Does BCBS Cover Partial Hospitalization Programs?
Does BCBS cover partial hospitalization programs?
Yes. BCBS may cover Partial Hospitalization Programs (PHPs) when a licensed medical professional determines it is medically necessary. BCBS rehab coverage may include behavioral therapy, medication-assisted treatment (MAT), relapse prevention, and dual diagnosis treatment.
ChoicePoint works with BCBS to verify your insurance coverage and clarify the PHP services available for your plan.
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When is PHP Necessary?
Partial Hospitalization Programs are for people who need intensive daytime care for substance use and co-occurring mental health conditions without the need of 24/7 medical supervision. During PHP, people attend regular in-center sessions while returning home at night so they can maintain family, work, or school responsibilities. PHP is necessary for people who,
- Need daily therapy to manage alcohol and drug addiction
- Require medical monitoring or medications
- Have frequent substance cravings or triggers at home
- Have co-occurring mental health conditions
- Need extensive addiction treatment without an overnight stay
PHP Substance Use Disorder Treatments Covered by BCBSĀ
BCBS-Covered PHP includes a complete set of services to treat alcohol and drug addiction. The includes,
| Service | Description |
| PHP for alcohol use disorder | Alcohol Evaluation, MAT, behavioural therapies, dual diagnosis treatment and aftercare planning. |
| PHP for drug addiction | Screening, testing, MAT, counseling, dual diagnosis treatment and relapse preventionĀ |
| Individual Therapy | One-on-one counseling to manage substance triggers and build a personal addiction recovery plan |
| Group Therapy | Sessions with peers to share experiences and practice coping strategies |
| Family Therapy | Includes family members in treatment to improve communication and home support |
| Cognitive Behavioral Therapy (CBT) | Helps patients with substance addiction identify and change behaviors leading to substance use |
| Dialectical Behavior Therapy (DBT) | Teaches emotional regulation and stress management to handle alcohol and drug cravings |
| EMDR Therapy | Processes trauma and past experiences that contribute to substance addiction |
| Medication-Assisted Treatment (MAT) | FDA-approved medications to manage substance withdrawal and cravings under medical supervision
|
| Dual Diagnosis Treatment | Provides integrated care for co-occurring mental health conditions such as: |
| Relapse Prevention | Helps patients learn strategies to avoid substance use relapse and maintain long-term addiction recovery |
Types of Addiction Covered in BCBS Partial Hospitalization Program
Partial hospitalization treatment at ChoicePoint covers a broad range of substance use disorders, including:
Will I Have to Pay Out-Of-Pocket for PHP With My BCBS Insurance?
Yes, even if BCBS covers PHP, patients may still incur some out-of-pocket costs, such as deductibles, copays, or coinsurance.
The exact amount you have to pay can depend on several factors:
Medical necessity as determined by a licensed provider
Length of treatment
Provider authorization requirements
State or location of treatment
Type of BCBS plan
Specific services included in your PHP program
At ChoicePoint, we help you understand your BCBS partial hospitalization program addiction coverage and potential costs so you can start PHP treatment without surprises.
How to Verify Your BCBS Insurance with ChoicePoint
It only takes about 2 minutes to verify your BCBS insurance at ChoicePoint. You just need to follow these three easy steps.
Step 1: Verify Insurance Online
Visit the website and navigate Admissions āverify your insuranceā
Step 2: Submit Your Details
Fill out the form with your BCBS plan information and personal details, then submit.
Step 3: Know Your Coverage
After submission, our specialists will contact you and guide you through your treatment benefit.
Frequently Asked Questions About Does BCBS Cover Partial Hospitalization Programs
Does BCBS Cover PHP for Opioid Addiction?
Yes, Many Blue Cross Blue Shield (BCBS) plans may cover Partial Hospitalization Programs (PHP) for opioid addiction when the treatment is medically necessary. Please verify your insurance to know what PHP services are covered under your BCBS plan benefits.
Does BCBS cover PHP for addiction treatment?
Yes, BCBS may provide benefits for PHP for alcohol and drug addiction when a licensed provider recommends this level of care. We recommend you fill out our insurance form to check your eligibility.
Can I live at home while attending PHP?
Yes. PHP is a daytime program, allowing patients to return home each evening. ChoicePoint makes your PHP plan in a way that you can balance family, work, or school responsibilities while getting the treatment.
How many hours per day is PHP?
PHP typically runs 4-8 hours per day, 5 days per week. However, the exact schedule depends on your individual needs. Our team of DEA-certified addiction specialists completes medical drug and alcohol evaluations and guides you through the exact time you need therapy.
How much does BCBS cover for PHP?
The exact amount BCBS may cover for PHP depends on your specific plan, provider authorization, coinsurance, copay, and deductible. Call us 844.445.2565 to confirm your coverage and out-of-pocket charges.
Can I start PHP after another treatment program?
Yes. PHP is suitable for patients at any stage of substance addiction treatment. ChoicePint can help you transition from detox or other therapy programs into PHP if you need intensive treatment.
How soon can I start PHP after verification?
Patients can often begin PHP within 24ā48 hours of BCBS verification. We manage the insurance approval process to ensure there are no delays in starting PHP care.
Other Major Insurance Plans We Accept
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24/7 ADMISSION HELPLINE 844.445.2565Medical 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.
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.
