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Blue Shield of California Addiction Rehab Treatment Coverage

Recovery from drug and alcohol addiction and mental health conditions can be challenging, but Apex Recovery in San Diego is here to help. Our treatment center is staffed with licensed mental health professionals and counselors whose goal is to help you on your journey to sobriety and mental health in a tranquil and comfortable environment.

Apex Recovery accepts health insurance and is in-network with many insurance plans. You can easily verify your insurance coverage and determine if your Blue Shield of CA policy covers addiction and rehabilitation treatment.

Blue Shield of CA Drug and Alcohol Rehab Coverage

Exploring San Diego, California, and Its Famous Towns

San Diego, California, is well known for its beaches, parks, and nearly idyllic weather. San Diego is California’s second-largest city and the United States eighth-largest city. You can find several world-class family attractions including the San Diego Zoo, Seaworld San Diego, and LEGOLAND California. San Diego County has 92 golf courses and a variety of sports, beachfront resorts, and luxury spas.

Roughly 112 miles north is the sprawling city of Los Angeles, which is the center of the nation’s film and television industry. The city of Los Angeles is also known as the City of Angels. There is a diverse economy and broad range of industries including one of the busiest container ports in the U.S. Riverside lies 60 miles east of Los Angeles, Anaheim, and Santa Ana. The city can boast several firsts, including the first polo field and golf course and having given birth to the California citrus industry.

Drug and Alcohol Addiction Statistics in Southern California

There is a growing drug problem across the U.S. and California has not escaped the challenge of drug and alcohol addiction. The data has shown that although the rate of opioid deaths fell 30% from 2011 to 2019, the death rate from fentanyl increased 10 times in the four years from 2015 to 2019. 

This caused a 68% growth in treatment centers that offer residential care for substance use disorders. In the Los Angeles area, 15.4% of the population used illicit drugs, and 11.1% used marijuana. There were 892,000 people in Los Angeles who were classified with a substance use disorder and 20% engaged in binge drinking.

Free Addiction Assessment

Schedule a free, confidential assessment with a licensed clinician. Apex Recovery can check your insurance coverage levels for drug and alcohol addiction, and mental health treatment.

Who is Blue Shield of CA?

Blue Shield of CA was once known as the California Physicians Service and was created by the California Medical Association in 1938. By 1946, it was one of the founders of the National Association of Blue Shield plans, which was later BCBS Association. There are roughly 65,000 Physicians and 340 hospitals in the Blue Shield of CA provider network.

Blue Shield of CA is a health maintenance organization (HMO) and prescription drug plan (PDP). The plan is a nonprofit health plan that’s dedicated to offering high-quality care to Californians at an affordable price. In addition to the managed care Medicare plans, Blue Shield of CA offers individual and family plans for those covered by an employer or who wish to purchase the plan separately.

Some of Blue Shield of CA Brands and Services in California

Blue Shield of California continues to evolve their products and health insurance plans to meet the needs of their beneficiaries. Some of the products and services include:

  • Blue Shield of California: This is the primary brand that offers a range of health insurance plans.
  • Blue Shield Promise: Blue Shield Promise is a Medi-Cal managed care plan that serves individuals and families who qualify for Medi-Cal, the state’s Medicaid program.
  • Access+ HMO: This HMO plan falls under the Access+ network, offering a range of healthcare services through a network of providers.
  • Blue Shield Trio ACO HMO: This is a more cost-effective accountable care organization (ACO) HMO option that focuses on a smaller network of doctors and hospitals to help control costs.
  • Individual and Family Plans: Blue Shield of CA offers a variety of individual and family health insurance plans, including PPO (Preferred Provider Organization) options.
  • Employer-Sponsored Plans: Blue Shield of CA provides plans for employees through their employers that include HMO and PPO options.
  • Dental and Vision Coverage: Blue Shield of CA can offer dental and vision insurance coverage as part of its health plans or as standalone products.
  • Medicare Plans: Blue Shield of CA offers health insurance plans designed for individuals eligible for Medicare, including Medicare Advantage and Medicare Supplement plans.

What is Blue Shield of CA Rehab Coverage?

Rehabilitation coverage refers to the part of your health insurance plan that provides coverage levels for mental health and substance use disorder treatment. Blue Shield of California is mandated by the Affordable Care Act to offer essential health services, which has been defined as including mental health and substance abuse

However, not all policies offer the same benefits and limitations to coverage. When you ask does Blue Shield of CA cover rehab, the answer varies depending on your insurance policy. The easiest way to determine your coverage levels is to call Apex Recovery at (877) 881-2689 and speak with one of our admission specialists. They can verify your insurance coverage, deductible, and copay. This helps identify your liability and out-of-pocket costs.

Blue Shield of CA Drug and Alcohol Rehab Coverage

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Blue Shield of CA Drug and Alcohol Rehab Coverage
Map of Apex Recovery locations in San Diego

Rehab Center in California That Takes Blue Shield of CA

Finding the right rehab center to treat your addiction or mental health condition can be challenging. Apex Recovery offers specialist care in both an inpatient and outpatient setting to address your specific needs. Apex Recovery accepts many major insurance company policies. Call us today to verify your insurance coverage.

Apex Recovery San Diego: 2810 Camino del Rio S #106 San Diego, CA 92108



Does Blue Shield of CA Cover Substance Addiction Rehab?

The short answer is yes, Blue Shield of California offers coverage for substance addiction rehab. But the answer is not that simple. While the insurance company is mandated to include coverage in all plans written after 2010, the level of coverage, benefits, and limitations can vary. For example, your policy may limit the number of sessions per year in outpatient care but may fully cover inpatient care.

