessment and customized treatment plan.

We work hard to offer high-quality mental health and MAT services both in person and online. If you are concerned about the cost of getting the care you need, we can help you verify your Blue Cross Blue Shield benefits and figure out what the actual out-of-pocket costs will be for our services, including things like deductibles and copays, based on your plan.

Areas We Serve

In-Person Care

We offer in-person outpatient mental health and addiction treatment in:

• Oregon
• Washington
• Utah

Virtual Care

Our telehealth services are available to eligible patients in:

• Oregon
• Washington
• Utah
• Arizona
• Minnesota
• Nevada
• New Mexico

Whether you’re looking for therapy, psychiatric care, medication management, or treatment for substance use disorders, our team can help you understand your options and verify your Aetna insurance benefits before you begin treatment.

Frequently Asked Questions

Does Blue Cross Blue Shield cover mental health treatment?

Yes. Most Blue Cross Blue Shield (BCBS) plans include benefits for medically necessary mental health services, such as individual therapy, psychiatric evaluations, medication management, and outpatient treatment. Coverage varies by your specific plan and network.

Does BCBS cover addiction treatment?

Many BCBS plans provide coverage for substance use disorder treatment, including opioid use disorder treatment and medication-assisted treatment (MAT).

Does Blue Cross Blue Shield cover therapy?

Yes. BCBS typically covers evidence-based therapy services for conditions such as anxiety, depression, PTSD, bipolar disorder, and other mental health concerns. Your out-of-pocket costs will depend on your deductible, copay, coinsurance, and whether your provider is in-network.

How can I verify my Blue Cross Blue Shield benefits?

Simply contact Skycloud Health. Our admissions team can verify your BCBS benefits, explain your coverage, estimate any out-of-pocket costs, and answer your questions before you start treatment.

Does Skycloud Health accept Blue Cross Blue Shield?

Skycloud works with many Blue Cross Blue Shield plans. Because coverage varies by state and policy, we’ll verify your benefits and explain your treatment options before your first appointment.

 

Find The Help You Need

Don’t wait to get help. Whether you want virtual therapy or in-person medication management for opioid addiction, our team can help. Call Skycloud to verify your Blue Cross Blue Shield benefits and start your treatment today.