Does Blue Cross Blue Shield Federal Pay for Adolescent Treatment?

Adolescence is a time of growth, but it can also bring unexpected setbacks that send an entire family off course. Recognizing and addressing adolescent substance use or mental health challenges early on is crucial for the health of your child and your whole family. If the cost of adolescent treatment is holding you back from moving forward with professional care, you should know that you have options. If you have Blue Cross Blue Shield Federal (BCBS Federal) insurance, for example, your plan may cover part or all of your child's residential adolescent treatment. 

Understanding Blue Cross Blue Shield Federal Coverage

Blue Cross Blue Shield Federal is a nationwide health insurance program available to federal employees, retirees, and their dependents. Like other insurance providers, BCBS Federal covers many health services, including behavioral health, mental health, and substance abuse treatment for adolescents.

• The Mental Health Parity Factor

The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 made it law that health insurance plans must cover mental health and substance abuse treatment at the same level as medical services. So, if your BCBS Federal plan covers treatments like surgery or emergency medical care, it should also cover adolescent mental health and substance use treatment.

• Inpatient & Outpatient Adolescent Treatment Coverage

All providers — including BCBS Federal — offer different coverage across their many plans. In most cases, BCBS Federal does cover both residential adolescent treatment and outpatient treatment for adolescents like virtual intensive outpatient programs for adolescents. Your plan may even cover both throughout your child's recovery journey.

• Pre-Authorization & Medical Necessity

However, many BCBS Federal plans require pre-authorization and proof of medical necessity. Our team can work with you to ensure that both are in place at the appropriate time in your child's admission process. We will provide BCBS Federal with the necessary records and documentation to fight for your child's care.

• Co-Pays, Deductibles, & More

Almost all insurance plans require subscribers to contribute a portion of the cost of treatment. This practice ensures that subscribers do not abuse their coverage. Therefore, you may have to pay a deductible, co-pay, or an out-of-pocket amount. Contact BCBS Federal customer service to understand your specific plan. Or, our caring experts are standing by to review your information with the insurance company and provide the numbers you need to move forward. Verify your benefits easily online or contact us to move forward.

In-Network & Out-of-Network Providers

What is the difference between in-network and out-of-network providers? In-network providers are contracted with the insurance company to provide services at a particular rate. This kind of agreement can make your contribution to adolescent treatment less. However, in many cases, out-of-network rates may be comparable, or your program of choice may be able to pursue a single case agreement (SCA) to provide services to your family at in-network rates. Don't assume that in-network is your only option.

Paying for Adolescent Treatment: Other Options

If your BCBS Federal plan is insufficient, or if you need financial support for other reasons, you may want to explore other options:

Scholarships and Grants 
Does your church, youth group, or community organization offer grants to families in crisis? If you belong to such an organization, it's worth asking.

Employee Assistance Programs (EAPs)
Some federal employers offer Employee Assistance Programs, which may provide your family with additional resources or financial support.

Adolescent Treatment Financing
Adolescent treatment financing is also available. Split up the cost of treatment into manageable monthly payments.

Get Your Child Back, Better

Taking the step to seek professional treatment for your child is a huge decision — one that will shape the course of the rest of their lives. If you have a Blue Cross Blue Shield Federal plan, you can use it to access mental health and substance use treatment for adolescents. Understanding the specifics of your plan is crucial, so verify your benefits to ensure you have clarity. Contact us for more information, or verify your benefits online.

Our team has years of experience working with all major insurance providers, including BCBS Federal, to ensure our families receive the best possible coverage and treatment. Investing in your child's well-being today can lead to a brighter future for them tomorrow. We're here to help you do it.