Discovering the right treatment program for you can feel daunting and difficult. There are many variables and factors to consider. For example, you will need to decide if you want to enroll in an inpatient or outpatient treatment. Also, you’ll need to decide whether you want to travel for treatment or stay in your hometown.
Moreover, you need to decide the length of the treatment you’ll enroll in. Will you enroll in 30-day treatment, 60-day treatment, or 90-day treatment? Once you make all of these decisions, you will also have to decide how you will pay for addiction treatment. Will you pay for it out of pocket? Will you pay for it through private insurance? Or, will you pay for your treatment through Medicare or Medicaid? There is all of this to consider but we are here to help you understand the basics. This page will help you understand what you need to know about Blue Cross Blue Shield Tennessee. If you would like more information about this or other insurance companies, please call us at 901-403-7925.
Blue Cross Blue Shield of Tennessee
Blue Cross Blue Shield of Tennessee (BCBS) is one insurance company that may be covering you at this time. BCBS prides itself on being a client-focused insurance company. Further, BCBS works closely with medical providers in the community. Since 1945, BCBS has served people in Tennessee. BCBS is a not-for-profit company. Therefore, BCBS’s priority is not to make money to pay shareholders. Ultimately, BCBS’s goal is to operate solely to provide services to its members.
At Blue Cross Blue Shield (BCBS), three plans are available. All services offer substance abuse treatment coverage but may require a copay or coinsurance and may require a deductible to be met. The three plans are Bronze, Silver, and Gold. First, the Bronze plan is good for infrequent care. However, care through the Bronze plan may have a high deductible. Second, the Silver plan has a lower deductible and offers more providers. Third, the Gold plan has the lowest deductible. However, the Gold plan usually comes with higher monthly premiums.
Medicare and Medicaid in Tennessee
Many treatment centers in the cities of Tennessee accept both Medicare and Medicaid. Medicare is for people ages 65 and older. It is a US federal healthcare plan, along with Medicaid. However, Medicaid is intended for people who are economically disadvantaged. These healthcare plans can help people who do not have coverage through private insurance.
Information on Medicare
Medicare mainly serves individuals who are 65 years and older. But Medicare can also be used in special circumstances on people younger than 65. For example, if someone had a disability such as ESRD, which is when the kidney permanently fails and a transplant is needed. Therefore, after the variables are determined Medicare is presented in four different parts. They are distinguished as Medicare part:
- A-Hospital Insurance
- B-Medical Insurance
- C-Medicare Advantage, or all-in-one coverage
- D-Prescription drug coverage
Each part of the healthcare plan will be explained down below. We want to guide you to the one that will work best for you.
Medicare Part A
Hospital insurance Part A will cover the care provided by a skilled nurse facility. Such as hospice care, an assisted living center, and inpatient hospital visits. In certain situations, Medicare Part A could cover home healthcare.
Medicare Part B
Medical Medicare insurance will cover some doctor’s services and visits, preventative services, medical supplies, and outpatient care.
Medicare Part C
Part C of the Medicare care plan is a combination of the previous two parts, A and B. Most of the time it also combines Part D which will be discussed below. Therefore, part C insurance means you gain coverage to prescription services, medical care, and hospital care.
Medicare Part D
The last part of the four stages of Medicare coverage is Part D. This covers prescription drugs allowing you to obtain your medication at a reduced cost.
Information on Medicaid
Many Americans receive the healthcare they need through Medicaid. Medicare generally serves millions of individuals who are economically disadvantaged in the United States. States administer Medicaid, and the program is funded by states and the federal government. Further, Medicaid covers more than people with disabilities. Medicaid will also cover children and women who are pregnant. Ultimately, Medicaid provides care to people who do not have the ability to receive health insurance.
Coverage of Inpatient, Outpatient, and Residential Treatment
Medicare may or may not cover certain aspects of addiction treatment. It will depend on your provider, they are the ones who decide. Therefore, that phone call is crucial when deciding what to do. However, Medicaid would cover addiction treatment services. Such as if you want to attend short-term or long-term residential inpatient care, or outpatient care. Tennessee’s Medicaid does cover adults who are looking for alcohol or drug addiction treatment.
Therefore, inpatient and outpatient therapy are covered but it is important to know that they are different services. Outpatient treatment is where you are coming to a facility or client a couple hours a week for your addiction. You can attend this type of program for as long as you need to heal. The usual range is between 90 days to a year if necessary. This type of treatment is great for individuals who want to beat their addictions but are still able to commit to the program and voluntarily come each day.
Inpatient residential treatment is where you would be staying at a treatment center anywhere from one month to six months depending on your condition. At this facility patients receive an intensive hands-on treatment that has proven to have high success rates. Inpatient treatment is more expensive but is crucial if the individual has been struggling with an alcohol or drug addiction that is particularly severe.
There are longer residential treatments that people can attend as well. Residential means you would be living at a private residence that represents more of a home. You would live with other patients who have been experiencing the same struggles you have. Depending on the program you could be treated there for your addiction or you could go to another treatment center with all of the other patients each day. The staff would be the ones who help you each day and have you attend what treatments and where. Residential treatment benefits those who want to live away from their previous home life and focus solely on healing.
How to Find Information
Substance abuse treatment options are commonly found on the Medicare or Medicaid websites. If you find a treatment center that you are interested in, first check to see if it will be covered under your insurance plan. You can do this by looking up the facility on either your Medicare or Medicaid insurance website. Some Tennessee facilities do offer assistance when it comes to payment.
More Information About Blue Cross Blue Shield
You can receive treatment, regardless of what kind of insurance you have. Whether you have Medicare, Medicaid, or Blue Cross Blue Shield, there is treatment out there for you. To review, Blue Cross Blue offers several types of plans. For example, the company offers Gold, Silver, and Bronze plans. As with other insurance companies, Gold offers the most coverage. However, the Gold plan also comes with the highest monthly payments. The Silver plan offers average coverage with average monthly payments. Finally, the Bronze plan provides the lowest amount of coverage with the lowest monthly payment. If you do not have Blue Cross Blue Shield Insurance then you can always look into Medicaid or Medicare.
Preferred Provider Organization and Health Maintenance Organization Plans
Within most insurance companies there are additional plans that are provided for you to choose from. There is the PPO plan which stands for Preferred Provider Organization plan and there is the Health Maintenance Organization plan. They vary in networks, costs, and copayments. For example, HMO offers coverage through specific in-network medical providers. But the PPO plan is more flexible with who a person can receive care from.
Further, the HMO plans usually provide lower monthly premiums, but you have to see a provider under the HMO network. The PPO plans do have higher monthly premiums but this is because of the flexibility they offer their clients. Being able to use out of network and in-network providers without a referral tends to make the prices higher. There are several questions you might have when it comes to deciding insurance and payments. We want to help you find the options that best support you. If you have any questions or concerns about Blue Cross Blue Shield insurance or the PPO and HMO additional plans, please contact us today. Call us at 901-403-7925.