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 was dealing with severe cocaine and alcohol addiction. After serving in the military and coming home, I needed help. And I knew that the average rehab and recovery program wouldn’t work with me. I needed something challenging, something different. Treehouse provided that. With a wide range of different and unique approaches to treating addiction like challenging workouts, team building, riding waves on the beach of Costa Mesa on rafts with other men struggling with the same disease, addiction education to help me better understand my disease on a scientific level, and outdoor adventures like going camping, taking trips to cool beaches to surf at. This place isn’t just a recovery center, it’s a family. I am now 6 months sober and graduated the program and I couldn’t feel more grateful and proud of myself. And I know my family could say the same. Anyone struggling with addiction and looking for a program that heals you both mentally and physically NEEDS to give this place a shot.
k to the roc
5 days ago
My son has been struggling with alcohol for years which grew into a full blown addiction. He tried a 30-day program which didn't last. Only when we found Treehouse Recovery in Costa Mesa did we find a place that could really help him. The staff are exceptional and they have cared for our son's success long after he completed his program. If you or your son need help look no further.
Kris Kazarian
3 weeks ago
I’ve been to so many treatment centers. I swore last time I relapsed I wouldn’t go back to another because there all the same. But I had a friend reach out and tell me about treehouse. They told me it was drastically different and maybe something to ge the off the hamster wheel of treatment. They came out and met me and vetted me and made me feel important when I felt as low as possible. This place isnt a place where they stick you in a room and make you do group from 9-5. They teach you how to live again. There is an education group on addiction but it’s only an hour. The rest of the time you’re doing therapy. Which is 4 times a week. Or your lifting, in the gym, or learning how to be social again. I can’t recommend this place enough. If you want to do something different and stay sober. This is the place.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult ProgramLGBTQ Program
Private insuranceSelf-Pay Options
The AMAZING staff at the Caron Foundation facility in Del Ray Beach truly saved my sons life. As of tomorrow, he will have been sober for one full year!! The treatment at Caron surpassed all of his and my expectations. He had been in several rehabs over many years, and they would assist in helping him to get sober but after 15 to 30 days, out he went. The reasons for his continued addiction was never addressed. At Caron, the program they offer is life changing. Not only did they help get him sober but FINALLY the reasons behind the addiction were brought out front and center. The staff's ability to guide and push when needed to help get at the root of the origin of his addiction was our answer. We know he will struggle each day but going from where he was, on the street, homeless, to where he is now, brought him back to his family. We truly went years not having the knowledge to help. The staff at Caron , not only helped my son , but helped me. We went to visit him a few times while he was in treatment and the staff were beyond accommodating, along with their kindness and compassion for what they do, with each patient. I would highly recommend the Caron Treatment Center for anyone or any family hoping to have their loved one back .
Pamela Newton
1 week ago
Caron is an outstanding place for substance recovery as well as mental health recovery. The staff was knowledgeable, professional and I truly felt they cared for my well being. I would recommend Caron to anyone who is dealing with a substance abuse challenge. The care and approach there significantly altered my view on recovery and months health. Thank you from the bottom of my heart.
Gordon Walker
1 week ago
Great too to add to your recovery tool box. The achievements and community make it new and refreshing to check in everyday.
DreamLife Recovery saved my life!!
I had a great experience in this rehab
There are so many people to THANK!!
I learned so much about Recovery & look forward to using the tools I learned in DreamLife Recovery, on my journey forward.
I especially loved going to equine w/ Ms
Bree & Ms. Rachel.
Ms. Rachel was a very helpful therapist ❤️
I enjoyed the structure of each day.
The food was great & lots of varieties each day.
Curtis was especially helpful when I had a couple ouchie moments. He was very knowledgeable to help me put my tools in place & redirect my thoughts.
THANK YOU DREAMLIFE RECOVERY
I look forward to the alumni group.
🙏❤️🙏❤️🙏
Sincerely & Sober
Kelly P.
Kelly Poore
1 month ago
I'll forever be grateful for DreamLife Recovery and their amazing team — from the therapists to the BHTs. You all changed my life, and I can't thank you enough for the care, compassion, and support you showed me every step of the way.
