ChoicePoint Blue Cross Blue Shield Therapy Coverage in NJ

Q: Do I Need a Counselor or Psychotherapist?

The treatment provider you need depends on your diagnosis. For preventative screenings or mild conditions, a counselor can help. For moderate to severe conditions requiring medication, a psychotherapist is the best option.

Q: Is It Better to See a Psychologist or Psychotherapist?

A psychologist treats medical conditions using therapeutic approaches such as therapy and counseling. A psychotherapist can prescribe medications along with therapy for serious mental health conditions.

Blue Cross Blue Shield covers online and in-person therapy sessions. The most commonly covered therapies are:

BCBS in NJ is one of the biggest insurance providers, covering most mental health and addiction treatments. If you or a loved one is struggling with addiction and needs therapeutic help, please reach out to us at 844.445.2565. ChoicePoint is in a rehab in NJ that accepts BCBS (Blue Cross Blue Shield), which means lower out-of-pocket payments for your therapy sessions.

Table of Contents

Understanding Blue Cross Blue Shield Therapy Coverage

Blue Cross Blue Shield therapy coverage can be a little tricky to understand because of various factors involved. First, the laws are different in every state, and the coverage also depends on the type of plan you have. In general, all insurance companies, including BCBS of NJ, are required to cover therapy to some extent under the Affordable Care Act law. The exact amount of coverage depends on:

Type of Insurance Plan

Your treatment plan usually decides the extent of coverage for your therapy sessions. The most popular BCBS of NJ plans are:

Plans	Benefits
BlueCard PPO	Lower out-of-pocket expenses with BCBS-preferred healthcare providers and therapists. You also do not need any referral or Primary Care Physician, saving you even more cost.
EPO (Exclusive Provider Organization)	Covers only in-network treatments, services, and therapists.
Horizon Direct Access	First, you must schedule an appointment with a Primary Care Physician (PCP). Your PCP will coordinate all aspects of your medical care, including any referrals to the rehab center or therapist.
Horizon HMO	The HMO plan also starts with a Primary Care Physician. Your PCP (Primary Physician) will refer you to a specialist based on your diagnosis.
OMNIA Health	OMNIA Health plans are divided into different tiers. For example, OMNIA Bronze covers almost 60% of the costs, while OMNIA Gold covers 80-90% of the costs.

Premium, Copay and Coinsurance Cost

The amount you may pay per therapy session depends on your copay, deductible, and coinsurance policy. However, you do not need to worry about any hidden costs, as these amounts are fixed and coordinated with the treatment receiver beforehand. Furthermore, if you feel like you have been charged more, you can always contact BCBS or your therapist and file a complaint. BCBS also provides an Explanation of Benefits (EOB) statement, which explains how much BCBS paid and how much amount you were owed.

Understanding Terminologies

Copay - A fixed amount you may pay
Coinsurance - It is a fixed percentage of treatment cost you may have to pay. For example, for 30% coinsurance, if the treatment cost is $100, you must pay $30, and BCBS will pay $70.
Deductible - The annual amount paid by the treatment received before the insurance starts to pay.

In-network or Out-of-network Providers

The best way to save out-of-pocket expenses is by choosing a BCBS in-network provider. These providers collaborate with the insurance companies to provide the most affordable treatment options.

ChoicePoint accepts Blue Cross Blue Shield for all of our therapy services. You can book a free initial consultation by calling us at 844.445.2565.

Are There Any Requirements For an Insurance Company To Cover Your Therapy Sessions?

Yes, in some states, there are repercussions that you must fulfill with the help of your healthcare provider to qualify for therapy insurance benefits.

Meeting the Medically Necessity Criteria

BCBS of NJ covers the therapy sessions if these sessions are medically necessary to treat a mental health or substance use disorder condition. For example, BCBS does not cover couples counseling because, though challenging, it is not a medical necessity. To qualify for the coverage, your doctor must provide a diagnosis and a written document stating the importance of therapy in your treatment procedure.

Prior Authorization Forms

Some insurance plans require prior authorization forms to provide coverage for therapy. This request is usually initiated by your healthcare provider and sent to the insurance company before the start of your treatment. The good news is that if necessary, ChoicePoint clinical staff can assist you with prior authorization forms for a more streamlined process.

Online Therapy Covered by Blue Cross Blue Shield

How Much Is The Co-Pay Amount For Therapy Sessions?

Now that we have established that there may be some co-payment costs according to your plan, you may be wondering the exact cost of planning your finances. These are a few ways to find the exact payment cost.

Contacting a BCBS in-network Treatment Provider

You can contact the admission staff of your therapist to know the exact cost or you can verify your insurance in minutes through our online portal.

Contacting BCBS Representative

You can visit the BCBS website and lodge an online query or call the helpline.

Checking out Blue Cross Blue Shield Cost Estimator Tool

There is also a BCBS of NJ treatment cost calculator tool available for members on the website that may be able to give you an estimate.

If you are deciding whether to go for therapy or not, please know that most BCBS insurance plans offer 0 co-pay for preventative screening. This will help you find if you need therapy. Call 844.445.2565 to schedule an appointment for Substance use disorder preventative screening.

