One of the primary barriers to drug and alcohol addiction treatment is the high cost of care. Luckily, people can find affordable recovery programs through CareFirst insurance coverage.
CareFirst is a private insurance company that offers coverage for an array of behavioral health services including dual diagnosis treatment, medication-assisted treatment (MAT), and more.
Does CareFirst Insurance Cover Rehab?
Yes, CareFirst covers drug and alcohol rehab programs and mental health treatment for adults and adolescents.
One of the features that sets CareFirst apart from other companies is its specialized program designed for substance abuse recovery.
To access this program, members can call the CareFirst support line. The support team can then connect policyholders with a number of trusted behavioral health providers in the area.
CareFirst health insurance is a sister company of Blue Cross Blue Shield (BCBS). Policyholders can always contact BCBS for more information about how to use CareFirst.
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Substance Abuse Treatment Services Covered By CareFirst
CareFirst insurance covers a wide range of evidence-based treatments and multiple levels of care. The extent of coverage for these services will depend on the insurance plan.
|Treatment Type||Covered||Not Covered|
|Partial Hospitalization Program||✔️|
|Intensive Outpatient Program||✔️|
|Dual Diagnosis Treatment||✔️|
CareFirst Insurance Coverage By Treatment Type
Below are some of the substance use disorder treatment options available to people with CareFirst coverage.
CareFirst Insurance Plan Types
There are several CareFirst insurance plans that range in cost based on the type of coverage offered.
Preferred Provider Organization (PPO)
These types of plans will allow members to use both in-network and out-of-network providers at a higher cost.
This may be beneficial for people who want to see an out-of-network treatment provider and get at least some of the cost covered.
Health Maintenance Organization (HMO)
HMOs will feature lower monthly premiums but will also only cover in-network treatment providers. Emergency services received out-of-network may be covered.
Metal Tier Plans
The metal system is used by many insurance companies to rate the level of coverage a specific plan provides.
Metal tiers at CareFirst include:
- Bronze plans — lowest monthly premiums and the highest deductibles
- Silver plans — moderate monthly premiums and deductibles
- Gold plans — high monthly premiums and very low deductibles
Plans in all categories provide free preventive care, and some offer selected free or discounted services before the deductible is met.
Catastrophic plans feature low premiums but high deductibles.
These types of plans are not generally recommended for addiction recovery as deductibles can quickly amount to thousands of dollars in out-of-pocket costs.
How To Use CareFirst Coverage For Substance Abuse Treatment
CareFirst insurance offers both regional plans in Washington, D.C., Maryland, and Virginia, as well as national plans that offer a large network of providers.
To use CareFirst for addiction treatment, members can talk to their primary care provider or contact a rehab facility of their choice and verify that their insurance plan is accepted.
The most efficient way to use CareFirst for drug treatment is by contacting the support team helpline. A representative can then schedule an appointment at a CareFirst regional center or help find a provider if you live outside the region.
CareFirst Insurance Co-Pays And Deductibles For Addiction Treatment
People participating in substance abuse recovery programs can get the costs for eligible services covered depending on the benefits in the plan.
Co-pays are fixed amounts a member pays for a healthcare service after they’ve paid a deductible. Plans with lower monthly premiums generally have higher co-pays.
Deductibles are the amount a policyholder pays before the insurance plan pays for care. For example, people with a $1,500 deductible will need to pay that amount out-of-pocket before insurance kicks in.
After the deductible is paid, members will also need to pay coinsurance for covered services. CareFirst will pay the rest of the costs.
CareFirst plans with lower monthly premiums typically have higher deductibles.
What Addictions Does CareFirst Cover?
CareFirst health insurance will cover a range of addictions and mental health disorders.
Types of addictions covered include:
- cocaine abuse
- opioid use disorder
- alcohol addiction
- methamphetamine abuse
- prescription drug addiction
- illicit drug use
People with co-occurring mental health disorders such as depression, anxiety disorders, bipolar disorder, or post-traumatic stress disorder (PTSD) can also have their treatment covered.
What If My Insurance Plan Doesn’t Cover The Treatment Program I Need?
In the event that CareFirst cannot cover your addiction treatment program, or if you cannot afford health insurance, there are many other options to pay for care.
Other ways to pay for treatment include:
- enrolling in a free faith-based or nonprofit drug rehab program
- using Medicare or Medicaid insurance for addiction treatment
- getting treatment at a facility that offers grants for people with limited income
- utilizing a scholarship to help cover the cost
- using a sliding fee scale that adjusts based on your income and family size
- paying your bill over a period of time via a payment plan
Finding A Rehab Center That Accepts CareFirst Insurance
Rehab centers that accept CareFirst or BCBS are available throughout the United States. The easiest way to find a facility is by contacting CareFirst customer support.
The Substance Abuse and Mental Health Services Administration (SAMHSA) treatment center database can also be used as a search tool to find a rehab facility in any state.
Policyholders can also talk to their doctors about a referral to a reputable treatment program in the area that may accept CareFirst insurance.
Find Substance Abuse Treatment Today
Reach out to AddictionResource.net today for more information about drug and alcohol recovery programs.
Updated on November 2, 2023
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- CareFirst — Substance Use Recovery
- HealthCare.gov — How to pick a health insurance plan
- Substance Abuse and Mental Health Services Administration (SAMHSA) — Find Treatment