Allyson Magliocco
1 month ago
Finally after numerous attempts dream life allowed me to live the dream WOW a amazing Recovery cent 5 star recovery retreat hello
I have been coming to this location since the Mt.Pocono office was closed down. Ishima was my therapist at that site, and I make the drive to Allentown specifically to see her. In the three years I have been seeking treatment with Kidspeace, it's always been a positive experience. My reason for seeking treatment forced me to be very thorough in my looking into many different organizations and I can say I have made the right choice with Kidspeace.
michael maul
4 months ago
Very good for kids
Soimary Ortiz
2 years ago
Hay Personal de habla hispana. Buen trato y servicio en tiempo.
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
1 year ago
Excellent place with excellent staff!
william wilcox
1 year 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
6 months ago
Blueprints is a good program.
Brian Sherrick
7 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!!
I was expecting sandals for junkies.. it wasnt that, but it was so much better. If you need to turn your life around and get clean and sober, this place is right for you. I made life long friends in this place the community is everything. The LIV program really makes this place different #Dohardshit 10/10 would recommend to friends and family.. there were some things to dislike like anywhere, my last day was the worst day there but it was a one off. Overall they took excellent care of me and the rest of the community.
Cassel Smith
1 week ago
Singer Island Health provided all the resources and opportunities to begin the ultimate recovery process. The LIV program was tremendous in the recovery experience, allowing clients to get out and be active via a multitude of opportunities; paddle boarding, surfing, snorkeling, rock climbing, pickleball, basketball, beach time.
5-STAR Program!
David Brochu
1 week ago
I am so thankful for this organization! I was truly suffering and they bent over backwards to help. I was in another hospital and one of the nurses was like this place (Singer) has called for the last 5 days to bring you in for help. They fly people in from other states as I was the only Floridian there! They have Dr's and medicine on site to help with detox so it was a more comfortable transition! They have groups throughout the day to help coach you also! I truly needed help with trauma and greif resolution, and they had 2 of the best Councilors, Erin and Brett, I can't say enough!! Thank you again! The tech staff REALLY help make this place run smoothly! My Therapist Julianna, really helped me find a path to sobriety and I think Singer is lucky to have her. Even the cleaning staff was always hard at work! I would HIGHLY recommend Singer to anyone looking for a change! Oh by the way they also provide rock climbing, beach trips, canoeing for those looking for some exciting events!
Journey Pure has a incredible team of staff, the best that I’ve ever seen, from an amazing Dr on site that cares and conforms to you and all your needs, along with a great staff of therapists, like Heather and Teeva; all the way down to everyone in the office that’s gets you started. They give personal care to everyone that walks in. This is the only place that I would go to without a doubt
ItsDomo954
2 months ago
Teeva is an awesome counselor and is very informative and I have learned a lot from her very caring
jonemilpatrick
2 months ago
Journey Pure is a diamond in the rough. It’s simple and it’s because they really care about all of us individually. It’s also an amazing support system of my peers in groups and the staff made me feel welcomed and that really helps when discussing deep feelings and emotions.
My daughter’s therapy got discharged. I spoke with Michelle and Katelin and they got it squared away when it wasn’t supposed to be a discharge and got her right back in with her therapist. Michelle is also so friendly and helpful. I had my 18m old with me and she accommodated to his needs so he would sit still during a session. Thank you so much for all that you both do in this office!!
Ashley Ellis
1 month ago
Hi my two grandsons go to Penessa and see Steven,he is amazing with the boy's and he his helping them so much with their issues. The receptionist Michelle is so nice and always is very welcoming. I myself see Kaitlyn on Mondays and she helps me a lot, such a wonderful person and therapist.
Thank you to the staff of the pediatrics center! You made such a difficult time so much easier to transition through!
Nicolette Tabacco
1 year ago
My experience here was great considering the situation. Staff was friendly, they feed you VERY well, and I met some really good people that genuinely care. They helped me through my issues and gave me the tools I need to take care of myself and live a happy life. Thank you
Russ Pup
1 year ago
The place is great. My daughter is there. Only complaint i have is there policy. Me and my wife drove 1 1/2 hour. And only one can visit. Then was told my service dog could NOT come inside.
Keven Hollan
2 years ago
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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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