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’m sharing my experience about someone close to me who completed Tree House Recovery’s five-month program in Costa Mesa through the partial hospitalization track.
From the start, Adam and Matt showed up with care, heart, and a steady light. My experience with the team was a blessing. The way they came together to support my friend—even at the very beginning—held nothing short of compassion and love. It was truly something special.
Tree House is a brotherhood. It goes deep and focuses on giving a real experience - not a curated, perfect, or cookie-cutter one. It gives the people who go through it the strength to stand up and get through real life when they leave. It highlights your strength, gives you the structure to build it into who you are, and keeps reminding you of it. They provide tools, support, and, beyond that, an environment where learning happens, beliefs are tested and strengthened, and new identities are allowed take root.
It's physiology and psychology, forged together.
And if you’re asking the question, “Does it last?”; In my experience, it grows. It takes the reins and leads. Even as someone standing on the sidelines, I haven’t just learned from this journey—I’ve been inspired by the person who walked it. This program isn’t a finish line; it’s a whole new game, a wider foundation—something that keeps inviting you to become more of who you are. And it is literally a life-saver.
I’m grateful for Tree House Recovery—and especially for Adam and Matt—for showing up and lighting the way. If you’re ready to believe that change is worth it, take the first step. They’ll have your back for the rest.
Nathaniel Roberts
1 week ago
Treehouse Recovery and the staff members are all really great people that care about your sobriety as much as they care about their own and take the role of guiding you into the right direction very seriously. Being apart of this program as changed my life for the better and I found not only a sense of happiness I have never felt before but I also found a sense of purpose and a strong brotherhood within this community of guys I went through this experience with. My outlook on life has completely changed for the better and I open my eyes in the morning thanking God I have another day to be the best person I could be. I am able to face challenges head on and be able to tackle them down without the thought of escaping reality and picking up that bottle. This experience I went through with the people I could now call lifelong friends with has been one of the best chapters of my journey I've been through so far. The good, the bad, the ugly; it was all worth wild. Thank you Justin, Vechi, Matt and everyone involved that saved my life! This book isn’t over yet. Let’s see where this new version of myself takes me.
ckuakini
1 week ago
I highly recommend the TREEHOUSE RECOVERY Program in Costa Mesa. Their comprehensive approach to drug addiction treatment is commendable. The program addresses the mental, emotional, physical, and spiritual components of your loved one, thereby focusing on the underlying causes of the addiction, rather than solely on ending the substance use. I believe this approach significantly reduces the risk of relapse. The male-only environment is a key factor in fostering focus and promoting successful outcomes.
My son successfully completed the five-month program and graduated. We are thrilled with the results! His physical and spiritual well-being have been significantly restored. Prior to his enrollment at Treehouse of Costa Mesa, I feared that I would lose him forever. He was at “the bottom” and was ready.
The program Is demanding and emphasizes accountability.
The parents, spouses, or family members have an optional video group meeting with other family members every week that helps immensely.
My son is 9+ months clean, and counting. He has a job and is on his feet again. He says that he’s a better man than he has ever been. I honestly don’t believe a different drug treatment program would have been as successful as the Treehouse Recovery Program for addiction.
AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid Addiction
Adult ProgramYoung Adult ProgramLGBTQ Program
Private insuranceSelf-Pay Options
My experience in December of 1985 was one of the best things to ever happen to me. I learned one of the biggest eye opening thing, that the first drink gets you drunk. I had experimented many times to see which drink got me drunk so I could stop before then. Imagine my surprise to find out if I didn't have the first one, I wouldn't have gotten drunk at all. This December 16, God willing, will be 40 years sober for me. I can't express my gratitude enough for the Caron Foundation. I also remember Rosie. Thank you for giving me the tools to have a great life ever since.
Cathy Petree
2 weeks ago
If your serious about getting help and your insurance covers / you can afford!,, Caton is the best Rehab! It's only the beginning. Their staff are top - notch! The facilities are nice, much nicer then many other top places! The food is too good honestly! And they give you a ton! The classes and gym are all excellent! The clinic being on campus is a great relief too! The medical staff is always there to help! Detox went very smoothly. Tge best part is you don't leave Caron, Caron never leaves you. And their Alumni is fantastic, the retreats, and other programs the offer just continue to support you on your journey! Can't say enough b love Caron! !
Jennifer Moesle
3 weeks ago
In May of 2010, I arrived at Wernersville, PA, via intervention. I would later realize, all of the seeds were planted during my time at Caron and I finally learned about my disease and about the chemical makeup of my brain when using. I wasn't ready after my 30 days. However, on June 25th, 2017, the miracle happened. Caron laid the foundation at my feet. Magic mountain is real and very a spiritual place. The facilities are very clean, good therapists and doctors, and a great overall team. I will be forever grateful of the gift I was given to attend Caron's 30 day inpatient stay. FYI..This included 3 days in their detox facility on site. The detox staff were truly compassionate and loving. Exactly what I needed after years of using and untreated mental health. Sincerely,
Paul B, CT
Finally after numerous attempts dream life allowed me to live the dream WOW a amazing Recovery cent 5 star recovery retreat hello
Paul Cassagnol
1 month ago
Twenty years ago, I went through a crisis involving addiction that had catastrophic implications for my family. While my loved one was at a nationally acclaimed residential treatment program, and I had confidence he was getting the help he needed, I felt lost, alone, left out, ignored, and in the dark. I had almost no communication with my loved one or his therapists. I remember going to an in-person educational seminar at the facility, where we learned about addiction, but had no personalized information about our person or situation.
