Capital Blue Cross Health Insurance Coverage for Addiction Treatment
Discover how Capital Blue Cross supports addiction treatment with comprehensive plans, specialized services, and valuable wellness programs.
Capital Blue Cross Health Insurance Coverage for Addiction Treatment
Discover how Capital Blue Cross supports addiction treatment with comprehensive plans, specialized services, and valuable wellness programs.
Capital Blue Cross is a health insurer in central and eastern Pennsylvania that is a licensee of the Blue Cross Blue Shield Association. They focus on simplifying and personalizing healthcare using patient centered models.
Capital Blue Cross offers a wide variety of plans. For example they may cover health benefits for you and your family if you’re insured through an employer. Other ways they cover people include CHIP plans, student health plans and Medicare Advantage plans. It’s also possible to get an individual or family plan from them on the state Insurance Marketplace.
Does Capital Blue Cross Insurance Cover Addiction Treatment?
Addiction treatment is part of behavioral health, and you can get behavioral health treatment from most Capital Blue Cross plans. The company subcontracts its addiction and mental health services through Carelon Behavioral Health.
You can still search for behavioral health services on the Capital Blue Cross webpage, but you might notice that a lot of contact information about addiction services will be from Carelon.
Every insurance plan is different and there may be requirements before you start treatment so be sure to get the details of your plan before you commit to a program.
I showed up to Treehouse ready to change but i didn't know how to make these changes. Anything i tried alone always seemed to fail until i was accepted into the treehouse family. They showed me how to handle simple to complex tasks with a rational clear thinking mind. They gave me the tools and confidence to stay in a state of gratitude day in and day out. They solidified my hard working ethics and gave me a place to call home. We worked hard and we had a lot of fun. I particularly love the ocean (surfing, diving, skimboarding) so being on the boats with the team was my favorite part of the physical modalities. I owe it big time to the clinical staff for listening intently, caring and asking the right questions at the right time to help me work through a lifetime of baggage.
Cruz Bokolas
2 months ago
Treehouse has made a huge impact on my life. The values, connections and education have given me an entire different perspective on life. They have given me the tools and knowledge on how to live a life in sobriety. The staff are all super cool and very supporting of whatever you are going through and will do the best they can to help you get where you need to be. Thank you treehouse !
Lansen Fung
3 months ago
Tree House is truly an incredible place. My life was changed in so many ways thanks to Tree House and the amazing staff. I love this place with all my heart and the people I got to know during my time there. The structure of the program combined with the camaraderie of the people around you is a match made in heaven. Thank you Tree House for giving me the life I live today.
This was a fabulous place. The staff was very knowledgeable in everything. And the community is very nice. The food is awesome. And I learned a lot about myself and my addiction and the tools how to recognize my triggers. I would recommend this place to anyone.
Paul Fisher
2 months ago
My husband just completed over 60 days and is on his way to his outpatient phase. Any phone call I placed was answered or quickly returned. I don't know what I would've done without the daily remote family support meetings. They were spot-on with information about addiction and it's effects on family as well as the patient (I know from my own work experience). The open discussions and parallel family support was a lifeline for me. They have done everything they've said they were going to do, above and beyond my expectations!
Sam Brew
2 months ago
Dreamlife was my first inpatient detox and residential treatment facility. Coming in without knowing what to expect, I can overwhelming say that Dreamlife set me up in the best way possible for recovery. The clinical staff is top tier with a major focus on mental health and addiction therapy. The many groups, outside activites, and recreation allowed for autonomy and a personal focus on myself. Overall, Dreamlife gave me a running start to a continued sobriety.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult ProgramLGBTQ Program
Private insuranceSelf-Pay Options
I am grateful to share that I attended Caron Grandview (FKA Caron Professionals Program) on the Wernersville Campus in May of 2018. I just celebrated 7 years of continuous sobriety. I could not have done it without the help of Caron. The entire continuum of care at Caron is first rate. From the medical detox to the excellent clinical treatment and to the support I received (and still receive) after leaving campus. Caron also treats the entire family, as this is a disease that affects more than the afflicted individual. Unlike many of its competitors, Caron is non-profit and is staffed by people who have chosen the eradication of this terrible disease as their life's work. If you are at your wit's end and are sick and tired of being sick and tired, look no further than Caron.
