Excellus Blue Cross Blue Shield Mental Health Coverage and Addiction Treatment

Does Excellus cover therapy for mental health, alcohol and drug addiction?
Behavioral health issues can vary widely. Anxiety and depression, the abuse of alcohol, prescription drugs, and illicit substances all have the ability to negatively affect your quality of life. Connect with We Level Up NJ and verify your Excellus Blue Cross Blue Shield mental health coverage for drug & alcohol rehab. Read to learn more.


Excellus Blue Cross Blue Shield Mental Health Coverage

Excellus BCBS mental health provides mental health coverage and addiction rehab services for its members. The specific coverage and benefits may vary depending on the plan and state where the member resides, but generally, Excellus BCBS mental health offers coverage for mental health and substance use disorder services.

Mental health coverage may include services such as therapy, counseling, and psychiatric consultations. For addiction rehab services, Excellus BCBS mental health service may cover detoxification, inpatient treatment, and outpatient treatment programs. The coverage may also include medication-assisted treatment (MAT) for opioid addiction.

Members can access mental health and addiction rehab services through the Excellus BCBS mental health doctors’ network of providers. Some plans may also offer out-of-network coverage, but at a higher cost to the members.

It’s important to note that there may be certain limitations and exclusions to the Excellus Blue Cross Blue Shield mental health coverage, so members should check their plan’s specific Blue Cross Excellus Plan mental health benefits and requirements. Additionally, some plans may require prior authorization for certain services, so it’s essential to follow the plan’s guidelines to avoid unexpected costs.

Does Excellus Cover Therapy for Addiction Treatment?

Yes, Blue Cross Excellus Plan mental health may provide coverage for therapy and other forms of addiction treatment. The specific coverage and benefits may vary depending on the individual’s plan and the type of treatment needed.

Excellus BCBS mental health coverage for addiction treatment typically includes:

  • Inpatient detoxification and rehabilitation services: This may include medically supervised detoxification, 24-hour nursing care, individual and group therapy, and other support services.
  • Outpatient treatment services: This may include individual and group therapy, medication-assisted treatment, and other support services.
  • Behavioral health services: This may include counseling, therapy, and other mental health services for individuals with addiction and co-occurring mental health conditions.
  • Medication-assisted treatment: This may include medications that help manage cravings and withdrawal symptoms, such as methadone, buprenorphine, and naltrexone.

It’s important to note that Blue Cross Excellus Plan mental health may require prior authorization for certain types of addiction treatment, such as inpatient rehabilitation services. It’s also important to check with your specific plan to understand your coverage and any potential out-of-pocket costs.

What Are the Insurance Coverage Levels and Plans for Excellus BCBS Mental Health?

The specific insurance coverage levels and plans for mental health services with Excellus Blue Cross Blue Shield mental health may vary depending on the individual’s plan and state of residence. However, here is some general information about the plans and coverage levels Excellus BCBS offers for mental health:

  • Individual and Family Plans: Excellus Blue Cross Blue Shield offers a variety of individual and family plans that include coverage for mental health services. These plans may include copays, deductibles, and coinsurance for mental health services.
  • Medicare Plans: Excellus Blue Cross Blue Shield offers Medicare Advantage plans and Medicare supplement plans that provide coverage for mental health services. These plans may include copays, deductibles, and coinsurance for mental health services.
  • Employer-Sponsored Plans: Excellus Blue Cross Blue Shield offers employer-sponsored plans that include coverage for mental health services. The specific coverage and benefits may vary depending on the employer’s plan and the level of coverage chosen.
  • Mental Health Parity: Excellus Blue Cross Blue Shield is committed to providing mental health coverage that is comparable to coverage for physical health conditions, as required by federal law. This means that mental health services must be covered at the same level as medical and surgical services.
  • Out-of-Network Coverage: Excellus Blue Cross Blue Shield may offer out-of-network coverage for mental health services, but the specific coverage and benefits may vary depending on the plan. Out-of-network coverage may require a higher copay, deductible, or coinsurance.

