Can You Use Carefirst Insurance To Pay For Drug Rehab Programs?

People seeking substance use disorder treatment may be faced with immense costs. Health insurance plans can help cover most of these expenses. 

Carefirst is a nonprofit healthcare company associated with Blue Cross Blue Shield Association. It currently covers over 3.5 million people across Washington D.C., Maryland, and Virginia. 

Insurance plans through Carefirst cover prescription drugs, emergency services, and behavioral health services. 

Using health insurance for substance use treatment will offer affordable options for people who wouldn’t otherwise be able to pay for care. 

How To Use Carefirst Insurance For Substance Use Disorder Treatment

Carefirst is a health insurance company that offers several insurance plans to help cover substance abuse treatment. 

To help facilitate the process, Carefirst has created a substance use disorder program to assist policyholders in finding an addiction treatment program that fits their needs. 

If a client attends a treatment center that is part of Carefirst’s preferred network of healthcare providers, the insurance company may waive cost-sharing requirements such as deductibles and copayments. 

Types Of Insurance Plans Available Through Carefirst

Carefirst offers a range of health insurance plans, including HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), and POS (Point of Sale) plans.

There are four tiers of insurance plans available through Carefirst. These levels differ in monthly premiums, deductibles, and copayment costs. 

Types of Carefirst plans:

• Bronze Plans — Bronze-level plans will have a cheaper monthly premium, but out-of-pocket deductibles will be substantially more expensive.
• Silver Plans — The silver plan will require that clients pay a 30 percent deductible before the health plan begins to pay for services. 
• Gold Plans — Gold-level plans cover 80 percent of healthcare costs, requiring clients to pay a 20 percent deductible. 
• Platinum Plans — The Platinum plan will have the highest monthly premium, but will ultimately cover 90 percent of all treatment costs. 

While these four categories will cover the same core benefits, it’s advised to weigh the varying out-of-pocket costs that may result from choosing a plan with a higher deductible. 

What Addiction Treatment Services Are Covered By Carefirst Insurance?

People with insurance plans through Carefirst may have access to a number of evidence-based treatment services.

Behavioral health treatment options covered through Carefirst may include:

• drug and alcohol rehab programs
• medically monitored detoxification
• outpatient treatment
• intervention services
• group therapy
• long-term or short-term residential treatment
• dual diagnosis treatment for co-occurring disorders
• medication-assisted treatment (MAT)
• support groups for people with opioid addiction
• partial hospitalization programs (PHP)
• intensive outpatient programs (IOP)
• family therapy
• inpatient treatment
• aftercare services
• relapse prevention

The extent of coverage will depend on the person’s insurance benefits. Coverage can be verified by contacting a Carefirst representative or by calling the rehab center. 

What To Consider Before Using Carefirst Insurance For Addiction Treatment

Before choosing a treatment facility to attend using a Carefirst insurance plan, there are a number of factors to consider that may influence your search. 

Factors that may influence insurance coverage for a drug rehab program include:

• prior authorization requirements needed before treatment can begin
• the details of the treatment plan
• whether the treatment center is in-network or out-of-network
• the type of insurance policy
• the average cost of the drug rehab facility
• the diagnosis received from a healthcare provider
• the level of care offered at the addiction recovery center

While Carefirst insurance programs can help place you or your loved one in an affordable rehab program with a network provider, costs are sometimes too prohibitive even with health insurance. 

There are several free and state-funded rehab centers in the United States that may be a better fit for people who can’t otherwise afford to enroll in addiction treatment. 

Keep in mind that many free rehab facilities may require clients to submit proof of income, family size, and other information before they can qualify for care. 

Find An Addiction Recovery Program Covered By Carefirst Insurance Today

Call our helpline today for more information on insurance providers for drug and alcohol addiction treatment. 

Whether you’re looking for inpatient or outpatient care, our team can help connect you to an accredited treatment facility that fits your needs. 

Published on October 7, 2022

Written by the Free Rehab Centers Editorial Staff