Todd Jacobus
1 month ago
There's a reason Caron Treatment Center is often referred to as "magic mountain. Without hyperbole, Caron saved my life, full stop. I went there at a particularly fraught time in my life, a time when I didn't really have anywhere left to turn. When I was there, I never felt judged; I was treated with dignity and respect and given the tools, both spiritual and scientific, I needed to battle addiction. The clinical staff is second-to-none, with world-class doctors who are at the forefront of addiction treatment and understanding. My time in treatment there was the greatest gift I have ever given myself (or ever received, truly). For families, the education program Caron offers is a HUGE help, offering tools to help them better understand what addiction is and what it is not. For anyone suffering from addiction (no matter the source), you'll receive no better care than in the embrace of Caron.
Melissa Case
2 months ago
Honestly a fun place, met tons of friends. I personally was in TMS (teen male sector) or some shit. But it was really fun and I liked the detox from everything. Funny story but I found Coke at Caron assuming it was one of the RA’s but they were very ontop of it and found it on me before I vacuumed all of it up. Later ended up hearing it got pinned on the wrong worker. Very sad but I loved my time there and will not be an experience to forget. I’d like to shout out John, Lorraine, Jake and Samir for helping me achieve abstinence from all drugs long term. Also shout out my counselor Jess which was very open and considerate. One thing I don’t like though is how if your a younger patient they will like you push an after care treatment on you. Being a kid this is scary as you have no control over it. At the time I had no idea what my parents were gonna choose and the counseling team is fast to convince them. Don’t fall for it though as it only helps Carons image of a successful rehab and Caron benefits from it. But that’s the only kicker and nail in the shoe I have for Caron.
I am pleased to give this 5-star review of MRC. I attended PHP and IOP, and had individual counseling twice a week. The counselors are excellent. They encourage a lot of participation in the groups. The topics are relevant to recovery- stress management, 12 steps, nutrition, body-mind connection, gratitude, and a lot more. Weekly yoga is offered and it doesn't matter what level you are. I was supported and cared for all the way through the process of outpatient recovery.
Erin Bayhan
9 months ago
Excellent place with excellent staff!
william wilcox
10 months ago
I am very happy going to Montco Recovery Center. I get a lot out of my groups and I especially like my counselor Bill. He's very helpful in my recovery. I also get along with the majority of people in my groups. If anyone asks where to go for recovery I will definitely recommend Montco!
Blueprints has been amazing. The staff care about the clients. Have been a vital part of my recovery. would recommend blueprints to anyone struggling with active addiction and wants to get sober
Jordan Sager
2 months ago
Blueprints is a good program.
Brian Sherrick
3 months ago
Great support, I am grateful for the care and concern. I would love to work a job like this helping others progress. If you know someone that needs help and structure, This is the place!!
The LIV program is the best thing offered! 10/10 recommend. It gives you the opportunity to step out of your comfort zone and pushes you to “Do Hard Shit.” The program changed my whole mindset. It taught me so much. I am doing things I never thought I’d be doing. My outlook on life is brighter than ever. Thanks to the LIV program!
Ryan Tucker
2 months ago
The LIV program is amazing. It changed my mindset and outlook on life. Do hard Shit
It teaches you to push thru the hard moments. LOVE LIV
Joshua Mick
2 months ago
Absolutely loved the therapy I got from doing the Liv program life changing 💜
JourneyPure exceeded my expectations in every way. The staff's compassion, expertise, and dedication to helping are truly inspiring. Buddy and Heather are two of the most caring & compassionate counselors who truly lead with their hearts. The entire team is amazing! From the initial intake process to the aftercare support, I felt heard, validated, and empowered to take care of my needs. I'm grateful for the progress I've made and the tools l've gained to maintain my healthy lifestyle. I highly recommend JourneyPure for its exceptional care and unwavering support. Thank you!
Patricia
2 months ago
Journey Pure has been absolutely amazing. From the staff in the front office to the therapists. If you are considering sobriety and don’t want to do it alone you’ve found the right place! It’s so much more than just about being sober it’s about dealing with past and present issues. Journey Pure gave me my life back!