It’s important to check with your specific plan to understand your coverage and any potential out-of-pocket costs for mental health services. Additionally, Excellus Blue Cross Blue Shield provides resources and tools to help members find mental health providers who are covered under their plan.

If you have Blue Cross Excellus plan mental health insurance and are searching for a drug and alcohol treatment facility covered by your plan, We Level Up NJ can help. Learn more about your Excellus Blue Cross Blue Shield mental health coverage.
If you have Blue Cross Excellus plan mental health insurance and are searching for a drug and alcohol treatment facility covered by your plan, We Level Up NJ can help. Learn more about your Excellus Blue Cross Blue Shield mental health coverage.

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Excellus Blue Cross Blue Shield Mental Health Coverage Statistics

Health plans: Excellus Blue Cross Blue Shield offers a variety of health insurance plans, including HMO, PPO, and high-deductible health plans. The company also offers Medicare Advantage plans, Medicare supplement plans, and dental and vision coverage.


1936

History: Excellus Blue Cross Blue Shield was founded in 1936 as Blue Cross of Central New York and later merged with Blue Shield of Central New York to become Blue Cross Blue Shield of Central New York. In 2003, the company changed its name to Excellus Blue Cross Blue Shield.

Source: Excellus BCBS mental health home page

1.5 million

Excellus Blue Cross Blue Shield is a nonprofit health insurance company based in Rochester, New York, that provides health insurance coverage to more than 1.5 million members in upstate New York.

Source: Excellus BCBS mental health home page

31 counties

Service area: Excellus Blue Cross Blue Shield serves 31 counties in upstate New York, including the Rochester, Syracuse, Utica, and Binghamton areas.

Source: Excellus BCBS mental health home page


Facts About Health Insurance Coverage

Here are some interesting facts about health insurance coverage:

  • As of 2021, over 91% of the US population has health insurance coverage through private insurance, Medicare, Medicaid, or other government programs.
  • The Affordable Care Act (ACA), also known as Obamacare, has significantly increased the number of Americans with health insurance coverage. Since its implementation in 2010, over 20 million people have gained coverage.
  • Health insurance coverage varies widely by state, with some states having much higher uninsured rates than others. For example, in 2019, the uninsured rate in Texas was 18.4%, while the uninsured rate in Massachusetts was just 3.0%.
  • Health insurance coverage can be expensive, with the average annual premium for a family plan exceeding $21,000 in 2020. However, many people receive subsidies to help offset the cost of their premiums.
  • Health insurance coverage can be a lifeline for people with chronic conditions or serious illnesses. Without insurance, the cost of medical care can be prohibitively expensive, leading to financial hardship or even bankruptcy.
  • Health insurance coverage can be complex, with many different types of plans, networks, deductibles, and copays. It’s important to carefully review your coverage options and understand the specifics of your plan.
  • Health insurance coverage can have a major impact on public health outcomes. Research has shown that people with health insurance are more likely to receive preventive care, manage chronic conditions, and have better health outcomes overall.
Excellus BCBS mental health service generally offers coverage for substance use disorder treatment, including a range of services depending on the individual's needs and insurance plan. Continue reading to learn more about  your Premera Blue Cross therapy coverage and Premera Blue Cross mental health benefits

Excellus BCBS mental health service generally offers coverage for substance use disorder treatment, including a range of services depending on the individual’s needs and insurance plan. Continue reading to learn more about your Excellus Blue Cross Blue Shield mental health coverage

Do Excellus BCBS Mental Health Insurance Cover Inpatient Addiction Treatment?

Yes, Excellus Blue Cross Blue Shield generally covers inpatient addiction treatment as part of their mental health coverage. Inpatient addiction treatment, also known as residential treatment, is a level of care where individuals with addiction disorders reside in a treatment facility while receiving comprehensive therapy and support to overcome their addiction.

The specific coverage for inpatient addiction treatment may vary depending on the individual’s plan and state of residence, but Excellus BCBS generally covers the following types of inpatient addiction treatment:

  • Medically supervised detoxification
  • Residential treatment
  • Partial hospitalization programs
  • Intensive outpatient programs

In some cases, Excellus BCBS may require prior authorization for inpatient addiction treatment. It is important to check with your specific plan to understand your coverage and any potential out-of-pocket costs for inpatient addiction treatment.

