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Empire Blue Cross Blue Shield: Insurance Coverage

Seeking addiction treatment for the first time is overwhelming. Between finding the right program for you, seeing if you qualify for insurance coverage, treatment can feel out of reach.

Gloria Rehab works to make substance abuse treatment accessible regardless of health care coverage. We work to cover a variety of insurance plans to ensure you have the access you need.

Did You Know?

The Substance Abuse and Mental Health Services Administration approximates that around 23 million Americans currently struggle or have struggled with some form of substance abuse. 

Due to financial access and support networks, only a portion of these individuals will seek treatment. 

At Gloria Rehab, you can receive the drug or alcohol addiction and mental health care that you need. We work directly with your insurance provider to make recovery and sober living a very real possibility.

What is Empire Blue Cross Blue Shield?

Currently parented by the company Elevance Health, Empire Blue Cross Blue Shield is one of the most commonly held plans. The Blue Shield companies are an insurance federation that include around 35 sister companies. 

Currently, Blue Shield companies cover around 33%, and over 110 million Americans. 

Blue Cross Blue Shield offers a range of coverages that include medical or health insurance, dental insurance, vision insurance, as well as various levels of mental health and substance abuse treatment services.

Types of Empire BCBS Plans

If you have Empire Blue Cross Blue Shield, you may be wondering the differences between all of the Empire Blue Cross insurance policies. Currently, Empire offers multiple tiers of plans, which may have different effects on your treatment eligibility.

Usually, Empire Blue Cross will provide coverage for the majority of the costs for treatment. These can include assessments, medical detox, MAT, mental health therapy, inpatient treatment, outpatient treatment, and medications.

Empire BCBS Health Insurance Plans

Bronze Tier Plan

The lowest tier plan of Empire Blue Cross, this plan will be the most cost-effective with the lowest monthly premiums. However, you will have a higher deductible to meet and will have to pay more out of pocket. Bronze Coverage: With this plan, you will be responsible for 40% of all medical costs while Blue Cross covers the remaining 60%.

Silver Tier Plan

One level up from the bronze plan is the silver plan. With this plan, you will have a slightly higher monthly premium but will have a lower deductible to meet and lower out of pocket costs. Silver Coverage: With this plan, you will be responsible for 30% of all medical costs while Blue Cross covers the remaining 70%.

Gold Tier Plan

One of the higher tier plans, the gold plan will have significantly higher monthly premiums, but will have a small deductible to meet and much lower out of pocket costs. Gold Coverage: With this plan, you will be responsible for 20% of all medical costs while Blue Cross covers the remaining 80%.

Platinum Tier Plan

The highest plan offering is the platinum plan. This plan will have the most full-range coverage, with the highest monthly premiums. However, you will likely not have to meet a deductible first before insurance begins to cover. Platinum Coverage: With this plan, you will be responsible for 10% of all medical costs while Blue Cross covers the remaining 90%.

Other Plan Options

Depending on the state you have insurance coverage in, you may also have additional plans available. One of those plans is the Empire Blue Cross Blue Shield “Catastrophic” plan. This has the lowest monthly premium of all of the plans, but is meant to be used in emergency circumstances, so it has a much higher deductible and out of pocket cost.

Addiction Treatment Cost

Due to the passing of the Affordable Care Act in 2014, health insurance companies cannot charge additional premiums or deny care for pre-existing conditions. 

Thankfully, due to the mental health care and substance treatment services needed to treat substance abuse, your insurance company is required to classify this as a pre-existing condition. 

Many fear having to pay out of pocket for rehab centers. However, your Empire BCBS substance abuse treatment insurance policy will make it easier to access the care you need. Your treatment facility will be able to work with you to determine what your insurance provider will cover, and can explain your Empire Blue Cross Blue Shield benefits to you.

Substance Abuse Treatment With Empire BCBS

Depending on your plan level, you may have different limits or costs for drug rehab coverage through Empire Blue Cross health insurance. With Empire Blue Cross drug rehab coverage, recovery may be within your reach!

Generally, Empire BCBS will cover some combination of the following for alcohol abuse or drug abuse:

  • Detoxification and Medication Assisted Treatment
  • Inpatient Treatment
  • Residential Rehabilitation
  • Partial Hospitalization Programs
  • Intensive Outpatient Rehab/Outpatient Services
  • Continuing Care or Sober Living Programs

Addiction Treatment With Gloria Rehab

Unsure about your Empire Blue Cross Blue Shield insurance coverage and eligibility? We can help you verify your insurance coverage and answer any insurance questions you may have. 

At Gloria Rehab, we want your treatment options to match your needs. We aim to create a treatment program that will help you through each stage of your recovery. Contact us at Gloria Rehab today to begin your recovery journey!

Reviewed by: Hasmik Karapetyan, PMHNP, MSN, RN

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