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Empire Blue Cross Blue Shield Insurance Coverage for Drug and Alcohol Rehab
When seeking any medical remedy for you or your dear one, the value of treatment is a significant consideration. Another vital prerequisite is location. Accessibility and affordability are essential elements in the choice of a medical facility.
Empire BCBS is a health insurance company whose members have reached a substantial web of contacts of healthcare providers. The extensive network offers members go to facilities conveniently. Empire BCBS has a comprehensive policy for drug and alcohol use disorders and other mental health issues.
What To Know About Your Empire BCBS Insurance
Our Admissions Experts Will Help You Navigate This Difficult Information.
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Co-Insurance
Deductibles
Co-Payment
Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.
The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.
Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.
Does Empire BCBS provide coverage for out-of-network providers?
What does the Empire BCBS insurance policy for drug and alcohol rehab entail?
What are the diverse rank of plans offered by Empire BCBS?
Who does Empire BCBS offer its coverage to?
Important terms you need to know concerning your policy
Bottom line
Does Empire BCBS Provide Coverage for Out-of-Network Providers?
You may wonder what happens if you seek medical treatment from a provider not part of your network list. Empire BCBS has an allowed limit for reimbursement for out-of-network providers. Most of the time, the total cash paid will be less than what the insurer would compensate a provider within the network.
Additionally, the portion will be repaid to you (the member under the policy). You will cover any difference between the cost of treatment and the amount refunded.
You would be exempted from the payment if the services you sought were emergency in nature, if you got an out-of-network bill for services offered outside New York City, if treatment was urgent, or if you used emergency transportation. You will be covered as if you used the in-network service providers.
What Does the Empire BCBS Insurance Policy for Drug and Alcohol Rehab Entail?
The cost of alcohol and substance use disorder therapy may differ depending on whether the provider utilizes inpatient amenities or outpatient programs. Outpatient services may require a copay of $15 if the healthcare provider is within the network, while inpatient admissions may need a copay of around $300. The Affordable Health Act requires parity in the provision of services falling under mental health.
Empire BCBS insurance coverage covers different treatment programs depending on your addiction treatment needs. The coverage requires preauthorization; you may need to call the office before treatment. The cost covered in SUD and alcohol treatment includes:
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Drug and alcohol screening and evaluation.
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Clinical insurance includes outpatient services, including telephone guidance, counseling, office visits, and nurse practitioners: preventive care and aftercare assistance.
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Hospital insurance covers inpatient facilities and can be paid in full. Inpatient service is necessary for patients who require detoxification and have painful withdrawal symptoms that need management by healthcare professionals.
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Crisis intervention and management are paid for up to three visits after your copay.
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Medication Assisted Treatment for substance use disorders. This will entail prescription drugs which can be generic or brand names depending on the policy in the plan or specialty drugs.
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Intensive outpatient programs for patients who do not need round-the-clock supervision can make do with scheduled visits to the provider facilities.
What Are the Diverse Rank of Plans Offered by Empire BCBS?
The premium paid under Empire BCBS is determined mainly by the income level or salary scale, collective employee bargaining, and the health insurance plan.
The number of deductibles and copay options will also direct the premium paid.
The amount of premiums paid then determines the number of providers and specialists one can access.
Empire BCBS complies with the regulatory insurance reforms and allows for par treatment of SUD and alcohol use disorders.
Treatment at Rolling Hills Recovery Center
Medically Reviewed:
Rolling Hills Recovery Center
Executive Director
Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.
Check Your Empire BCBS Coverage
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Who Does Empire BCBS Offer Its Coverage To?
Empire BCBS provides policy coverage to single persons and households, groups, employers and workers, and unions. Employees must, however, be within the confined area of the HMO.
Empire BCBS Medicare programs are aimed at retirees and persons above 65 years of age and their dependents, and also an insurance plan for eligible individuals for Medicaid.
Empires EPO - Exclusive provider organization mainly offers policy coverage to retired but non-active Medicare policyholders and gives them access to the BCBS associations. The advantage of this coverage is that the web structure is extensive, and you don't have to pick out a primary caregiver. Visiting a specialist for any covered services does not need a referral and no filing of claim forms. Another advantage is that each family member can choose their preferred primary care physician.
Why Recover With RHRC?
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There are affordable options for addiction treatment
Rolling Hills Recovery Center works with a variety of healthcare providers.
Rolling Hills Recovery Center is dedicated to your success. We provide evidence-based treatments backed by science and holistic therapies that heal the mind, body, and spirit.
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We are fully accredited
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Mater level clinicians
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We treat you as an individual
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Respectful and peaceful setting
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Insurance is accepted
Important Terms You Need To Know Concerning Your Policy
Premiums – A negotiated set amount you must pay the insurer to enjoy the policy’s benefits. The money is spent regularly. Some patients are eligible for the state share of the cost of coverage.
Out-of-pocket costs - These are costs that your insurer does not cover, and you will need to pay for them individually. You cannot lay a claim or be repaid for such expenses. They include:
Copay - This is a specified sum of cash you must pay whenever you seek healthcare or treatment. It is also known as coinsurance. The copay commences after you have paid your deductible.
Deductibles - A portion of the money you have to pay for services covered with the insurance policy before the coverage can start financing your treatment. Deductibles can be for each individual or the whole family.
Maximum out-of-pocket – The limit set for out-of-pocket cost, which is set by Federal laws annually.
Some situations and individuals are exempted from out-of-pocket costs. They include; emergency, protective help for minors and pregnancy-related services. Individuals under nursing care and children below 18 years are among those exempted.
Preauthorization certification – Any procedure that is not an emergency will require you to call your insurer and seek authorization.
Allowed amount – An insurance provider has the highest payment limit for treatment. You will settle any amount above the negotiated maximum. There are also limited days to utilize inpatient facilities and outpatient visits.
Bottom Line
Insurance coverage for drug and alcohol rehabilitation is essential owing to the costly character of treatment. Mental health issues and substance use disorders determine your general wellness. Drug and alcohol use disorder often causes an individual to develop other chronic somatic illnesses.
Empire BCBS insurance coverage will give you access to quality healthcare professionals, specialists, skilled nurses, and rehabilitation regimens to assist you or your beloved in recuperation.
Sources
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https://www.cs.ny.gov/employee-benefits/hba/shared/publications/choices/2022/active-choices-2022.pdf
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Understanding Addiction
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Empire BCBS
Empire BCBS covers many addiction treatment services.
Rolling Hills Recovery Center accepts a variety of Empire BCBS insurance coverage.
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