Blue Cross Blue Shield of Rhode Island: Rehabs in RI that Take BCBS

Blue Cross Blue Shield (BCBS) is an association of 35 independent and locally run BCBS companies that operate in all 50 states.² The Rhode Island company is called Blue Cross Blue Shield of Rhode Island (BCBSRI).

BCBSRI began operations in 1939 as the Hospital Services Corporation of Rhode Island. By 1945, they covered more than 50% of Rhode Island’s population. They began to offer major medical coverage in 1962 and became BCBSRI in 1982. Today, the company focuses on enhancing the health and well-being of Rhode Island residents.³

Yes. Thanks to the Affordable Care Act (ACA), all long-term health insurance plans must cover 10 essential health benefits.⁴ One of those benefits is treatment for substance use disorder.⁴

That means that Blue Cross Blue Shield of Rhode Island will provide at least some coverage for rehab treatment, both in Rhode Island and elsewhere. The specific coverage you receive and the costs you will pay depend on the BCBSRI plan you have.

If you struggle with using opioids in particular, you can take advantage of a treatment program without advanced approval. Your doctor will review your health history and recommend the right treatment plan for your needs. This might include office visits, intensive outpatient programs (IOPs), inpatient care, or partial hospitalization programs (PHPs).⁵

To learn more about your coverage, you can call the number on the back of your insurance card and speak with a BCBSRI representative.

The coverage you receive for addiction treatment will vary depending on your specific plan. Your insurance may be able to cover some or all of the cost of addiction treatment for alcohol, marijuana, opioids, or other substances.

Some of the types of addiction treatment that Blue Cross Blue Shield of Rhode Island may cover include:

• Medical detox: Medical detox can help ease withdrawal symptoms, which can be uncomfortable and sometimes dangerous. This helps get patients through the detoxification process comfortably and safely and facilitates the transition into ongoing addiction treatment.
• Inpatient treatment program: In an inpatient program, you will live at the facility while you learn new habits and work on your substance use triggers. This often involves both group and individual therapy and other activities to facilitate your recovery.
• Outpatient program: An outpatient program lets you live at home while attending treatment several times a week. This may be a step-down from inpatient care or you may start with an outpatient program.
• Intensive outpatient program (IOP): This type of outpatient program involves more frequent and longer treatment sessions. You will attend treatment multiple times a week for a few hours at a time.
• Partial hospitalization program (PHP): A PHP is similar to an inpatient program except that you live at home. You spend up to 6 hours a day in treatment, 5 days a week or more. After each session, you return home for the night.
• Aftercare: Aftercare is an important part of any treatment program. It helps you get the support you need to maintain your new habits and stay substance-free.

It’s very common to have both a substance use disorder and a mental health disorder.⁶ In fact, research has found that about 50% of those struggling with substances in their lives will also experience a co-occurring mental disorder. Some common mental health issues that occur alongside substance use are ADHD, anxiety, bipolar disorder, and depression.⁶

Having a diagnosis of substance use disorder and a mental health disorder concurrently is known as a dual diagnosis. With dual diagnosis, also known as comorbidity, the illnesses can affect one another.⁷ Dual diagnosis treatment can help address both disorders.

Like substance use disorder treatment, mental health disorder treatment is included in the ACA’s list of essential benefits. This means your Blue Cross Blue Shield of Rhode Island plan should cover some, if not all, of the cost of mental health and dual diagnosis treatment. You can even receive coverage for preexisting conditions, and the health insurance plan cannot impose a spending limit for medically necessary care.⁸

There is also a provision in the ACA known as “parity protection.” This means that a health care plan must cover mental health and addiction treatment at the same level as they would for another medical issue.⁸ They cannot, for example, provide a higher level of coverage for a long-term medical need than they do a long-term mental health need.⁸

Finding a treatment facility can feel overwhelming but knowing in advance what your BCBS of Rhode Island 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 Rhode Island or out of state, fill out the form below.

1. Prevent Overdose RI. (2021). Overdose Death Data.
2. Blue Cross Blue Shield. (n.d.). BCBS® Companies and Licensees.
3. Blue Cross Blue Shield of Rhode Island. (n.d.) Our History.
4. Healthcare.gov. (n.d.). What Marketplace health insurance plans cover.
5. Blue Cross Blue Shield of Rhode Island. (n.d.). Help for Opioid Use Disorders.
6. National Institute of Mental Health. (n.d.). Substance Use and Co-Occurring Mental Disorders.
7. National Institute on Drug Abuse. (2020). Common Comorbidities with Substance Use Disorders Research Report, Introduction.
8. Healthcare.gov. (n.d.). Mental health & substance abuse coverage.
9. Healthcare.gov. (2021). What you should know about provider networks.