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Blue Cross Blue Shield of Illinois: Rehabs & Detox Centers in IL That Take BCBS

Blue Cross Blue Shield of Illinois (BCBSIL) provides health insurance coverage to individuals and families statewide. If you’re a BCBSIL member in need of help for substance use, your insurance plan may provide partial or full coverage for rehab. This page will help you understand the types of addiction treatment that may be covered.

If you or a loved one is struggling with addiction, you’re not alone. In 2018, there were more than 67,000 drug overdose deaths in the U.S.1 The number of deaths involving prescription opioids and heroin this same year was nearly 30,000.1 In Illinois, nearly 80% of drug overdose deaths involved opioids.1 In Chicago alone, the Fire Department EMS team responded to an average of 23 opioid-related overdoses every day.2

Deciding to get help for drug or alcohol use is a courageous step on your journey to recovery. Unfortunately, the cost of rehab prevents many people from seeking the care they need. The good news is, there are several ways to pay for rehab.

If you’re a BCBSIL member, your insurance plan may cover at least some of the cost of detox treatment, inpatient or outpatient treatment, or a long-term residential treatment program.

What Is Blue Cross Blue Shield of Illinois?

Blue Cross Blue Shield (BCBS) is the parent company of Blue Cross Blue Shield of Illinois and oversees 35 independent BCBS companies delivering health insurance coverage to millions of Americans.3 Together, BCBS companies deliver health coverage to 1 in 3 Americans across the U.S.3

As an independent licensee, BCBSIL has been providing Illinois residents with health insurance since 1936.4 Today, BCBSIL is the state’s largest health insurance company, providing coverage to more than 8 million members.4

BCBSIL provides a variety of health care plans, including plans for families and individuals, as well as Medicare and Medicaid plans.5 The company’s goal is to provide affordable, comprehensive health plans to members. 5

To ensure members receive the best care for their needs, BCBS developed the Blue Distinction designation for centers to help recognize those that are committed to improving the quality and affordability of care.6 The Blue Distinction Centers for Substance Use Treatment and Recovery helps facilitate treatment for substance use disorder.7 If you have a BCBSIL plan and attend a facility that has a Blue Distinction, you may be able to receive your rehab treatment at little to no out-of-pocket cost to you.

Does Blue Cross Blue Shield of Illinois Cover Rehab Treatment?

Yes, although coverage may vary. The Affordable Care Act (ACA) requires almost all health plans, including plans issued by Blue Cross Blue Shield of Illinois, to provide coverage for 10 healthcare services that are considered essential health benefits (EHBs).8 Because of this, your BCBSIL plan must provide some level of coverage for mental and behavioral health services, which can include:9

  • Treatment for substance use disorders (e.g., rehab).
  • Inpatient treatment for mental and behavioral health disorders.
  • Treatment for behavioral health disorders (e.g., therapy).

Although this mandate means that your plan must provide coverage in some capacity, it doesn’t guarantee full coverage. It also doesn’t guarantee that all treatments from all facilities may be covered fully or partially under your health plan. BCBSIL has a portfolio of resources to help its covered members access behavioral health benefits they may need.10 While the level of coverage you receive may vary based on your plan, BCBSIL plans may cover the following common substance use disorder treatments:11

  • Community-based alcohol or drug treatments
  • Community-based behavioral health services
  • Inpatient or residential rehab
  • Outpatient rehab
  • Intensive outpatient programs (IOPs)
  • Partial hospitalization programs (PHPs)

It’s a good idea to know exactly what your BCBSIL insurance will get before obtaining care. Unless you’re experiencing an emergency, you may need to check if a facility is in-network or if you need prior authorization for your care to be covered.12 You can do this by calling the number on the back of your insurance card.

You can also call American Addiction Centers at to talk to an admissions navigator who can provide answers about addiction treatment and verify your insurance. American Addiction Centers is an in-network provider with most BCBSIL plans, which means your rehab care may be fully or partially covered under your health plan.

Types of Addiction Treatment That Blue Cross Blue Shield of Illinois May Cover

The types of addiction treatment covered by Blue Cross Blue Shield of Illinois may vary based on your specific plan. However, BCBSIL may be able to cover the cost of rehab for the treatment of substances like alcohol, cocaine, opioids, and more in some capacity.

