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Decoding the complexities of Blue Cross Blue Shield federal insurance for rehab

Serious addicts and alcoholics who seek Blue Cross Blue Shield federal insurance for rehab are treated to a nationwide network of nearly forty smaller companies under the BCBS umbrella. This is good news for people involved in rehabilitation and detox efforts that require long-term care, since you may see identical or similar coverage even if you have to switch healthcare providers because of a move. Choosing the correct plan to meet your needs is a complex and confusing procedure. Here are a few major points you should know when talking to insurance providers in your area.

Do They Offer an HMO or a PPO?

Depending on your geographical area, your healthcare options may either be limited or abundant. If your healthcare provider within the Blue Cross Blue Shield organization offers an HMO only, here’s what you should know:

  • An Health Maintenance Organization requires that you choose a primary care physician.
  • This PCP writes all your referrals to specialists and clinics or hospitals, so barring an emergency room visit, you will have to wait for appointments and recommendations before seeking treatment.
  • With an HMO, your PCP will make referrals based on the specialists within your network. Going out-of-network is very costly — unless there is no local option in-network for the care you require. In this case, your HMO will pay your out-of-network expenses.
  • You are primarily responsible for a co-pay on the day of your appointment.

A PPO (Preferred Provider Organization) is basically the same: it operates on a system of in-network physicians, pharmacies and facilities, and you are responsible for co-pays during visitations. However, there are some key differences:

  • PPOs often won’t require you to chose a primary care physician, but you still may need to get approval from a PCP for expensive procedures like complex radiography scans.
  • With a PPO, you have more flexibility going out-of-network for care. Once you hit the deductible on your plan, your PPO will cover a percentage of your subsequent visit. Keep in mind that your deductible may be quite high. Still, Blue Cross Blue Shield federal insurance for rehab with a PPO is a benefit to those who need rehab or detox care from a specific doctor.

Are You Eligible for the Blue Cross Blue Shield Federal Employee Program?

This program has created a healthy environment for managed competition within the boundaries of the Federal Health Employee Benefits System, which keeps cost low for you. If you’re seeking substance abuse or mental health rehab care and are a federal employee, you will probably have access to an HMO network, though it’s worth finding out from your employer if a PPO is available.

Once you’ve determined your eligibility for the Blue Cross Blue Shield Federal Employee Program, you can decide on more specific plan options, deductible levels and how much co-pay you can afford for each visit.

Get More Information

You could spend a week learning the details of insurance plans and providers. But don’t worry, there is help. Fill out the simple form to the right of this page to get answers about Blue Cross Blue Shield federal insurance for rehab and detoxification today.

About The Contributor
The editorial staff of Recovery First is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More