Erica Snell
3 months ago
Journey Pure trueIy saved my life. I felt genuinely welcomed, cared and empowered to begin my recovery. I was welcomed by Zilpa with love and compassion. JP staff are amazing; supported, qualified, experienced, knowledgeable and compassion individuals. Heather, Buddy and Dr. Dickun developed an individualized treatment plan that included, intensive therapy and strong relapse prevention tips and treatment. Thank you Teresa for holding the front office and helping me in my most challenging days. Overall, I felt comfortable and respected sharing my struggles. Today I can say I was born again. I am happy, healthy and productive. I found a wonderful support system and most important a Family. I am able to walk the road to recovery and embrace the changes thanks to JP and their staff. I highly recommend Journey Pure. If you are struggling with substance abuse give journey Pure the opportunity to assist you.
Monique was absolutely wonderful to work with. She helped our son and our family so much. She went above and beyond to support us during a really hard time and our son is in a much better path now. Thank you so much!
Leigh Hurst
3 months ago
Michelle with Support Staff is a literal angel and was so amazing. The staff I met here today was extremely accommodating went above and beyond to make me feel comfortable and welcomed. I can't wait to continue care with them here. Micheal Fox is wonderful at his job and helping me through my therapy and care.
Kris-Sama
8 months ago
I really appreciate the service of Greg& Michelle ,I can say that they really care about everyone that comes on Tuesday. I GIVE THEM A 5 STAR.
Adult ProgramYoung Adult ProgramProgram For WomenProgram For Men
Private InsuranceMedicareMedicaidSelf-Pay Options
Bowling Greens staff is down to earth. Cuts no corners
Tennille Bedney
1 month ago
not a bad place if you work it the right way. I made the most of my stay. lots of clients that don't want to even get clean so stay away from them and surround yourself with those who are serious about recovery and it should work out. love the techs shout out to six and chase thanks for all your help. just follow the rules and it will go smooth.
Ceo Dadoq
2 months ago
I was there in march of 2024 and I need to come back again I guess I forgot some items
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Frequently Asked Questions
What Types of Plans Do They Have?
Capital Blue Cross offers a variety of plans. They have individual and family plans they offer through the Insurance Marketplace and through employers to their employees. Capital Blue Cross also offers Medicare plans, CHIP coverage, and student health plans.
In individual and family plans you will find three different formats of insurance. They are Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs) along with Exclusive Provider Organizations (EPOs).
PPO plans have a higher monthly premium but give you the most freedom. If you get a PPO plan, you may be able to go outside of their network and still get covered. Keep in mind if you go out of network, your coverage won’t be as much and you might have to pay a higher deductible.
In an EPO, you’re only covered if you get care from providers in their network. This type of plan usually doesn’t need referrals to see a specialist. Finally, an HMO is the least expensive each month but has more requirements. You have a primary care doctor that provides referrals to specialists and you’ll also need to choose providers from the plan’s network.
Capital Blue Cross also provides Medicare plan options for those who qualify. If you have Original Medicare you can get Medicare Supplement plans to help you cover costs like coinsurance and deductibles. You can also replace Original Medicare with a Medicare Advantage plan. This gives you the same benefits as Original Medicare but often has extra coverage such as vision and dental care. However you generally have to stay within the provider network and you may have to get preauthorizations for care.
Does Capital Blue Cross Have Any Special Features?
The Capital Blue Cross Connect program is a feature clients enjoy. That program has wellness centers you can visit and you can get health coaching and fitness training there. They also teach you skills like how to make healthy meals.
Blue365 gives discounts on fitness gear and gym memberships along with other lifestyle choices that help support your overall health. You register with your member ID card to create an account and get access to everything you need to enjoy these extra benefits.
The Healthy Blue Awards is another wellness program that helps support you based on what motivates you to make a change. There are several different packages including programs that are incentivized and non incentivized. Some tools are available year round while others are available for a predetermined time.
When your care is complex you also have access to case management and a health savings account that can help you save for qualified medical expenses using tax free money. Depending on your plan you may require a referral or prior authorization before being able to get care. Capital Blue Cross also provides online resources to help you determine what’s needed based on your insurance plan and coverage.
What Inpatient Addiction Treatment Does Capital Blue Cross Cover?
Health insurance policies focus on providing medically necessary care including behavioral health services to treat substance use disorders and mental health conditions. It is crucial to have a treatment plan from your doctor that provides the necessary information on what treatment you need based on your diagnosis and symptoms.
When necessary your addiction treatment may start with medical detoxification before moving into an inpatient or residential care program. Medical detoxification is managed by a healthcare professional who can manage and monitor your withdrawal symptoms. This process may also include FDA cleared prescription drugs that reduce withdrawal symptoms and help you stay safe and as comfortable as possible during detox.
