Clinical & Effective Drug and Alcohol Rehabilitation in San Diego Covered by Blue Shield of California
Our San Diego treatment program provides caring and highly effective substance abuse and dependency treatment, designed to help those in need of recovery from alcohol or drug addiction.
Present Moments Recovery's unique brand of evidence-based treatment provides the entire continuum of care, from detoxification to sober living and outpatient treatment. All levels of care have been CARF accredited and recognized for excellence.
The Present Moments Recovery continuum of care serves the growing need for evidence-based treatment of substance abuse, notably alcohol and opioids like fentanyl. Clients can start or continue their treatment in the outpatient program, receiving individual and group therapy.
More About Using Blue Shield of California Insurance for Addiction Rehabilitation
Understanding precisely what Blue Shield of California covers regarding addiction treatment can be difficult, so it never hurts to pick up the phone and call us at (619) 363-4767 to speak directly with an intake counselor who can help .
Present Moments Recovery is proud to be an in-network provider for Blue Shield of California insurance. This means if you have Blue Shield insurance, they typically pay a higher percentage of treatment costs since Present Moments Recovery is a preferred provider. With Blue Shield, you’re likely able to receive coverage for addiction treatment and can be covered up to 100% depending on your plan and deductible.
See if your Blue Shield of California plan will cover all or parts of your treatment at our San Diego drug rehab by filling out our insurance verification form.
For example, Blue Shield of California offers several insurance policies that include substance abuse treatment coverage. However, each plan covers different amounts for different forms of treatment and for different lengths of time.
Variables that will affect the coverage provided by your Blue Shield insurance policy may include:
- Co-payments
- Hospital benefits
- Outpatient treatment
- Partial hospitalization program
- Physician benefits
Depending on the specific treatment needed, the co-payment and out-of-pocket costs will differ significantly. However, Blue Shield does guarantee that substance abuse treatment copayments and coinsurance costs will reflect similar medical services. Also, there are no limits on the amount of medically necessary services covered.
Blue Shield of California health insurance will cover some of the cost associated with:
- Acute inpatient hospitalization
- Medical detox
- Intensive outpatient treatment
- Partial hospitalization program
- Residential treatment
Blue Shield is a globally recognized healthcare provider covering over 106 million people across the nation, operating 36 local independently owned and operated community-based companies.
Blue Shield is one of the most comprehensive insurance companies in the U.S., with over 95% of doctors and hospitals contracted, making it the top healthcare provider nationwide.
Does Blue Shield of California Cover Rehab Expenses? Yes. Even before the passing of the Affordable Care Act in 2014 (which required it), Blue Shield covered drug rehab expenses.
Does Blue Shield of California Cover Mental Health Disorders? Yes. Even before the passing of the Affordable Care Act in 2014, Blue Shield covered mental health disorder treatment.
Blue Shield Policies Regarding Rehab Coverage
When using Blue Shield insurance to enroll in rehab, the first step is to contact our team, and we will assist you in getting more information from Blue Shield. Sometimes, rehab services require preauthorization to be covered. The preauthorization process can be done over the phone or by filling out paperwork. Most Blue Shield plans do not require referrals to see the specialist of choice, just a verification for services rendered.
Depending on which plan, coverage for rehab can vary. For example, some plans might require a co-payment for office and outpatient appointments. There will be a copayment needed, which is a set amount paid upfront for treatment services.
Insurance plans will also have a deductible amount, coinsurance rates, and annual fees.
Clinical, Effective, & Comprehensive Addiction Treatment
Present Moments Recovery is passionately dedicated and committed to the treatment of adults with a substance use disorder. We are DHCS & CARF licensed and accredited and have two locations in San Diego County, in Carlsbad and San Marcos.
We provide multiple levels of ASAM care for the substance use disorder spectrum:
o Detoxification and Stabilization | o Intensive Outpatient Treatment |
o Residential Treatment | o Outpatient Treatment |
o Partial Hospital Treatment | o Medication Assisted Treatment (MAT) |
In addition to our ASAM levels of treatment, we also perform Interventions, SUD Assessments, Urine Screening, and have a Family Support Educational Program.