To receive the full benefit of your insurance policies benefits, it’s important to understand what the policy covers and what it doesn’t. The easiest way to determine your insurance policy’s requirements to submit a claim, your deductible, copay, and out-of-pocket costs is to call Apex Recovery at (877) 881-2689 and speak with one of our admissions specialists.

Does Blue Shield of California Cover Medical Detox?

Medically-assisted detoxification is an important part of drug and alcohol addiction treatment. Blue Shield of CA alcohol rehab and Blue Shield of CA drug rehab offers coverage for medical detox to support your rehabilitation, journey to sobriety, and sustainable recovery. You can determine your coverage levels by calling Apex Recovery today.

Does Blue Shield of CA Cover Residential Rehab?

Yes, Blue Shield of California offers coverage for residential rehab, which is the most intensive form of addiction and mental health treatment available. However, your policy may have limitations on the number of days you can remain an inpatient or the number of times your policy covers an inpatient stay. Call Apex Recovery today to learn more about your insurance coverage.

Does Blue Shield of California Cover Dual Diagnosis Treatment?

Yes, Blue Shield of California covers dual diagnosis treatment. A dual diagnosis is not a medical diagnosis but rather a description of someone who has a substance use disorder and a co-occurring mental health condition. Most frequently, those mental health conditions can include depression, anxiety, post-traumatic stress disorder, and eating disorders. 

The licensed mental health professionals at Apex Recovery are well-trained and experienced in treating individuals with dual diagnoses. They understand the necessity of treating both diagnoses simultaneously to increase the potential for successful recovery. If you believe you have a dual diagnosis, don’t wait – call Apex Recovery today to start your journey to sobriety.

Free Addiction Assessment

Schedule a free, confidential assessment with a licensed clinician. Apex Recovery can check your insurance coverage levels for drug and alcohol addiction, and mental health treatment.

Average Cost of Addiction Rehab in California With Blue Shield Insurance?

The average cost of addiction treatment in California varies depending on several factors. The first is the cost of your treatment, which is dependent on the level of care that you need. For example, a 90-day inpatient rehab stay will cost more than a 90-day intensive outpatient program. The second factor is influenced by your insurance policy.

All insurance policies have premiums that you pay each month to maintain your insurance policy and a deductible, which is the amount of money you must pay every year out of pocket before your insurance company begins to pay for costs. In some cases, you may also have a copay. This is a percentage of the remaining amount for which you are responsible. Typically, the insurance company pays 80% and you pay 20%. Each of these factors influences how much you pay for addiction rehab with Blue Shield of CA insurance.

Other Rehab Treatment Programs Covered by Blue Shield of CA

Blue Shield of CA covers several types of rehabilitation programs to offer you the best chance to find the program that works for your situation. Apex Recovery offers you several choices in outpatient and inpatient care using individualized treatment plans to address alcoholism, mental health conditions, and dual diagnosis.

Blue Shield of CA Drug and Alcohol Rehab Coverage

How To Check Blue Shield of CA Coverage Levels for Rehab Treatment

Your insurance card has a customer service number on the back. When you call that number, you can get information about your insurance policies benefits, limitations, and requirements to submit claims. In most cases, the insurance customer service person reviews the insurance policy manual for the specific benefits that you are inquiring about.

However, when you call our admission specialists at Apex Recovery, we not only determine your benefits, but also discuss the limitations and documentation you may need for insurance claims, and determine if your policy requires prior authorization before treatment can begin. Additionally, we will help estimate costs for the initial rehabilitation treatment. It is impossible to initially estimate your follow-up care, but we can keep you updated during your rehabilitation when you request our assistance. Call us today at (877) 881-2689 or contact us online.

How To Get Blue Shield To Pay For Rehab Treatment in CA

The best way to get your insurance company to pay for rehabilitation treatment is to understand their requirements to submit claims and follow them as closely as possible. When you know your insurance policy’s benefits and limitations, you can also work with Apex Recovery financial counselors to help find outside funding that may help cover some of the cost.

You can begin by calling Apex Recovery admission specialists who will verify your insurance coverage and determine the type of documentation required to receive your full benefits. You may need prior authorization before treatment can begin and our admission specialist can guide you through gathering the necessary paperwork from your primary care provider and therapists.

How Many Times Will Blue Shield of California Pay For Rehab?

The number of times that Blue Shield of CA will pay for rehabilitation is not dependent on the insurance company, but rather on your individual policy and insurance plan that you or your employer purchased. Each policy defines benefits and limitations and one of those limitations can be the number of times that the insurance policy will pay for rehabilitation.

The best way to determine if your policy will cover your inpatient care or outpatient care treatment is to call Apex Recovery admission specialists. They can verify your insurance policy, determine how much is left on your deductible, and determine your benefits and limitations. The admission specialists are here to help make your transition to rehabilitation as smooth as possible.

Addiction Statistics in San Diego, California

  • Data showed that while the rate of prescription opioid deaths fell 30% from 2011 to 2019, the death rate from fentanyl increased 10 times from 2015 to 2019.
  • In response to the growing problem, the number of treatment facilities that offered residential care for substance use grew by 68% between 2017 and 2019.
  • In the Los Angeles-Long Beach-Santa Ana area, 1.6 million people aged 12 and older used illicit drugs in the last year, which was 15.4% of the population, but lower than the overall rate for the entire state. 
  • In the Los Angeles-Long Beach-Santa Ana area, the rate of marijuana use in the past year was 11.1% and the rate of nonmedical use of prescription-type pain medication was 4.4%.
  • There were 892,000 people 12 years and older in the Los Angeles-Long Beach-Santa Ana area who were classified with a substance use disorder in the past year.
  • Roughly 19% of people 12 years and older had smoked cigarettes in the past month and the rate of alcohol binge drinking in people in the same age range was 20.3%.
Aetna Addiction Rehab Treatment
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