Once the addictive substance is out of your system you may move into full time evidence based therapy and counseling in an inpatient or residential setting. This helps to identify what triggers your addictive behavior and helps you to develop healthy coping strategies that reduce your need for drugs or alcohol.
Inpatient treatment is ideal when you require 24/7 supervision and monitoring and a highly structured and intensive treatment program. During inpatient and residential care you live at the treatment facility. In some instances, you may be allowed a day pass on the weekend when therapy and counseling are not as intensive and you’re preparing for discharge.
What Outpatient Rehab Does Capital Blue Cross Cover?
Your comprehensive assessment will determine the level of care for your initial treatment. This can include an inpatient program or one of several outpatient programs. Outpatient treatment may include a partial hospitalization program (PHP) or intensive outpatient program (IOP) or even general outpatient treatment. A PHP provides the same level of intense therapy and counseling as you would receive as an inpatient or in residential care with the benefit of living at home or in sober living.
An IOP typically includes therapy several days per week for a few hours each day. While this program is less intensive it is just as structured as a partial hospitalization program. You will continue to meet with your therapists and counselors as well as participate in group support meetings. Some treatment centers offer IOPs during the morning hours or evening hours to help accommodate your family and work or school obligations.
A general outpatient treatment program usually provides therapy or counseling once or twice weekly. This can also include group support meetings and family therapy. Once you have completed your outpatient programming, you may have access to an aftercare program. The resources available in aftercare depend on the treatment center you’re working with.
Some treatment centers have alumni programs where you can connect and receive support from people who have graduated from the treatment center. Your aftercare program may include therapy sessions and community group support sessions along with routine drug or alcohol testing and life skills training. This may include sober living arrangements and educational or vocational support.
Does Capital Blue Cross Cover Methadone & Suboxone (MAT)
Methadone and Suboxone are integral parts of a medication assisted treatment (MAT) program. These programs use the FDA cleared medication to reduce your experience with withdrawal symptoms and lower the risk of severe complications that may occur during withdrawal from certain drugs.
MAT is also used in ongoing treatment for opioid and alcohol use to reduce cravings and help prevent overdose deaths. Medications that are commonly used include methadone, buprenorphine, naltrexone, and suboxone. Methadone and buprenorphine are opioid agonists. They bind on the same receptors as opioids but do not produce the euphoric effects.
This helps prevent withdrawal symptoms and reduce cravings. Naltrexone also blocks the effects of opioids at the receptor level and can help prevent relapse when you have already detoxed from opioids. Buprenorphine and methadone are used exclusively for opioid use disorders while naltrexone may be used for both opioids and alcohol. Suboxone is a combination drug of buprenorphine and naltrexone.
Does Capital Blue Cross Cover Other Mental Healthcare?
The 2010 Affordable Care Act and 2008 Mental Health Parity and Addiction Equity Act are federal laws that help provide access to mental health and substance use disorder treatment through coverage by insurance providers. However not all plans are subject to these laws so it’s crucial to check your benefit and limitation levels with your insurance provider.
Mental health conditions may include depression, anxiety disorder, eating disorders, bipolar disorders, and borderline personality. Your insurance coverage may cover therapy and crisis support when you need immediate help or pose a risk to your safety or the safety of others. This type of support is critical to stabilize the situation and connect you with the appropriate care long term.
Co occurring mental health conditions are common with substance use disorders. When your insurance provider covers treatment for substance use disorders and mental health conditions, they will typically cover integrated care for dual diagnosis. This is the medical term used to describe having both a mental health condition and a substance use disorder simultaneously.
Treatment for dual diagnosis can be more complex and requires integrated care administered concurrently to achieve the best potential for long term success.
Does Addiction Treatment Need to Be In Network?
Some Capital Blue Cross insurance plans cover out of network care and some do not. Before choosing to receive care it’s important to understand if the provider is in network or out of network for your plan and your coverage levels for each. While your insurance plan may offer some coverage for out of network care it likely comes with higher co payments and a higher deductible.
You can maximize your insurance benefits by receiving care with an in network provider. Whatever your choice by reviewing your insurance plan carefully you can make an informed decision about which provider to use.
Calls to any general helpline will be answered or returned by a paid advertiser.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
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