It is also worth noting that Excellus BCBS is committed to providing mental health coverage that is comparable to coverage for physical health conditions, as required by federal law. This means that coverage for addiction treatment must be at the same level as coverage for other medical conditions. Excellus BCBS also offers resources and support for individuals seeking addiction treatment, including a 24/7 mental health crisis hotline and access to mental health providers who specialize in addiction treatment.

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What are the Types of Drug Addictions Covered by Excellus BCBS Mental Health Insurance?

Excellus Blue Cross Blue Shield’s mental health insurance generally covers a range of drug addictions, including:

  1. Opioid addiction: This includes addiction to prescription painkillers like oxycodone and hydrocodone, as well as illegal opioids like heroin.
  2. Stimulant addiction: This includes addiction to drugs like cocaine, methamphetamine, and prescription stimulants like Adderall.
  3. Sedative and hypnotic addiction: This includes addiction to prescription drugs like benzodiazepines and sleep aids.
  4. Alcohol addiction: Excellus BCBS provides coverage for alcohol addiction treatment, including detoxification, inpatient rehabilitation, and outpatient treatment.

It’s important to note that Excellus BCBS’s mental health coverage is designed to provide comprehensive coverage for addiction treatment and other mental health conditions. The specific coverage for addiction treatment may vary depending on the individual’s plan and state of residence, and it’s important to check with your specific plan to understand your coverage and any potential out-of-pocket costs.

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What is the Difference Between HMO and PPO Plans?

HMO and PPO plans are two common types of health insurance plans. Here are the main differences between HMO and PPO plans:

  • Provider Network: HMO plans typically have a more restricted provider network than PPO plans. With an HMO plan, you must choose a primary care physician (PCP) as your gatekeeper for referrals to specialists within the HMO network. With a PPO plan, you have more flexibility to see any provider you choose, whether they are in or out of network.
  • Referrals: As mentioned above, HMO plans typically require you to obtain a referral from your PCP before seeing a specialist within the network. PPO plans generally don’t require referrals and offer more provider flexibility.
  • Out-of-pocket costs: HMO plans often have lower out-of-pocket costs, including copayments and deductibles, than PPO plans. However, HMO plans may restrict the types of services covered and require you to pay a higher percentage of the cost for out-of-network services.
  • Premiums: HMO plans often have lower monthly premiums than PPO plans since the network is more restricted and the out-of-pocket costs are lower.

Overall, the main difference between HMO and PPO plans is the level of flexibility and control you have over your healthcare choices. If you prefer a plan with lower out-of-pocket costs and don’t mind a more restricted network, an HMO plan may be a good choice. A PPO plan may be better if you want more flexibility in choosing providers and don’t mind paying higher out-of-pocket costs.

Battling drug and alcohol addiction is hard and should not be dealt with alone, Including rehabilitation expenses. This article will help explain what "Excellus Blue Cross Blue Shield mental health coverage" is.  Learn about Blue Cross Excellus Plan mental health options, Call us today.
Battling drug and alcohol addiction is hard and should not be dealt with alone, including rehabilitation expenses. This article will help explain what “Excellus Blue Cross Blue Shield mental health coverage” is. Learn about Blue Cross Excellus Plan mental health options, Call us today.

 

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In-Network Vs Out-of-Network Insurance Provider

In-network and out-of-network insurance providers can affect the coverage and cost of addiction treatment. Here’s what you need to know about in-network vs. out-of-network insurance providers for addiction treatment:

In-Network Providers:

  • If you have an in-network insurance provider for addiction treatment, you’ll typically pay lower out-of-pocket costs for care.
  • Your insurance company will have a list of in-network providers that offer addiction treatment services, including detoxification, therapy, and medication-assisted treatment.
  • You’ll be responsible for paying any copay, coinsurance, or deductible for the care you receive, but these costs will typically be lower for in-network providers.
  • In-network providers will have an established relationship with your insurance company, making the billing and payment process smoother.

