Blue Cross / Blue Shield for Addiction Treatment
The Guardian Intensive Outpatient Program offers comprehensive gender-specific and age-specific treatment programs for adults recovering from substance abuse. The Intensive Outpatient Program offers structure and programming similar to residential treatment facilities, while allowing clients to return to their home each evening.
Although choosing an IOP can in some cases be a much less expensive option than residential treatment, Guardian IOP programs may still be covered by your insurance provider, and in some cases, an outpatient program may be required before an insurance provider will provide coverage for residential treatment. For assistance clarifying your coverage and payment options, please contact a Guardian IOP Recovery Specialist who can help you understand your specific insurance benefits.
At Guardian IOP, Blue Cross Blue Shield is just one of many insurance providers we work with to ensure an affordable, stress-free recovery plan. Cost should never be a barrier to life-changing treatment, which is why we accept most major insurance plans, including Blue Cross Blue Shield. Blue Cross Blue Shield has been an industry leader since 1929, and offers additional coverage for a wide range of personal issues through BCBS Behavioral Health. Your BCBS policy may operate under a different brand name, depending on the state in which your plan originated.
Blue Cross Blue Shield is the health insurance provider for close to 106 million Americans, meaning 1 in 3 across the nation are insured through BCBS. In addition, BCBS insures over 5 million federal employees, and individual U.S. citizens who live and work outside of the United States. Your BCBS coverage may operate under a different brand name, such as Florida Blue, Anthem Blue Cross Blue Shield Maine, or Horizon Blue Cross Blue Shield of New Jersey.
Your Blue Cross Blue Shield plan may cover the cost of some or all treatments associated with your Guardian IOP treatment plan, including group and individual therapy, family therapy, cognitive behavioral therapy and dialectical behavioral therapy, as well as relapse prevention training. BCBS Behavioral Health programs typically cover Intensive Outpatient Programs such as psychological and social assessments, monitoring and treatment planning and education and counseling on maintaining recovery. Care under the direction of licensed social workers, psychologists, psychiatrists and psychiatric nurse practitioners are all covered under BCBS Behavioral Health plans.
Your specific coverage is dependent on several factors, including the state in which your Blue Cross Blue Shield plan originated. BCBS operates in all 50 states under 36 separate health insurance organizations, each of which differs slightly in coverage and applicable deductible and co-pay rates. If your plan is a Health Maintenance Organization (HMO), you may receive better coverage for medical costs associated with in-network providers. If your plan is a Preferred Provider Organization (PPO), it may be more widely applicable. In addition, the details of your individualized treatment plan, and the length of your time in the program will contribute to costs that are specific to you.
Some Intensive Outpatient Program services may require pre-authorization by Blue Cross Blue Shield. Routine services such as individual and family therapy, or psychiatric medication management normally do not require pre-authorization. To determine benefit coverage and to determine if preauthorization for intensive outpatient services are required by a specific employer group, members should call the preauthorization MH/SA number listed on the back of their ID card. This preauthorization requirement only applies for members who have BH Outpatient Management as part of their BH benefit plan through BCBS.
The quickest and easiest way to determine your financial responsibility, if any, is to call a Guardian IOP Recovery Specialists who can help you understand your Blue Cross Blue Shield coverage. With just a 20 minute phone conversation we can determine if our Intensive Outpatient Program is right for you, if your needs include treatment for any co-occurring mental health disorders, and what your financial responsibility will look like while in our care.