Now I’m walking this journey with my daughter, whose loved one is in residential treatment at DreamLife. At intake, she was given a packet of information that included links to family sessions that were held over Zoom six times a week for a total of 10+ hours! We both jumped in the first week, and even in the early days of this crisis, when we were emotionally reeling, we felt seen, known, informed, cared about, communicated with, and supported.
Some classes are led by a recovered addict, who gives us an understanding of what life is like for an addict, how they think, and what their early recovery journey will look like, including how they might push buttons or manipulate their family members in ways that are counterproductive to their recovery. Others are led by the mother of an addict, who sensitively helps families understand the emotions and situations that we are thrust into, and how our well-intentioned efforts might sabotage their progress. Both have the objective of helping us to understand how our behavior contributes to enabling addiction, and to give us the skills and knowledge that will strengthen our resolve and ability to be healthy ourselves, and stop being naive participants in the circus of addiction.
The family program at DreamLife is remarkable. The instructors are knowledgeable, articulate, and passionate when lecturing, and attentive, compassionate, kind, and wise when applying the principles to individual questions and situations presented by family members. The classes have a rotating ‘membership’ as there is always a mix of people who have just arrived and people whose loved ones are ready to come home or move to the next step in treatment. This creates a dynamic much like an Al Anon meeting, where we all benefit from hearing the facilitator talk about a particular client’s situation with their family, as well as learning insights from each other as family members jump in to share their own experiences. It also gives a very real sense that we are not alone, and even though we may never meet any of our fellow participants in the Zoom sessions in real life, we feel seen and supported by them.
If you have a loved one at DreamLife and you have not taken advantage of the Family Sessions, then you are missing out. Anyone who loves an addict who is or has been at DreamLife is welcome. My daughter is learning how to live with her loved one in a way that supports his recovery and acknowledges that she has her own recovery journey, too. Living thousands of miles away, I am learning how to support my daughter. Without the opportunity to attend, I might feel helpless, and I would be ignorant about the disease of addiction and what it takes to commit to recovery. I might feel angry, rather than compassionate, as the behaviors that can look like willful, selfish, moral failures are actually symptoms of a neurologic disease that overrides the ability to live a deliberate, purposeful life.
It appears that very few of the residents have a family member attending the sessions that we have found invaluable. This is such a lost opportunity to learn about addiction and to be informed about the progress of your loved one as they engage in recovery. Please consider this an invitation from someone like you, with nothing to gain. You will benefit, and we all will benefit from your participation.
Thank you, DreamLife, for pioneering ways to include and equip families of your primary clients. It is a gift. And no matter how our journey unfolds, my family is grateful.
Lisa Olson
2 months ago
My loved one is currently in residential treatment at DreamLife Recovery in Donegal. As a family member, I give DreamLife five stars for their family programming sessions run by Curtis Rogers and Robin Miller over Zoom.
These classes have been critical to my own parallel journey as I learn more about how to effectively support my loved one without enabling the addiction. I've developed new skills for how to recognize manipulation, set boundaries, and "wear my own hat". These classes have empowered me with the wisdom to recognize what is and is not in my control and the courage to make hard choices that are in the best interest of me and my loved one.
Addiction is a family disease and it affects everyone touched by it. Because of the nature of the disease, it is often the family members and loved ones who need to change first in order for the addict to change themselves. I highly recommend that anyone with a loved one at DreamLife to prioritize attending as many of the classes as they can. The time commitment is worth it and you will learn so much.
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
2 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
5 months ago
Blueprints is a good program.
Brian Sherrick
6 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 just wanted to say thank you to all the staff at singer island. I had a great experience. I especially want to thank the LIV team. Troy, Adam Angie and Dakota are all so amazing!! They challenged me to get comfortable with being uncomfortable and “DO HARD SHIT!!!” They made me realize that I can do so much more that I thought possible. Love you guys! Singer island is a great rehab but with the LIV PROGRAM singer island is the best!!
Shawn Dioguardo
3 weeks ago
The LIV program with Troy and Adam helped so much- it’s a great program and really helped my recovery! Big thank you too them
Easton Curtis
1 month ago
My experience at Singer Island Rehab was truly life changing! I learned to love myself again with self care for my MIND and BODY. I learned for the first time in a rehab that my addiction is not who I am! It was what I used to get out of my head when it was too much to handle. Thru the groups, I was able to be open and honest with my people I grew to call my little rehab family in the 31 days I was there. Individual therapy sessions with Anjalee were so helpful and I felt heard & understood. Facilitators really we’re passionate about helping all of us, by teaching us all they could so we can stay Sober! The LIV program was the part that really built my confidence by allowing me to “Do Hard Shit” ( the motto of the LIV program) that I would never have done otherwise, such as cold plunging 20 mornings I believe, rock climbing, pickleball and just waking up at 5:15 am for 3 weeks for Sunrise. Be present and grounded! I even got out of my shell and painted a picture on the new surf board for 2025-2026 that clients can sign when they really jump into the LIV program! I am eternally grateful for this journey I started there! I would refer anyone there to find out the Why? Behind our addictions…. the mind and brain can repair and change!
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
1 month ago
Teeva is an awesome counselor and is very informative and I have learned a lot from her very caring
jonemilpatrick
1 month 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.
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.
Cindy Gilbert
1 month ago
Best Therapy and Michelle receptionist
Eglys De la cruz
2 months ago
Since coming to Ponessa, Andrew has provided excellent behavioral health services to my child! He is very patient and takes the time to explain things. Andrew is flexible with scheduling and works around what works for you. He is easy to get in touch with and responds in a timely fashion. Ms. Michelle at the front is always so welcoming with a smile and willing to answer any questions. She takes the time to get to know everyone with a few moments of friendly interaction while you check in. I highly recommend Ponessa, they are great!
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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