Out-of-Network Providers:

  • If you choose to receive addiction treatment from an out-of-network provider, you’ll typically pay higher out-of-pocket costs for care.
  • Your insurance company may cover some of the cost of care, but you’ll be responsible for paying a larger portion of the cost, including higher copays, coinsurance, and deductibles.
  • In some cases, your insurance company may not cover the cost of out-of-network addiction treatment, leaving you responsible for the entire cost of care.
  • It’s important to note that some insurance plans may not cover out-of-network addiction treatment at all, while others may have limited coverage.

If you’re seeking addiction treatment, check with your insurance company to understand your coverage options and the costs associated with in-network and out-of-network providers. You may also want to consider talking to your healthcare provider or treatment center to understand their relationship with your insurance company and how they can help you navigate the insurance process.

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Want to learn more about your  Excellus BCBS mental health coverage costs? Call us today!
Want to learn more about your Excellus BCBS mental health coverage costs? Call us today!

We Level Up NJ Makes It Easy to Verify Excellus Blue Cross Blue Shield Mental Health coverage for Drug Rehab

We understand that combing through the Excellus BCBS mental health policy can be challenging, time-consuming, and frustrating. Fortunately, you don’t have to do it alone. At We Level Up NJ, our admissions staff works with many Excellus behavioral health providers’ customers during admissions.

Once we determine the appropriate level of care for you or your loved one, we will quickly verify your insurance benefits and have an open and honest conversation about your Blue Cross Excellus plan mental health and Excellus BCBS mental health services.

Excellus BCBS Mental Health Service Video

Our team of admissions coordinators is here to assist you in the first step toward recovery and is available to answer any questions or concerns you have. We know taking the first step in anything can be difficult, especially when dealing with addiction. Our staff knows firsthand what you’re going through. We want you to know that you are not alone, and we are here to assist throughout the journey.

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Sources

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[4] How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care – Beronio K, Glied S, Frank R. How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care. J Behav Health Serv Res. 2014 Oct;41(4):410-28. doi: 10.1007/s11414-014-9412-0. PMID: 24833486. / Tag: Excellus blue cross blue shield mental health coverage

[5] Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health – Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. PMID: 28252892. / Tag: Excellus blue cross blue shield mental health coverage

[6] Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 4, EARLY INTERVENTION, TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424859/Tag: Excellus blue cross blue shield mental health coverage

[7] Mental Health & Substance Abuse – https://www.hhs.gov/programs/prevention-and-wellness/mental-health-substance-abuse/index.html / Tag:

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[9] Private Health Insurance Coverage for Substance Use Disorders and the Receipt of Specialty Treatment among U.S. Adults – Cummings JR, Wen H, Ritvo A, Druss BG. Health insurance coverage and the receipt of specialty treatment for substance use disorders among U.S. adults. Psychiatr Serv. 2014 Aug 1;65(8):1070-3. doi: 10.1176/appi.ps.201300443. PMID: 25082606; PMCID: PMC4189808. Tag:

[10] Tran Smith B, Seaton K, Andrews C, Grogan CM, Abraham A, Pollack H, Friedmann P, Humphreys K. Benefit requirements for substance use disorder treatment in state health insurance exchanges. Am J Drug Alcohol Abuse. 2018;44(4):426-430. doi: 10.1080/00952990.2017.1411934. Epub 2017 Dec 20. PMID: 29261341; PMCID: PMC5940489 / Tag: Excellus Blue Cross Blue Shield mental health coverage

[10] Tran Smith B, Seaton K, Andrews C, Grogan CM, Abraham A, Pollack H, Friedmann P, Humphreys K. Benefit requirements for substance use disorder treatment in state health insurance exchanges. Am J Drug Alcohol Abuse. 2018;44(4):426-430. doi: 10.1080/00952990.2017.1411934. Epub 2017 Dec 20. PMID: 29261341; PMCID: PMC5940489 / Tag: Excellus Blue Cross Blue Shield mental health coverage