HCSC Insurance for Addiction Treatment
HCSC (Health Care Service Corporation), America’s largest customer-owned health insurance company, provides a wide array of coverage packages through Blue Cross and Blue Shield. Because HCSC does not have stockholders, it is able to keep the cost of insurance down for patients.
HCSC takes addiction treatment seriously. Substance abuse is considered by insurance companies to be a chronic medical illness, so it is generally covered to some extent under most insurance programs—HCSC included.
Because each HCSC insurance plan is unique, coverage for drug and alcohol detox and rehabilitation varies. Depending on your plan, you may be able to get at least a portion of the cost of either inpatient or outpatient rehabilitation covered by your insurance. Some plans offer full coverage, and most plans offer at least partial coverage for detox and rehab services.1
Does HCSC Cover Addiction Treatment?
Rehabilitation services are typically covered under the Substance Abuse Disorder section of the Essential Health Benefits provided by HCSC. Individual coverage will vary depending on the plan, but most plans will provide some coverage for both inpatient and outpatient rehabilitation options Depending on your individual plan, you may have to meet a deductible or pay a copay before your insurance provides coverage.
Treatment coverage may vary, and it is important to carefully review your coverage package with HCSC and talk with your provider about payment before starting treatment.
Many plans provide coinsurance, meaning that HCSC will cover a specific percentage of the bill, and then you will be responsible for the rest. There may be a limit to the number of times detoxification services are covered, so always double check your benefit coverage, especially if you have received detox treatment in the past.
How to Check Your Insurance Benefits?
Before you decide which rehab center might be best for your needs, it’s important to check your insurance benefits to understand what costs are covered by your insurance provider and which ones you are responsible for.
Knowing exactly what your HCSC plan covers can give you peace of mind while you or your loved one is in rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. For more information on HCSC insurance plans and to check what your plan covers, call , click here, or fill out the form below.
What Are the Coverage Levels and Plans for HCSC?
HCSC is the largest customer-owned health insurance company in the United States and serves nearly 16 million members. It operates in Illinois, Montana, New Mexico, Oklahoma, and Texas. They offer a variety of plans to serve their members.2
HCSC offers health insurance plans under the BlueCross BlueShield license.3 They offer a variety of health insurance group and individual plans, along with Medicare options.
You can choose between health maintenance organization (HMO) and preferred provider organization (PPO) plans.
- HMOs are generally more restrictive about receiving substance use treatment inside the network but are less expensive.
- PPO plans give you more flexibility, but you will pay more in monthly premiums.
Knowing which plan you have will help you understand how HCSC insurance will apply to your addiction recovery needs.
HCSC, Medicare, & Medicaid
HCSC insurance also offers Medicare Advantage plans under BlueCross BlueShield.4 Medicare Advantage is a private insurance product that replaces Original Medicare but also provides you with additional benefits. For instance, you get built-in prescription drug coverage and other health and wellness opportunities. You can choose between HMO and PPO options for Medicare Advantage as well.
The state you live in and the plan you choose will affect your benefits, copayments, and deductibles. Contact your treatment provider to find out if they offer financing options or grants.
Do Treatment Centers Need to Be In-Network?
In-network providers have a contract with the insurance carrier to offer services at a set price. This means that your out-of-pocket expenses will typically be lower than if you choose an out-of-network facility. In some cases, you may even be responsible for the full cost of rehab if you choose an out-of-network facility.
Whenever possible, try to choose a facility that is in-network with HCSC. If you are unable to find an in-network provider or prefer a facility that is out-of-network, you may be able to work out a payment plan with the facility so you can pay back the cost of treatment over time.
Addiction Treatment Length HCSC Will Cover
Inpatient treatment programs for addiction can vary in length. The most common rehabilitation services are 30, 60 and 90 days long. Some treatment programs last a year or longer depending on the severity of the addiction.
Insurance coverage will vary depending on your individual plan. The most common length of treatment covered is 30 days. Under some plans you may have limited coverage for longer programs, especially if you have been previously treated for addiction. For more information, check the Summary of Benefits listed for your individual plan.
What Different Types of Addiction Treatment Does HCSC Cover?
With most Medicaid plans covering at least some of the costs of treatment for alcohol addiction or drug addiction, the types of treatment can vary in intensity and frequency. Types of treatment may include:5,6
- Detox services: In some cases, you may need assistance when detoxing from drugs and alcohol, which can potentially be uncomfortable, painful, or even life threatening. Medical detox helps you safely withdrawal from drugs and alcohol, as you’ll receive around-the-clock medical supervision. You might also be given medications to help minimize withdrawal symptoms.
- Inpatient or residential care: Inpatient/residential live-in treatment centers provide drug and alcohol rehab while you live onsite at the facility. Most inpatient programs last anywhere from 15–90 days, depending on the program you’re in and your individual needs.
- Partial hospitalization (PHP): Partial hospitalization programs give you the opportunity to live at home while attending treatment during the day.
- Intensive outpatient program (IOP): Intensive outpatient programs involve attending treatment programs a few evenings a week. In an intensive outpatient program, you can live at home and even go to work during the day.
- Outpatient treatment: Individuals who have completed inpatient treatment often attend outpatient treatment for ongoing support on their journey to sobriety. You live at home and spend 10–12 hours a week at the treatment facility for therapy and support.
When you decide to get treatment for a drug or alcohol addiction, you will need to decide what type of treatment is best for you.
How to Verify the Coverage of Your HCSC Plan?
The cost of drug and alcohol addiction treatment will vary from person to person. It will depend on the treatment center, the type of program attended, and specific services received.
Before deciding on a rehab center, check your HCSC policy benefits to determine which costs will be covered by your insurance plan and which will be out-of-pocket for you. Call the number on your insurance card or log in to your account on HCSC’s website to determine how much you may need to cover in terms of copays and any deductible that must be reached before coverage kicks in for the services you need.
American Addiction Centers can also verify your insurance coverage for you. Visit our insurance verification page, enter your information, and you will immediately be able to see if the center you are considering is in-network with HCSC. Or call to speak to one of our admissions navigators to have them check your benefits and help you understand what is covered.
What Should I Do if HCSC Won’t Cover the Total Cost of Rehab?
HCSC may cover some, if not all, of your rehab costs, depending on the policy you have. In some cases, your policy may not cover all the expenses related to treatment at drug and alcohol rehab facilities and treatment centers.
There are many cases when an insurance plan doesn’t provide full coverage for certain detox and recovery programs. You may find your insurance coverage is limited, for example, when it comes to:
- Out-of-state or out-of-network treatment.
- Specialty or luxury rehab programs.
- Relapse treatment following a recovery program.
Fortunately, there are still payment options available to help finance your treatment in these cases. If you are unable to pay your out-of-pocket costs for treatment in full, consider setting up a payment plan or installment option with the rehab facility of your choice. Many treatment programs also provide sliding-scale rates for those who qualify. Additionally, there may be scholarships or grants available.
For more information on other ways to pay, visit these web pages:
Cost of treatment can be prohibitive for many individuals who need help. Knowing what costs your Cigna health insurance plan covers for drug and alcohol addiction services can help you plan for any costs that you will be responsible for while you or your loved one are getting drug or alcohol addiction treatment. Because addiction is a chronic and debilitating illness, finances shouldn’t prevent you from seeking treatment. If you need further help, we would be happy to answer your questions and help you sort through your options at .
- HCSC. (n.d.). Medical Policies.
- HCSC. (2020). HCSC by the numbers.
- HCSC. (2020). Newsroom news release.
- BlueCross BlueShield of Illinois. (2020). Medicare Advantage plans.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.
- National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide: Treatment Settings.