Independence Insurance Coverage for Drug & Alcohol Treatment

Does Independence Insurance Cover Addiction & Drug Abuse Treatments?

Independence Blue Cross plans will generally cover the costs of addiction treatment, with the organization having an especially strong focus on the opioid epidemic. They offer various benefits, including these:

• Removing member cost-sharing for injectable and nasal spray formulations of naloxone
• Not limiting visits to detox facilities
• Lifting various prior authorization requirements on addiction treatment medications
• Covering various other inpatient and outpatient treatment options

It’s also worth noting they have a page that provides a quick reference to a number of addiction support resources.

Verifying Your Coverage

The best way to guarantee coverage is to talk with a treatment provider and make sure they accept your insurance. You can also contact Independence Blue Cross directly if you have questions or concerns about your coverage. 

Like many insurance providers, they also offer a tool to search for providers and find relevant cost information. Generally speaking, you should be able to get the coverage your plan normally provides for addiction treatment if you use an in-network provider and stick to evidence-based, doctor-recommended addiction treatments. You must also keep your plan active by paying your premiums and any other associated costs.

Typical Cost of Addiction Treatment

According to the National Center for Drug Abuse Statistics, the average cost of drug rehab is $13,475. Other relevant numbers they provide include the following:

• The cheapest medical detox programs cost about $1,750 per episode.
• The cheapest inpatient rehab programs cost about $6,000 per month.
• The cheapest outpatient rehab programs cost about $5,000 for a three-month program.

The above needs to be taken in context, however. First, some of these statistics come from data from 2006 that has been adjusted for inflation. Second, treatment for addiction varies significantly in cost depending on the specific treatment one is receiving. Third, much of a person’s addiction costs can be covered by insurance.

Plan Options

Independence Blue Cross provides a useful chart to check the benefits provided by various plans they offer, with the ability to click on a given plan and see more details about it. Some important details about a plan to note include the following:

Deductibles

This is the amount of money you will have to pay out-of-pocket before your plan takes full effect and you receive all its benefits. Some plans don’t have deductibles, meaning you receive the benefits of your plan right away.

Mental Health & Behavioral Services Fees

All plans have a section outlining coverage for mental health and behavioral services, which make up a large part of addiction treatment. Note that there may also be copayment maximums as well. 

Coinsurance Rate

Your coinsurance rate is the amount you will actually need to pay for most covered services once you meet your deductible. For example, a coinsurance rate of 20 percent means that, once you meet your deductible, a $125 doctor’s office visit actually costs you $25.

Out-of-Pocket Limit

This is the maximum amount of money you will generally need to pay for covered medical expenses before your plan begins to completely cover most applicable medical costs.

In-Network vs. Out-of-Network Coverage

Using their tool, you can search for providers within your insurance network. These are the companies that, in one way or another, have negotiated with your insurance provider, so they will accept your insurance, and your insurance provider can then extend the coverage their plans provide to that treatment provider’s services. 

If you want the full benefits of your plan, you will need to use an in-network treatment provider. If you instead want to use an out-of-network treatment provider, your options vary depending on your plan. 

Generally, you can only get coverage for out-of-network treatments through preferred provider organization (PPO) plans. These plans will cover some of the cost of out-of-network treatments, although you will still get greater coverage if you use an in-network treatment provider.

Length of Treatment Covered

As long as your insurance plan remains active, your treatment should generally be covered for its entire length, assuming it would normally be covered by your plan. Some plans have certain limitations, such as the maximum days you can stay at an inpatient facility in a year, but these limits are often fairly high and can cover the length of a standard treatment episode. 

With that said, it is worth checking the exact limitations of your plan if you have concerns.

Covering Out-of-Pocket Costs

While there are many ways to potentially cover any out-of-pocket medical expenses, two of the most effective are getting personal loans from friends or family or getting a loan from an official loan provider or treatment facility.

When it’s an option, loans from friends or family are ideal, as these people aren’t generally trying to profit off you. They can often offer no or very low interest on your loan, and they may be able to wait a long time for you to pay it back. 

Official loan providers, such as loan companies or treatment providers who offer financing, can also frequently offer fairly reasonable interest rates that may not start building up interest for multiple months. In these cases, you may not have to worry about paying back the loan cost until you are finished with treatment.