Blue Cross Blue Shield of Michigan: Rehabs & Detox Centers in MI That Take BCBS
When looking for a rehab facility for yourself or a loved one, it’s important to consider what your health insurance will cover. If you’re a Blue Cross Blue Shield (BCBS) of Michigan member, your insurance may be able to cover some, if not all, of the cost of drug or alcohol rehab. This page will help you understand the types of addiction treatment in Michigan that may be covered by your BCBS of Michigan plan.
In 2018, approximately 78% of drug overdoses in Michigan involved at least one opioid.1 That same year, Michigan providers wrote 63 opioid prescriptions for every 100 persons, which was higher than the national average.1 Within the 2017-2018 timeframe, there were 599,000 people in Michigan living with a substance use disorder (SUD).2 And by June of 2020, 40% of adults across the U.S. reported struggling with mental health or substance use, correlating with the stress of a global pandemic.2
The need for treatment is on the rise in Michigan and throughout the U.S., but the good news is, help is available. With your BCBS of Michigan plan, you may be able to receive full or partial coverage for addiction treatment, including detox, inpatient and outpatient rehab, and long-term residential treatment.
What Is Blue Cross Blue Shield of Michigan?
Blue Cross Blue Shield of Michigan is a nonprofit mutual insurance company founded in 1939.3 Today, BCBS of Michigan is the state’s largest health insurance provider, serving over 4.5 million members within Michigan and another 1.6 million members out of state.3 BCBS of Michigan also boasts the biggest network within the state, with over 33,000 doctors and 152 hospitals participating in the network.3
BCBS of Michigan offers health plans for individuals, families, and Michigan-based employers. Plans include:3
- Preferred provider organization (PPO).
- Health maintenance organization (HMO).
- Medicare.
- Medicaid and state plans.
- Wellness-based plans.
- Health spending accounts (HSA).
- Dental and vision plans.
- International plans.
- Pharmacy plans.
The company is a licensee of the Blue Cross and Blue Shield Association (BCBSA), which has 38 independent and locally run health insurance companies throughout the U.S.4
Does Blue Cross Blue Shield of Michigan Cover Rehab Treatment?
Yes, your Blue Cross Blue Shield of Michigan plan should cover some, if not all, of the cost of rehab and other addiction treatment in Michigan or out of state.
The Affordable Care Act mandates all health insurance providers with Marketplace plans to provide coverage for 10 essential health benefits, one of which is substance use disorder (SUD) treatment.5 Plans must also cover medically-necessary behavioral health treatment (e.g., counseling and psychotherapy) and inpatient mental and behavioral health services.6 BCBS of Michigan also has substance use facility programs that offer traditional treatment options for members who need help.7
Keep in mind that coverage will vary depending on your BCBS of Michigan plan and factors such as the type of treatment you receive, where you receive treatment, and for how long. You can learn what will be covered by calling the number on the back of your insurance card and speaking to a BCBS of Michigan representative.
Types of Addiction Treatment That Blue Cross Blue Shield of Michigan May Cover
Coverage for detox, rehab, and other types of addiction treatment will vary depending on your specific Blue Cross Blue Shield of Michigan plan, where you receive treatment, and for how long. While coverage will vary, per the Affordable Care Act, your plan will cover the cost of substance use disorder treatment in some capacity.
Addiction treatments that may be covered by your BCBS of Michigan plan include:8
- Medical detox: While not always necessary, medical detox can help you comfortably and safely withdraw from a substance (e.g., alcohol, drugs). Medical detox is not considered treatment, but it can help you transition into an ongoing treatment program, such as inpatient or outpatient rehab.
- Inpatient programs: Inpatient programs allow you to get treatment within a comfortable, residential setting. Each facility will differ, but patients can expect a variety of therapeutic approaches to help them live a drug-free lifestyle once treatment is completed.
- Outpatient programs: Outpatient programs allow you to live at home while attending treatment at a rehab facility during the day. This can be a good option for patients who have completed an inpatient program or have home, school, or work responsibilities they need to attend to.
- Intensive outpatient programs (IOP): IOPs are similar to an outpatient program but require more frequent and longer treatment sessions. Sessions typically last for a few hours at a time and occur multiple days of the week.
- Partial hospitalization programs (PHP): Often referred to as day treatment programs, PHPs provide patients with a high level of care while allowing them to return home in the evening. Treatment typically occurs 5 or more days per week, for 4 to 6 hours per day.
- Aftercare: The term “aftercare” is used to describe ongoing or follow-up substance use treatment (e.g., 12-step meetings like A.A. or N.A.). Aftercare programs can help patients sustain their recovery and live a happier, healthier, and more fulfilling life.
Does Blue Cross Blue Shield of Michigan Cover Mental Health & Dual Diagnosis Treatment?
Yes, Blue Cross Blue Shield of Michigan should cover some, if not all, of mental health and dual diagnosis treatment. This is mandated by the Affordable Care Act, as every Marketplace plan is required to cover behavioral health treatment, substance use disorder treatment, and mental and behavioral health inpatient services.6
“Dual diagnosis” is a term used when someone is diagnosed with a substance use disorder and a mental illness (e.g., anxiety or depression).9 Dual diagnosis is common and more than 50% of people who have a substance use disorder also have a mental illness.9 Research strongly suggests that treating both conditions at the same time provides better outcomes.9 Effective dual diagnosis treatment integrates assistance for each condition, helping people recover from both in the same setting, at the same time.10
How to Check Your Blue Cross Blue Shield of Michigan Coverage for Rehab
Finding a treatment facility can feel overwhelming but knowing in advance what your Blue Cross Blue Shield of Michigan insurance will cover can ease the stress. The good news is, checking your coverage is easy by calling the number on the back of your insurance card or filling out the form below.
Insurance Providers and Rehab Treatment Coverage Levels