Depending on your plan and unique needs, a provider will make a treatment recommendation, which may or may not include any of the following common addiction treatments:13,14

  • Medical detox: Those entering rehab may need to undergo medical detox, which is the process of ridding the body of substances (e.g., alcohol or drugs) in a medically supervised environment. Medical care is usually facilitated to help manage withdrawal symptoms which can be life-threatening, in some cases.
  • Inpatient program: Inpatient programs are those in which a patient receives treatment in a facility and stays overnight. Care may range from a few days to a few months.
  • Outpatient program: Outpatient programs generally involve a patient coming to a facility once or twice a week to receive the care they need. It’s called an outpatient program because it doesn’t involve an overnight stay.
  • Intensive outpatient program (IOP): Patients in an IOP attend outpatient programs for a minimum number of hours each week, but don’t stay overnight.
  • Partial hospitalization program (PHP): Patients in a PHP typically attend a facility 4 to 8 hours per day a few days a week and go home at the end of the day.
  • Aftercare: The term “aftercare” is used to refer to many types of follow-up care or ongoing care that is received by a patient after their initial rehab treatment is finished.

Does Blue Cross Blue Shield of Illinois Cover Mental Health & Dual Diagnosis Treatment?

Yes, although coverage may vary. Under the ACA, your Blue Cross Blue Shield of Illinois plan should cover mental health and dual diagnosis treatment in some capacity. In some cases, your plan may cover all the costs related to your treatment, whether it be for a mental health condition, a substance use disorder, or both—which is known as a dual diagnosis or co-occurring disorder.

A co-occurring disorder or dual diagnosis is defined as a patient having a co-existing mental health and substance use disorder. It’s estimated that there are 9.2 million people in the U.S. with a co-occurring disorder.15 Many experts agree that for those who have a dual diagnosis, treating both disorders at the same time is the most effective treatment path.16

How to Check Your Blue Cross Blue Shield of Illinois Coverage for Rehab

Finding a treatment facility can feel overwhelming, but knowing in advance what your Blue Cross Blue Shield of Illinois insurance will cover can give you peace of mind. The good news is, checking your coverage is easy. To learn about your specific coverage in Illinois or out of state, contact an admissions navigator at , or fill out the form below.

Which Rehab Centers Take Blue Cross Blue Shield of Illinois?

There are a variety of rehab centers that may take Blue Cross Blue Shield of Illinois health plans. American Addiction Centers is also an in-network provider with BCBSIL, which means your insurance plan may fully or partially cover treatment at a facility, including:

  • AdCare Rhode Island: Located in Rhode Island, these treatment facilities are comprised of 4 locations, North Kingstown (inpatient), Warwick (outpatient), Greenville (outpatient), and South Kingstown (outpatient).
  • Desert Hope Treatment Center: The upscale Desert Hope Treatment Center in Nevada provides high-quality r addiction treatment. Unique to Desert Hope is the specialized rehab program for veterans and first responders.
  • Greenhouse Treatment Center: Located in Texas, the Greenhouse Treatment Center provides individualized addiction treatment to patients. This facility provides medical detox, inpatient and residential treatment, PHP, IOP, telehealth, and outpatient therapy services.
  • Laguna Treatment Center: Located near the famous Laguna Beach, this California treatment facility provides medical detox and inpatient and residential treatment.
  • Oxford Treatment Center: Situated in a natural, serene environment in Mississippi, the Oxford Treatment Center provides medical detox, inpatient and residential treatment, PHP, IOP, telehealth, and outpatient therapy services.
  • River Oaks Treatment Center: The River Oaks Treatment Center near Tampa, Florida, provides medical detox, inpatient and residential treatment, PHP, IOP, telehealth, and outpatient therapy services.
  • Sunrise House Treatment Center: Located in Lafayette, New Jersey, the Sunrise House Treatment Center, a premier facility, provides medical detox and inpatient and residential treatment.

Deciding to seek treatment for drug or alcohol use is a brave step and you deserve to be supported on your journey to recovery. American Addiction Centers is committed to helping people struggling with addiction break the cycle. If you have questions about addiction treatment or want to know what your Blue Cross Blue Shield of Illinois insurance covers, contact us at to speak with an admissions navigator. Our compassionate team is available 24/7 to offer support and assist you with the admissions process when you’re ready.

 

More resources about Blue Cross Blue Shield of Illinois: Rehabs & Detox Centers in IL That Take BCBS: