Horizon Blue Cross Insurance Coverage

Navigating insurance coverage can be a complicated task. If you are looking for the answer to the question “Does Horizon Blue Cross Blue Shield cover rehab?”, then this page provides a detailed overview of Horizon Blue Cross Blue Shield (BCBS)’s coverage for substance use and mental health rehab and treatment.

If you have further queries, you can reach out to the NuView Treatment Center, and we will do our best to answer them. Call us at (323) 307-7997 or mail us at info@nuviewtreatment.com.

Yes! Horizon Blue Cross Blue Shield is a reputable insurance provider that offers different plans for drug or alcohol rehabilitation (or rehab). This means you get the financial assistance you require for the care services you need, including substance use and mental health treatment.

With regard to drug and alcohol rehab, Horizon BCBS’s insurance covers a diverse range of treatment programs. This includes residential rehab, outpatient rehab, and outpatient therapy and counseling.

NuView is a premier outpatient rehabilitation facility located in the heart of Los Angeles. With outpatient programs, your Horizon BCBS insurance plan can cover a greater number of sessions as it is a more cost-effective option than residential treatment.

Horizon Blue Cross Blue Shield offers different kinds of insurance plans. While all insurance plans cover substance use treatment, not all plans are the same. The specific services covered, out-of-pocket expenses, and exclusions specific to each plan can differ.

Generally speaking, Horizon BCBS is willing to cover a broad spectrum of substance use disorders, no matter how severe. 

Substance use disorders covered by Horizon BCBS health insurance plans include (but are not limited to):

• Alcohol use disorder
• Tobacco use disorder
• Cannabis use disorder
• Prescription medication misuse
• Opioid use disorder
• Cocaine use disorder
• Heroin use disorder
• Methamphetamine use disorder.

Yes, Horizon Blue Cross Blue Shield insurance covers mental health treatment. This includes outpatient rehab, therapy, counseling, medication-assisted treatment, and others.

Horizon BCBS insurance covers the treatment for a broad spectrum of mental health disorders, including (but not limited to):

• Anxiety disorders
• Major depressive disorder (depression)
• Bipolar disorders
• Developmental disorders
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Personality disorders
• Eating disorders
• Psychosis
• Schizophrenia

Dual diagnosis is when substance use and a mental health condition occur together. The prevalence of co-occurring disorders can range from 20% - 70%. So, yes, Horizon Blue Cross Blue Shield insurance typically does cover dual diagnosis treatment.

Dual diagnosis treatment can take longer than treating one condition at a time. However, it is more comprehensive and paves the path for lasting recovery.

Horizon Blue Cross Blue Shield’s insurance covers a wide range of outpatient rehab programs. Outpatient rehab programs offer intensive structure and treatment during the day, and you can return to the comfort of your home/sober living residence afterward. As outpatient rehab is a cost-effective option, your Horizon BCBS insurance will be able to cover a greater number of sessions.

Outpatient rehab programs covered by Horizon BCBS insurance are as follows:

• Partial Hospitalization Programs (PHPs)
• Intensive Outpatient Programs (IOPs)
• Evening Track
• Telehealth or Telemedicine
• Aftercare
• Outpatient therapy/counseling.

When you step down from a more intensive program to a less intensive one, Horizon BCBS does offer insurance coverage accordingly. In the case of ongoing care services, Horizon BCBS’s insurance coverage can vary.

Here's an overview of how Horizon Blue Cross Blue Shield insurance works:

Plan Selection - You can choose from different Horizon BCBS insurance plans depending on your needs and eligibility. These plans may differ in terms of premium, coverage, and network options. 

Network Providers - There are two kinds of network providers - in-network and out-of-network. In-network providers are healthcare providers who have a contract with Horizon BCBS and, hence, can maximize your coverage and minimize out-of-pocket costs. Out-of-network providers are healthcare providers who do not have a contract with Horizon BCBS. In this case, you might experience higher out-of-pocket expenses.

Coverage and Benefits - Horizon BCBS insurance plans typically cover a wide range of medical services, like preventive care, emergency care, hospitalization, medication, and mental health and substance abuse treatment. The specific extent of coverage will depend on the plan you choose.

Cost Sharing - With Horizon BCBS insurance, you may be responsible for certain costs, like premiums, deductibles, copayments, and coinsurance. These vary depending on your plan and the services you receive. 

Prior Authorization - Some Horizon BCBS plans may require prior authorization for specific substance use or mental health treatment services. This means policyholders need approval from the insurance company before receiving specific care programs.

Utilizing Insurance Benefits - To use your Horizon BCBS insurance, present your insurance card at the time of service. The provider will verify your coverage and bill Horizon BCBS directly for the covered services. 

To check your Horizon Blue Cross Blue Shield’s rehab coverage, you can contact your insurance provider and have an open conversation with them. You can also fill out the adjacent insurance form, and we will reach out to you within minutes to have a detailed conversation regarding your insurance coverage and find the best payment option going forward.

Horizon Blue Cross Blue Shield offers a diverse range of insurance plans to cover your healthcare needs. Here are some common types of Horizon BCBS insurance plans:

Health Maintenance Organization (HMO) - HMO plans require you to choose a primary care physician (PCP) who coordinates your care and provides referrals to treatment centers within the plan's network.

Exclusive Provider Organization (EPO) - EPO plans typically require you to receive care from providers within the plan's network, except in emergencies.

Preferred Provider Organization (PPO) - PPO plans offer more flexibility in choosing healthcare providers. You can receive both in-network and out-of-network care.

Point of Service (POS) - POS plans combine features of HMO and PPO plans, allowing you to choose a PCP and receive referrals for specialist care. You will also have the option to see out-of-network providers, albeit at a higher cost.

Medicare - Horizon BCBS offers various Medicare plans, including Medicare Advantage (Part C) and prescription drug plans (Part D), to provide comprehensive coverage for those eligible for Medicare.

Medicaid - Horizon BCBS participates in Medicaid programs, providing coverage for eligible low-income persons and families based on state-specific guidelines.

If you have Horizon Blue Cross Blue Shield as your insurance provider and need to pay for the costs not covered by your plan, consider the following options:

Review Your Plan - Carefully review your Horizon BCBS insurance policy to understand the coverage limitations and exclusions. Take note of the services or treatments that are not covered or require out-of-pocket expenses.

Flexible Spending Account (FSA) or Health Savings Account (HSA) - If you have an FSA or HSA, check if your plan allows you to use these funds to cover the costs of your medical expenses. This way, you can set aside money for healthcare expenses.

Payment Plans - Speak with your treatment center regarding setting up a payment plan. At NuView, we are willing to work with you and offer flexible payment options to help manage the costs over time.

Reimbursement Process - You may need to pay for the out-of-pocket expenses upfront if you are utilizing an out-of-network rehab, and then submit a claim to Horizon BCBS for reimbursement. It is crucial to keep detailed records of all expenses, such as invoices and receipts, as they will be required for reimbursement.

Personal Savings or Loans - Consider utilizing personal savings or exploring loan options to cover the costs not covered by your Horizon BCBS plan. Consult with a financial institution or advisor for guidance on the best approach for your situation.

Financial Assistance Programs - Inquire about any financial assistance programs offered by the treatment center or charitable organizations. You can receive financial aid or grants based on your income or other specific circumstances.

Medicaid or Medicare - If you are eligible for Medicaid or Medicare, check if these programs can provide coverage for the services not covered by your Horizon BCBS plan. Medicaid and Medicare may have other mental health and substance abuse treatment coverage options as well.

At NuView, we understand how confusing insurance can be. At the same time, we are committed to eliminating financial barriers so that you can receive the care you need and deserve. So, at the time of your admission, you can communicate openly with us regarding your insurance and other concerns, and we will collaborate with you to find the best payment plan going forward. We can surely work something out together. 

Reach out to us today at (323) 307-7997 or mail us at info@nuviewtreatment.com.