Does Blue Cross Blue Shield (BCBS) Cover Online Therapy Sessions?

Yes, our Blue Cross Blue Shield therapists in NJ accept insurance for online therapy and telehealth treatment sessions. ChoicePoint offers the following online and in-person insurance-covered therapy sessions:

Therapy Type	Description
Cognitive Behavioral Therapy	It helps individuals to identify and change negative thought patterns that influence behaviors to a more positive perspective.
Dialectical Behavioral Therapy	Combines self-acceptance and self-directed change strategies to manage your emotions.
Group Therapy	A collaborative environment for shared healing and support among peers with similar challenges.
Psychotherapy	A conversational process to explore and resolve mental health and addiction challenges.
Behavioral Therapy	Focused on modifying and helping you manage harmful behaviors.
Individual Therapy	It offers a confidential space to work on achieving personal goals and overcoming different challenges.

ChoicePoint Accepts Blue Cross Blue Shield For Therapy In NJ

ChoicePoint accepts Blue Cross Blue Shield insurance for substance use disorder treatment and therapy in NJ. Our stand-out services include:

Licensed Therapists: Our team of certified professionals specializes in treating substance use disorders through solution-focused approaches like Cognitive Behavioral Therapy (CBT group activities) and Dialectical Behavioral Therapy (DBT).
Online Therapy Options: We offer the same levels of high standard of care online therapy from the comfort of your home.
Comprehensive Care: We offer different types of therapies according to your diagnosis, including individual counseling, group therapy, and family therapy.

Now, you can focus on overcoming addiction without worrying about the financial burden. Start your journey to a healthier life with our BCBS Health Doctors today by calling 844.445.2565.

Please note this assessment is an initial self-screening, and it is not meant to be a medical assessment or clinical diagnosis of addiction. For proper diagnosis and treatment, schedule an appointment with ChoicePoint

Frequently Asked Questions About Blue Cross Blue Shield Therapy Coverage in New Jersey

We often get these questions related to BCBS drug rehab coverage and therapy in NJ:

Does Horizon NJ Health cover mental health services?

Yes, Horizon NJ Health covers mental health services such as:

Psychiatric care
Therapy
Medication prescriptions
Counseling

ChoicePoint offers BCBS-covered dual diagnosis treatment that treats both addiction and mental health problems. Call 844.445.2565 to schedule an appointment.

Do I Need a Counselor or Psychotherapist?

The type of treatment provider you need depends on your diagnosis. If you are looking for a preventative screening and have a mild condition, then a counselor can help you. However, if you have a moderate to severe mental health condition and you require medications to improve your health, then a psychotherapist is the best option for you.

Is It Better to See a Psychologist or Psychotherapist?

A psychologist can treat your medical condition through a therapeutic approach. This approach involves therapy and medical counseling. A psychotherapist can prescribe medications along with a therapeutic approach if you have a serious mental health condition.

Does Blue Cross Blue Shield Cover Substance Abuse Treatments?

Yes, BCBS covers substance abuse treatments and addiction rehab. ChoicePoint substance abuse treatments are covered by BCBS. Call 844.445.2565 to schedule an appointment.

Additional Resources

References

https://www.horizonblue.com/members/plans/medical-plans/horizon-direct-access.
Horizon BCBSNJ Health Plans – BlueCard® PPO. (n.d.). Horizon Blue Cross Blue Shield of New Jersey. Retrieved December 9, 2024, from
https://www.horizonblue.com/members/plans/medical-plans/bluecard-ppo
Horizon BCBSNJ HMO Plan & Services. (n.d.). Horizon Blue Cross Blue Shield of New Jersey. Retrieved December 9, 2024, from
https://www.horizonblue.com/members/plans/medical-plans/horizon-hmo
Horizon Blue Cross Blue Shield. (n.d.).
https://www.horizonblue.com/national/plans/medical-plans/epo-exclusive-provider-organization

Medical Disclaimer:

ChoicePoint aims to improve the quality of life for people struggling with substance use disorder and mental health issues. Our team of licensed medical professionals research, edit and review the content before publishing. However, this information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. For medical advice please consult your physicians or ChoicePoint's qualified staff.

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Jessica Plonchak

(LCSW, MBA, LCADC)

Executive Clinical Director

Jessica Plonchak serves as Executive Clinical Director at ChoicePoint. She has a Bachelor’s degree in Psychology and a Master’s degree in Social Work. She is a Licensed Clinical Alcohol and Drug Counselor (LCADC). With 17 years of relevant experience, she has helped several clients in their journey to recovery from addiction.

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Zainab Iqbal

(B.Sc., M.phil. Biochemistry)

Medical Content Writer

Zainab is a skilled member of the ChoicePoint team of medical content writers. With 4 years of relevant experience, she is passionate about conveying accurate and up-to-date information through her writing. Her area of expertise includes writing on addiction challenges, providing guidance on treatment procedures, and addressing co-occurring mental issues.

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