Empire Blue Cross Blue Shield New York: Rehabs & Detox Centers in NY That Take BCBS
Blue Cross Blue Shield (BCBS) is a nationwide health insurance provider in the United States. In New York, BCBS is branded as Empire Blue Cross Blue Shield and provides healthcare coverage for New York residents. If you’re looking to get help for drug or alcohol use, your Empire BCBS plan may cover at least some, if not all, of the cost of addiction treatment.
New York is known for its cultural diversity and spectacular sights like Niagara Falls and the Statue of Liberty. It’s also known for being home to one of the most famous cities in the world. But in the Big Apple and beyond, New York is impacted by drug and alcohol use.
Between January and April 2021, more New Yorkers died of drug overdoses than car accidents, homicides, and suicides combined.1 Statewide, nearly 2 million New Yorkers struggle with substance use.2
If you’re an Empire BCBS member seeking addiction treatment, you’re taking an important step on your journey to recovery. Depending on your Empire BCBS plan, the cost of addiction treatment, such as medical detox, inpatient rehab, and outpatient rehab, may be partially, if not fully, covered.3
What Is Empire Blue Cross Blue Shield?
Empire BCBS has been providing health insurance coverage for New Yorkers since 1934. Today, Empire BCBS is the largest health insurance provider in New York and provides over 4 million members with access to affordable, high-quality healthcare.4
Empire BCBS is an independent licensee of the Blue Cross Blue Shield Association (BCBSA), a nationwide federation of 35 independent and locally run health insurance companies.5 Empire BCBS is dedicated to delivering better care to its members while helping improve the health of communities throughout the state.5
For families and individuals, Empire BCBS offers standard, Affordable Care Act (ACA) compliant plans through the Health Marketplace.6 Empire BCBS also offers Medicaid, Medicare, dental, and vision plans.6
Does Empire Blue Cross Blue Shield Cover Rehab Treatment?
Yes, Empire BCBS provides coverage for rehab and other addiction treatment. The Affordable Care Act (ACA) mandates coverage for substance use disorder treatment, as it is listed as an essential benefit.7 This means at least part of your rehab costs will be covered by your Empire BCBS plan.
The amount of rehab coverage you’ll receive depends on your specific Empire BCBS plan. Coverage varies depending on factors such as the type of treatment you need, the rehab you choose, and how long you attend rehab.
Empire BCBS also offers a care management program for members with substance use disorder.8 The program aims to help members suffering from addiction manage their substance use disorder and help them navigate the treatment process. Through the care management program, members have access to Empire BCBS staff who will create a care plan that fits their lifestyle and needs and provide support during and after treatment.
To speak with an Empire BCBS representative and learn about your coverage and the care management program, you can call the number on the back of your insurance card.
You can also call American Addiction Centers at to speak with an admissions navigator. Our team is available to answer your questions about addiction treatment, verify your insurance, and help you with the admissions process when you’re ready.
Types of Addiction Treatment That Empire Blue Cross Blue Shield May Cover
There are many types of addiction treatment in New York for various substances including alcohol, illicit drugs, and prescription drugs. The right treatment for you will depend on your unique needs.
Empire BCBS may cover several types of addiction treatment, including:
- Medical detox: Medical detox can help patients safely withdraw from substances comfortably and safely. This helps prepare patients for the transition to ongoing addiction treatment (e.g., inpatient rehab, outpatient rehab).
- Inpatient rehab: Inpatient rehab programs provide addiction treatment in a comfortable, home-like setting. A combination of group and individual therapy is an integral part of an inpatient rehab program. Patients live at the rehab facility for the duration of the program and have access to 24/7 support from staff.
- Outpatient rehab: Outpatient rehab programs allow patients to live at home while attending treatment during daytime hours.
- Intensive outpatient (IOP): An IOP is similar to outpatient rehab but more structured. Patients are allowed to live at home and attend treatment several days a week, typically for 3 to 4 hours at a time.
- Partial hospitalization programs (PHP): A PHP is similarly structured to an inpatient rehab program, but patients can still live at home. With a PHP program, patients typically attend treatment around 5 days a week for 4 to 6 hours each day.
- Aftercare: Aftercare programs provide ongoing support to patients who have completed an inpatient or outpatient program to help prevent relapse and ensure ongoing recovery.
The exact coverage provided for these treatments can differ depending on the Empire BCBS plan you have. Certain costs, such as copays and deductibles, may not be covered. Speaking with an Empire BCBS representative or American Addiction Centers admissions navigator before you enter treatment can help you know what you’ll be responsible for paying out of pocket.
Does Empire Blue Cross Blue Shield Cover Mental Health & Dual Diagnosis Treatment?
Yes, Empire BCBS should cover some, if not all, mental health and dual diagnosis treatment as mandated by the Affordable Care Act (ACA).7
Research shows that nearly half of individuals with substance use disorder also experience a co-occurring mental health disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD).9 This is known as a “dual diagnosis.”
Rehab facilities that provide treatment for both substance use disorder and other mental health disorders use a comprehensive, integrated approach that can address both conditions. Treating both conditions at the same time may help prevent relapse and support a person’s ongoing recovery. 9
Empire BCBS offers mental health benefits for members, which are integrated into all medical plans to provide a full spectrum of coordinated care.10 As an Empire BCBS member, your plan will cover at least some of the cost for dual diagnosis treatment in an accepted rehab program.
Check Your Empire Blue Cross Blue Shield Coverage for Rehab
Finding a treatment facility can feel overwhelming but knowing in advance what your Empire BCBS 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 New York or out of state, contact an admissions navigator at , or fill out the form below.
Which Rehab Centers Take Empire Blue Cross Blue Shield?
Empire BCBS members have access to a vast network of healthcare providers in New York state and beyond, including providers who offer treatment for substance use disorders.
If you have an Empire BCBS insurance plan, Sunrise House Treatment Center is an American Addiction Centers’ facility that accepts this insurance. Located in Lafayette, New Jersey, Sunrise House Treatment Center is a premier addiction center that provides a comprehensive continuum of care and individualized treatment plans.
American Addiction Centers is committed to helping those struggling with addiction on their recovery journey. You can get the answers you need about addiction treatment or your Empire BCBS coverage by contacting us at . Our admissions navigators are available 24 hours a day, 7 days a week to answer questions, provide resources, and assist you with the admissions process when you’re ready.