At Present Moments Recovery our treatment programs are flexible, providing daytime and evening treatment options (Monday-Friday) to accommodate the schedules of our adult clients. We have a maximum of only 10 clients in each track of our PHP, IOP, OP levels of care and 6 in our Residential Treatment to preserve quality of care.
Examples of Treatment Activities:
- Cognitive Behavioral Therapy
- Motivational Interviewing
- Expressive Therapies: Art Therapy, Music Therapy, and Journaling
- Individual Therapy Sessions
- Dialectical Behavioral Therapy
- Group Therapy
- Somatic Therapies: Mindfulness and Qigong
- Holistic Processes: Yoga, Meditation, Physical Fitness, Acupuncture and Nutrition
Our Psychoeducation sessions focus on the components that will support lasting recovery: Understanding SUD, Relapse Prevention, Identification of Triggers, Healthy Coping Skills, Establishing a Sober Support System, Clear Communication Skills, Managing High Risk Situations, Healthy Leisure Activities, Self-Care, and Stress Management.
The Present Moments Recovery Clinical Team is comprised of a MD Medical Director, PA’s, Licensed Marriage and Family Therapists, Licensed Social Workers, Licensed Clinical Addiction Specialists, CADC II, and Registered Alcohol and Drug Technicians who each bring their passion and commitment to providing best care for every client.
Clinically Effective Drug Rehab in San Diego Covered by Blue Shield of California
We’re committed to helping the you achieve long-term recovery through an interdisciplinary approach that aims to strengthen the mind-body-spirit connection.
Blue Shield covers not only substance use disorder treatment, but also treatment for other mental health conditions for members. Blue Shield may cover drug detox, inpatient or residential addiction programs, and outpatient addiction programs.
Help with Health Insurance
This graphic is great to explain deductibles. Click here for full document.
This graphic contains helpful Insurance Terminology, click here for the full document.
Blue Shield plans are all very different; but many plans will cover mental health, behavioral health, and distribution treatment services. These include:
- Hospital treatment
- Inpatient treatment
- Office visits
- Outpatient treatment
- Partial day treatment
- Psychological testing
- Residential treatment
Verification will be required prior to enrolling in the program offered through a Blue Shield provider, like Present Moments. Outpatient and inpatient treatment services will usually include relapse prevention skills training, educational programs, therapy, medical and mental health care, support groups, detox services, and medication management.
Medical Necessity
One of the roadblocks in obtaining precise information regarding what is not covered by Blue Shield is the medical necessity issue. The therapist or physician who determines that residential treatment is necessary might need to provide an addiction diagnosis to the insurance provider, proving it is a medical necessity.
Unfortunately, physical dependence and withdrawal symptoms are usually not enough proof that residential treatment is a medical necessity. The increased risk of relapse during outpatient treatment will not guarantee approval for inpatient treatment. In some instances, patients will need to prove that outpatient treatment won’t work for their situation, or they might be required to utilize it first if they want their insurance to cover the cost.
Clients will also benefit if they proactively get pre-authorization for the therapy services needed before they begin treatment to guarantee that their insurance company covers them.
Covering Additional Rehab Costs
Even in the best-case scenario, most health insurance policies do not cover the entire cost of detox and residential treatment. Clients will be responsible for coming up with the remainder of the bill. Although this may sound overwhelming, especially when someone involved is suffering from addiction, it could be a life-saving decision.
Many people side step using health insurance to solely cover the cost of addiction treatment because it delays the admissions to rehab or because the effort doesn’t equate the time put in. Instead, people will utilize various resources to cover treatment costs.
Get Help Today
Do not hesitate to inquire into substance abuse treatment any longer. At Present Moments, our admissions specialists are here to ensure that you receive all of the financial help you are entitled to with your Blue Shield of California coverage plan.
Present Moments is in-network with Blue Shield of California. Therefore, we will work collectively to make substance abuse treatment coverage possible and convenient. Our treatment team understands the importance of catering to the patient’s treatment while budgeting simultaneously.
If you or a loved one requires a rehab but is still uncertain you can afford it, contact us today for a free consultation. Our admissions specialists will answer any of your questions by getting you the answers you seek regarding your Blue Shield of California addiction treatment coverage options.
Contact Mark Gladden directly by calling (619) 363-4767 to discuss your situation.